Trans-conjunctival Eye Bag Removal or Non-incisional Laser Eyebag Procedure? (photo)

I'm 22 and plagued with serious genetic dark circles and eye bags, along with very dry lower eyelid area, which has made me look very old.. I'm looking to undergo an eye bag removal procedure and have heard of the transconjunctival eye bag removal where the incision is on the inner surface of lower eyelid, and another method which uses laser instead of cutting. I would be really grateful if I could be given some advices and insight which would be more appropriate for my situation. Many thanks..

Doctor Answers 3

Tranconjunctival blepharoplasty is best suited for you.An incision is needed on the inside, but it can be done with a laser

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Puffiness under the eyes is caused by something called lower eyelid fat prolapse. This represents fat pockets underneath the eyes that have pushed forward and created a bulge. As a surgeon practicing for 20 years, I have learned a lot of procedures to address this problem. Unfortunately, some surgeons have used non-incisional techniques that have left patients with complications. It is important to understand that fat pockets are hernias that have to be addressed by an incisional way to reduce and reposition the fat.

Lasers, specifically CO2 laser, and radio frequency technology are tools that are used to make an incision. The beauty of using these tools is that it reduces bleeding giving the surgeon a cleaner field to work and also results in lesser bruising for the patient.

In my practice, I usually do a transconjunctival approach using laser or radio frequency to address the fat pockets. To help with the skin quality and dark circles, I use platelet-rich plasma. This material is derived from your blood in which platelets are separated from the plasma by centrifugation. When the platelets are injected to the area, it improves the quality and healing of the skin and reduces the appearance of dark circles. I hope that was helpful, I wish you the best of luck, and thank you for your question.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Eye bag removal surgery options

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I would think at your age and after viewing your photos that a transconjunctival lower blepharoplasty would be my recommendation to deal with your lower eyelid bags.  I think you would get a good improvement with that procedure.  If you wanted to try a non-surgical option, you could also use Restylane to help camouflage the bags, but the result would not be as long lasting as surgery.   

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

Eye bags

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You are young and a transconjunctival removal of fat bags will work well for you. That is all that you will need. Given your skin (in appears brown) you should avoid any laser procedure on the outside of the skin. If you are talking about laser being used on the inside to cut the fat bags, that is ok, it is no different than the cautery instrument that most surgeons use. Regards 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.