What is the Best Treatment Options for Under Eye Bags with Little Recovery Time? (photo)

I am 31 yrs old and developed bags under my eyes around 3 years ago. They have become increasingly noticeable over the last year and predominant in photos. I am very healthy, frequently exercise, non-smoker, seldom drink, and eat very healthy. I am getting married in two months and am worried to take on anything that may cause complications or worsen the bags but also don't want to see these in all of my pictures! I have heard mixed reviews on results of fillers. I appreciate any advice. Thanks!

Doctor Answers 9

Your best option with 2 months to go before the wedding is probably photoshop.

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There I've said it.  Surgery would be a big mistake this close to your wedding.  Please do not get talked into this option.  I agree with others that a lower blepharoplasty with arcus marginalis release and preservation of this fat transferred into the top of the cheek is a surgery that looks perfect for you.  Here's the but-not this close to the wedding date.  Who really needs the stress?  You have obviously avoided dealing with the bags for a while now.  Rushing to make a decision about surgery when you have so many responsibilities and decisions to make-its just not the right thing to do in my opinion.  I am even uncomfortable with under eye fillers at this point.  If you end up going to a clown for under eye fillers, this will also prove to be an escapade that you don't need right now.  My best advice is take a deep breath, talk with your makeup artist about your under eye problem, talk with the photographer about photoshopping this areas in your wedding photo's, and also discuss your concern with the videographer if you are using one.  Oh, and plan on confiscating everyone's cell phone cameras on your wedding day-OK just kidding about that one.  Then, after the wedding, once the bills are paid, you can start thinking about what to do for those lower eyelids.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

What is the Best Treatment Options for Under Eye Bags with Little Recovery Time?

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    Filler would be a better option than would surgery for a short recovery time.  However, bruising in this area can occur and could be prolonged.  Kenneth Hughes, MD Los Angeles, CA

Fillers are an option in my book

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Based on the one photo with suboptimal lighting that is posted, I agree with most of the opinions posted already that a blepharoplasty with fat repositioning would be definitive treatment for you.  I also agree that this is out of the question this close to your wedding.  I also understand  how you could feel that Photoshop or makeup are really unsatisfying options too.  In my hands, Perlane placed along the orbital rim using a blunt microcannula is an excellent option for this kind of thing, and while it may not produce results exactly like a blepharoplasty, in a 31 year old girl it will get pretty darn close and without the risk and expense either.  In my hands, this causes very little bruising if any at all, and very little swelling, and in both cases it is gone within a few days.  Additionally, in the event that an area is overcorrected and there is a little unwanted bulge or fullness, a small amount of hyaluronidase will reverse that within hours.  In fact, you could essentially make the entire volume resolve safely with hyaluronidase overnight if you wished.  It is very important to find someone with the right skill and experience to perform this however, as the area is not as forgiving as some other areas on the face.  That is to say that this is not an injection that you would want to have done at the local medspa.  However, I do many of them every week, and I have minimal to no problems with them, happy patients, and many returning for retreatment after a year or so.  I never use Juvederm for this as it is too "hydrophilic" and it tends to get puffy.  Radiesse, Artefill, Sculptra, and even fat all have the tendency to last a long time or be permanent, and with your schedule, they shouldn't be an option.  Perlane will give you the safety margin that you need and a nice improvement if performed correctly.  Good luck and congratulations!

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

What is the Best Treatment Options for Under Eye Bags with Little Recovery Time? (photo)

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The ideal long term option is a Lower Eyelid Blepharoplasty with fat repositioning and tear trough correction. In the short term Hyaluronic Acid fillers such as Juvederm would help.

These fillers last for 12 months and then you can make up your mind regarding surgery or fillers. 2 Months is plenty of time to recover from Fillers. Since you haven's scheduled surgery 2 months to D Day is inadequate.


No Filers byVillar

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A thorough physical examination (touch and feel) is essential to determine the  appropriate technique suited for each individual patient.  Poorly lit photos will generate a lot of bad advice.  However, from your single photo it is evident you have herniation of the middle and medial fat pads.  Do not waste your time with fillers.  There are products that will temporarily shrink the skin for a few hours at your pharmacy.

In skilled hands you could reasonably recover in three weeks.  Full unrestricted activity is typically at three weeks.  But some of these fat relocation procedures can result in severe bruising that may last much longer so avoid these until after the wedding.  Best wishes.  Knowledge is power.  Luis F. Villar MD FACS


Luis Villar, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 11 reviews

Surgery vs Fillers

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A lower eyelid blepharoplasty with fat repositioning would be a great option for you if you can get this scheduled relatively quickly to have at least a month of recovery before your wedding.

But if time does not permit, haluronic acid fillers [Restylane, Juvederm, Boletero] are wonderful to address this in the short term. The beauty of this approach is that the effect is reversible if you are not happy with the results.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Treatment options for under eye bags

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Your under eye bags, as in most people, are due to protruding fat in the lower eyelid area.  Fillers can be used to help and normally work well, but will only camouflage the bags and the result will be temporary.  Surgery is needed to treat the bags long-term.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Fillers for Under Eye Bags

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Hi Kittles.  You have several options, but it sounds like you want the least invasive.  

First, you are a great surgical candidate and this will be the most effective way to address your issue.  Even though you are young, your genetics make you a great candidate for lower blepharoplasty.

You can also try injections, but you are not an excellent candidate for this procedure.  The protruding fat pads make you a better candidate for surgery and why the injection results will be limited.

Finally, you can also try fractional laser resurfacing to tighten up the skin in this area.  Again, not as good an option as surgery, but using the Sciton Profractional, we could likely get some improvement.  There would be about a week of recovery using the type of resurfacing we do.  

You can review photos of the injection procedures below.  Make sure to try and find someone that is experienced at this type of procedure and can show you good pictures.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Eye bag surgery can heal in two months if there are no other medical issues like allergies - a physical examination is needed

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There are a lot of reasons that motivates people to do something about their appearance and certainly, getting married is a very good deadline to aim for when you consider a procedure. The photos you submitted shows these puffy areas under your eyes which mostly likely represent something called herniated fat. Herniated fat, or lower eyelid fat prolapse, means that the fat that is normally around your eyes have pushed forward.

In my experience with lower eyelid fat prolapse, adding fillers to try to hide it may result in bigger bags. Many of my colleagues, particularly non-surgical doctors, will use injectables such as Restylane to try to fill in to camouflage the bags. And slowly, a lot of them are learning that that is a bad idea because a lot of people then come to me and get Hyaluronidase to reduce and melt the Restylane.

I think the best procedure for you is transconjunctival blepharoplasty, which is the reduction and sculpting of fat pockets from behind the eyelid. In my opinion, it is one of the least traumatic surgeries to address lower eyelid fat prolapse. Now given that, if I were to do a physical exam, I would probably be able to give you a more specific answer, but it has not been unusual in my practice to have someone come and have their fat pockets done two months before their wedding and look good. The only concern that I have is that in some people, they can have fluid lingering under the eye and cheek, especially with people with chronic allergies and sinus problems. If you are less likely to have that concern, then in about two months you should be in a very good shape. Finding a highly experienced cosmetic surgeon who does a lot of eyelid surgery with the most minimal trauma is the most practical thing to address the fat pockets before the wedding.  I hope that was helpful to you, and thank you for your question.

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