I am 33 years old and have puffiness ever since I was a kid. I'd love to get rid of them (Photo)

is their a way i can improve the look of the bags or like a laser thing which can help than you

Doctor Answers 12


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I always like to start with the least invasive approach. Schedule a consultation with a board certified plastic surgeon in your area to discuss putting a bit of HA filler such as Restylane in your tear trough area. It's what I use on myself to disguise my bags and diminish the appearance of dark circles. 
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Eye bag treatment

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Under eye bags and dark circles are a common complaint and are usually caused by a combination of several factors. These factors include increased pigmentation in the area, increased blood vessels in the area, fine lines and wrinkles, and periocular volume loss. In your situation, it seems like the main contributors are mild volume loss and increased pigmentation. These two issues can be addressed with injectable fillers and laser respectively. Fillers will need to be re-injected every 6 months or so to start until a level of satisfaction is achieved, then used on an as-needed basis. Good luck!

Douglas Wu, MD
San Diego Dermatologist
4.9 out of 5 stars 53 reviews

Lower Blepharoplasty

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Consult with a Board Certified Plastic Surgeon to discuss eye bag reposition.  The fat can be moved into the tear trough for a smooth pretty look.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Dark Circles, Eyelid Wrinkles/Bags Treatment -- Restylane or Belotero with Cannulas, Clear+Brilliant, Eclipse Micropen, Viva

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There are many ways to treat dark circles, as well as under eye wrinkles and bags. It is important to note however, that the majority of times the cause for discoloration is genetic and due to the viability of the blood vessels below the skin. A combination approach is always needed to get the best results in this area and this includes: topical skin care, laser and/or radiofrequency treatments, and fillers if placed appropriately.
All my patients are on topical lightening agents, typically a vitamin C serum product in the AM and a brightening agent and/or a vitamin A based product in the PM. Sun protection is essential.

Resurfacing and tightening are essential. My patients get offered a menu of options, for which a combination gives the best results. Light salicylic acid peels help give textural and pigment improvement; nonablative lasers (Fraxel or Clear + Brilliant) can be used to tighten and improve fine lines/wrinkles and crepe skin; fractional radiofrequency devices (Sublative, Viva) are cutting edge and improve texture, tone, and wrinkles with very little downtime; radiofrequency with pulsed electromagnetic fields (Venus) are amazing for puffiness and bags, in patients who do not want eyelid surgery; appropriately placed fillers can replace lost volume, cover up the vessels and fat pads below improving the appearance -- patients should pick a well experienced practitioner to prevent complications such as Tyndall (blue discoloration) and irregularities, one that uses a cannula for injection will help give results with little bruising or swelling; microsecond Nd:YAG laser treatments (Laser genesis) has produced dramatic improvement in discoloration in some of my patients and is safe in dark skin types, similar to the radiofrequency devices. For lifting, ablative laser resurfacing such as co2 laser combined with monopoloar radiofrequency deep heating (thermage) give amazing results. The key is for a patient to see a cosmetic dermatologist with experience in all the latest devices and techniques so the persons goals can be met by a combination approach of individualized treatments and skin care. In some cases, those who smile and have crepe skin or under eye wrinkles, a small amount of neurotoxin (botox, dysport, xeomin) strategically placed in the lower eyelid skin can improve wrinkles dramatically and give the eye a more "open" appearance.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Lower eyelid puffiness

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Thank you for your pictures. In my opinion, you need to control your allergies if you have them first.  Then consider a lower lid Blepharoplasty to improve your contour. 


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Based on your pictures you have prominent eyes with lower lid fat herniation and a visible  tear troughs "hollows" on both sides.   You can consider non surgical as well as surgical solutions.   Filler can efface the troughs. I like re density 2 filler and on occasion bellafill.    
Lower Blepharoplasty would certainly help enhance your appearance.  Transconjunctival Blepharoplasty where incisions are from inside the lid and fat repositioning can provide permanent results.  

Philip Solomon, MD, FRCS
Toronto Facial Plastic Surgeon
4.4 out of 5 stars 119 reviews

Lower eyelid bags

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You have some prominent fat pads in the lids.  You can mask these by putting some HA filler below the fat pad into the tear trough.  when you do this it makes the area appear smoother and less dark.  A more permanent solution is a lower lid blepharoplasty with fat repositioning where the fat is placed further down to fill in the tear trough.  Do not have a bleph where they take out fat or you will look more hollow.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Too young for a bleph

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You are starting to show the mild tissue laxity of lower eyelids that occurs with age, with fair skin tones and people who keep their weight down.  Don't resort to a bleph too quickly.  You have the ability to produce new collagen and elastin at your age.  Controlled injury to that lax skin can make a big difference.  We use several modalities including Laser Genesis, Ultherapy, Infini and periorbital resurfacing all based your severity, your skin type and your willingness to accept some down time.  

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

Lower eye lid puffiness

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Thank you for your question. Based on the picture you may get benefit from lower blepharoplasty. There are different ways to do this. I suggest to see a board certified PS for evaluation and to discuss your goals and options.

Eyelid puffiness ever since I was a kid

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Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: Botox or Dysport, temporary fillers, micro-fat grafts, blepharoplasties and combination of procedures. Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

In a patient with your inherited anatomy, a blepharoplasty and micro-fat grafts to the tear trough depressions will produce the best and longest lasting cosmetic result.

Following the advice of anyone who would presume to tell you what to do without seeing photos and without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or Canadian Society for Aesthetic Plastic Surgery (CSAPS) . You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 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.