How to fix under eye bags and wrinkles? I am only 27 so it is really affecting my confidence (photo)

Question

I have always suffered under eye bags but they have always been manageable. However, a few years ago I was prescribed hydrocortisone for facial eczema. Since then, I have noticed that my eye bags are much bigger and darker and when I smile I have different wrinkles under each eye. I'm wondering what I can do about it?

Randal Haworth, MD, FACS · Answer

There are generally three methods to reduce lower eyelid bags and wrinkles.
1. Utilizing peels, lasers or any other ablative or semi ablative techniques to stimulate new collagen growth. Though effective, most people want to have little to no downtime and in order to get a very effective result with which most patients would be extremely satisfied, these techniques will fall short of their stated goals. These techniques are wonderful if they are utilized in an appropriate strength. 
2. Carefully injecting a temporary filler (such as Belotero® or Restylane®) underneath the skin in hollow areas with magnification. This could be quite effective but does involve the risk of producing irregularities and lumps and will necessitate a certain amount of bruising. A permanent filler such as Bellafill ® or even a fat transfer utilizing purified fat from your body are also options.
 3. Performing a simple surgery under local anesthesia called a pinch blepharoplasty. In this operation, a small strip of skin is removed directly underneath the lower eyelash line and results in a nearly invisible scar. The recovery is very rapid (a couple of days) and involves one single stitch which is removed in five days. This approach is actually the least complicated in appropriate hands and will produce the most consistent and significant of results in reducing lower eyelid bags and wrinkles.

John Michael Thomassen, MD · Answer

A lower lid blepharoplasty in which the fat that is herniated and causing the small bags is removed and replaced along the tear trough would be indicated.

Camille Cash, MD · Answer

You can consider a lower blepharoplasty.  In this surgery excess fat is removed and remaining fat redraped revealing a smoother under eye appearance.  For non surgical options you may find improvement with use of fillers.  When combined with treatments such as lasers or chemical peels you will see a more complete result.  I recommend visiting with a board certified plastic surgeon near you to explore what may be best for you.

Paul Nazemi, MD · Answer

The under eye bags can be removed with a procedure referred to as a "transconjunctival lower eyelid blepharoplasty".  In this procedure, a small incision is created on the inside of the lower eyelids, and the "excess or bulging" fat is carefully removed, leaving no visible scar.  The fine wrinkles can be addressed at the same time with laser skin resurfacing or a chemical peel.

John R. Burroughs, MD · Answer

There are many good treatments now for under the eyes to include wrinkle blockers, dermal fillers, peeling, laser/RF resurfacing, PRP, and surgery.  SkinCeuticals even has an "AOX Eye Gel" that helps tighten the skin under the eyes.  Find a qualified provider in your area.  Oculoplastic surgeons usually are the most experienced eyelid surgeons, and also offer non-surgical options as well.  Best regards.

Ivan Vrcek, MD, FACS · Answer

Thank you for your question and photos. It looks like there may be 3 potential elements resposible for your lower eyelid changes. First, the orbicularis muscle contraction is resulting in the soft tissue roll that you see when you squint and smile. Second, volume loss from your lower eyelid region may be contributing to a depression that results in lengthening of the lower eyelid. Finally, skin changes from the Sun as well as possibly from the hydrocortisone, contribute to changes in your eyelid that can be improved. I would recommend an in-person consultation with an oculoplastic surgeon to see what treatments could be available. From your photos, it looks like a mixture of Botox, skin resurfacing, and filler might be a nice way to improve your lower eyelid Aesthetics.
Best of luck!

Rita Rakus, MBBS - Account Suspended · Answer

Thanks for your question- This area can be a challenge to treat so only make decision after a full assessment with your cosmetic physician. We have great results for this area with a combined approach of injectables, energy based devices and take home skincare. Always seek a qualified and experienced injector

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

Thank you for your question.  The most definitive permanent solution to correct I bags of the lower eyelids with deep dark circles underneath the procedure called a trans-conjunctival lower eyelid blepharoplasty with arcus marginalis release and fat grafting.

How to fix under eye bags and wrinkles? I am only 27 so it is really affecting my confidence (photo)

Answers (8)

More Eyelid Surgery Questions

I need orbital decompression with tissue removal. What is cost, procedures & recovery time on average for the procedure? (Photo)

Is one eye smaller than the other? (Photo)

Surgery to get upturned/slanted eyes? (Photo)

Is there anyway to fix my different sized eyes? (photo)

Wrinkled upper eyelids 10 months after upper blepharoplasty, what can I do? (photos)

Will a warm eye compress help with hollow eyes?

WE SEND PRETTY
EMAILS