Surgery or Fillers Can Do for Now? (photo)

Hello, I'm 32 years old and have under eye bags which are getting worse. I'm really scared and not ready for surgery. Does it look like I can prolong it and have some fillers done? Thanks.

Doctor Answers 7

Eyelid surgery vs eyelid fillers, best option for someone in their 30's #cosmeticsurgery

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Dear Nellik

Thank you for your question!  Either Fillers such as Restylane or a surgery of the lower eyelid can give you very good results. With either procedure- care must be taken to preserve the shape of your eyelid and give the proper aesthetic- so that you do not appear to "have had work done"

With Warm Regards,


Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Fillers can't address the anatomy behind eye bags. Surgery can be done that leaves no scar, looks natural & recovery is fast

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A lot of people think that salt intake or various types of allergies contribute to the bags under the eyes which are present regardless of sleep, fluid, etc.  However, this puffiness is a manifestation of herniated fat or lower eyelid fat prolapse. This means that the fat pockets that are normally around the eyes have pushed forward.

Most of the time, people use topical creams and lotions but these cannot reduce the puffiness under the eyes. One strategy to hide these bags is to camouflage it by making everything else below it move forward as well. However, fillers such as hyaluronic acid and restylane are not a solution to that because these are placed along the tear trough area which is a relative depression under the eye. This depression can be accentuated with fillers and the bags can even look bigger when more volume is placed in the area.

The best strategy for lower eyelid fat prolapse is surgery such as lower eyelid blepharoplasty or transconjunctival blepharoplasty. Since the fat pockets causing the eye bags are sculpted and removed from the inside of the eyelid, there is no visible outside scar. This surgery is not disruptive and is combined with a technique called LITE™ anesthesia. This is an IV sedation type of anesthesia where the patient is conscious all throughout the operation. This allows the surgeon to wake the patient during the surgery if he needs the patient’s cooperation to aid with the artistry and surgical technique. Many patients have less bruising after this type of surgery when compared to using fillers, and also have a faster recovery time than having this surgery done under general anesthesia.

So before you start pursuing options, I think you need to find an experienced specialist who has a lot of experience in the eye area. You probably have saved yourself a lot of money and aggravation in trying to use just fillers alone. Again, without doing an examination I can’t give you a definite answer but at least you get to have a better understanding of the anatomy and the rationale on how I make choices of who’s a good filler candidate and who’s a surgical candidate. I hope that was helpful, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Surgery or Fillers Can Do for Now?

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     Restylane to the tear troughs may be the best solution at this point.  Kenneth Hughes, MD Los Angeles, CA

Non-surgical rejuvenation of the lower eyelids

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If you are seeking improvement and rejuvenation of the lower eyelids then there are two methods, surgical and non-surgical.  Non surgical improvement consists of soft tissue fillers such as Juvederm.  In addition to soft tissue fillers you may consider microablative fractionated CO2 laser treatment such as SmartSkin and SmartXide will help to tighten the skin.  These can be performed in combination.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Based on your photo, you may be a candidate for an under eye filler treatment.

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I read your concerns and reviewed your photos:

It's not possible to determine your candidacy for under eye fillers without examining you. Fillers to your under eye grooves may help blend your lower lid bags into your cheeks. My personal experience is with Silikon-1000, an off-label filler for permanent results.

Hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

With the right injector, you are likely to be happy with fillers for the next 10 years.

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You should to great with Restylane for the under eye circle.  Treatment last about 1 to 2 years.  The essential task is finding the right injector.  Do not let anyone inject this area with jeuvederm, fat, radiesse, etc.  Because these services benefit from adjusting, it is best if you can get service close to home.  However,  many communities lack an injector with sufficient expertise in which case you will need to travel to get the best service

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Quick Eyebag correction

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If you have bags under your eyes and are not ready for surgery then injection of a filler in that area called ' Nasjugal groove' or 'tear trough' can help. It will minimized the baggy look. I use Restylane for it and it lasts upto a year.


Dr. J

Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.