Can a lower eyelid lift/blepharoplasty help minimize the appearance of lines? Should I consider other options? 24 y/o (photos)

Question

I have these bags under my eyes, but they're not puffy. It's more like sagging skin, although I'm only 24, and I feel like it drags my entire face down. I hate them so much! I have some hollowness under my eyes as well, but my biggest concern is the lines they create downwards. Can a blepharoplasty help me? If not, what do I need? Thank you!

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photos you have extra saggy skin under your eyes. Also you have sad face image. The cheeks are down, lip corners are down. For get rid of the sad face image I recommend you endoscopic mid face lift. For the extra saggy skin I suggest upper eyelid blepharoplasty. With these surgeries you have more upward and fresh looking. Best Regards!

Jason Emer, MD · Answer

The eye area needs significant combinations to get improvement. Lasers like erbium, co2, halo, profractional/contour, or Fraxel can all be used to build collagen long term. Plasma pen is a newer less invasive option but will take many treatments and require proper skincare. Plasma Pen is focused electrical plasma energy to tighten skin, producing small columns of energy just above the skin, allowing the skin to tighten to help improve wrinkles. This area will have 3-5 days of small “dots” that will then scab and peel, then the skin will tighter and brighter after. Numerous treatments are needed over lasers where only one or two give a bigger result, but more downtime. After plasma pen you NEED peels 2 weeks like later Cosmelan, enlighten or aerify, see emeragecosmetics (link). At home derma rolling should be started weekly even after plasma pen or lasers to further increase collagen, see emeragecosmetics AERIFY x anteagemd stem cell ampules. To properly heal you need light Stim red LED, EmerageSkin refit face, refit eye; AnteageMD serum, silagen silicone gel, jan Marini bioshield, EmerageSkin enzymatic polish, and EmerageSkin hyla b and AOX, and Sente dermal repair. Otherwise there is EXTREME risk of pigmentation issues and “dots” in the treatment area. at home peels like cosmelan, enlighten and aerify along with dermarolling (AERIFY emerageskin roller with Anteage MD ampules) should be started now regardless for antiaging, sun damage, and wrinkle prevention. There are many things you can do to treat under eye hollows and dark circles. A surgical option to remove skin and/or fat will such as eyelid blepharoplasty with or without fat pad repositioning (if doing lower eyelid surgery) will be the best long term. There are many things you can do to treat under eye hollows and dark circles without surgery. Non invasive less downtime options such as fillers, lasers, microneedling/PRP, cosmelan peels, and microneedling RF like Fractora, PiXel8 or morpheus can all help give some improvement. Accutite can often be used or stronger lasers like erbium or co2 spot treatment can tighten the skin and give very quick improvement in wrinkles and texture. I suggest you get a formal consultation to see what is best for you and your goals. Best, Dr. Emer.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your questions and posting your photographs. You could use fillers and laser skin resurfacing to improve your lower eyelids and cheeks. See an experienced oculofacial surgeon for consultation and guidance. 
Good luck,

Kenneth D. Steinsapir, MD · Answer

Do not get wrecked for a life time trying to fix this. The state of the art treatment for this is a small amount of high G prime hyaluronic acid filler in the dark circle and the mid cheek groove. Less is more. Avoid runny fillers for this area. That includes the so-called "smooth" fillers like Belotero, Juvederm, Voluma, and others. I only use Restylane for this type of work. Who does the treatment and their understanding of mid face anatomy is critical. Do not get grafted fat or permanent filler in your mid face. There are many planes that need to glide on each other to make your mid face work and these permanent filler damage this glide function and it can't be restored. Your eyes can be your best feature.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  The slanting dark circles underneath your lower eyelids is what is distressing you and it is common and is often and inherited problem that patients noticed since they were a young child.

There is only one effective treatment to correct these dark circles or depressions underneath your eyelid that you see.  The procedures called a transconjunctival lower blepharoplasty with arcus marginalis release and fat grafting.

There is a structure called the arcus marginalis which is holding your skin tight against the orbital bone creating the shadow underneath your lower eyelid.  During the procedure this structure is released so that the eyelid skin can effectively move over the bone.  A small fat graft is placed to prevent reattachment of the skin to this area the result is a uniform straight appearance from the lashes to the cheek without the dark circle.

Javier Vera Cucchiaro, MD - Account Suspended · Answer

Due to your age, I would recommended filling the nasojugal groove with Hyaluronic acid in a sub muscular plane attached to the periosteum, with will give the result a duration of 2 to 4 years. It is a procedure without exams and without anesthesia and outpatient

Can a lower eyelid lift/blepharoplasty help minimize the appearance of lines? Should I consider other options? 24 y/o (photos)

Answers (6)

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