Undereye Bags in my 20s. How to Get Rid of Them?

Hello, I am 26 years old and I noticed I have major undereye bags. These bags make me look very old and tired. I think my case is heredity. My father also has severe amount of eye bags under his eyes.Am I too young to have eye bags removed? What treatment do you recommend? Thank You Alot

Doctor Answers 11

Send those lower eyelid bags packing! 20 is too young.

The high point of the bag can be matched to the local tissue by injecting filler around it..... THEORETICALLY.  In practice, it's harder than you might think.  The problem is that the bag is very dynamically positional.  Tilt your chin down and look at them.  They are worse.  Tilt your head back and look "down your nose" at them.  They aren't even there.  So with such a dynamic problem, how will a static injection be just right - all the time?  But 20 is too young for bags and too young for major surgery.  IF they are really bad and you are really bummed about it, a little fat reduction trans-conjuctivally might be the ticket.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

Fillers first.

From the photos I see you seem to have mid facial volume loss around the cheek area medially (nose to middle of your eye). Fillers in this area can restore volume to the cheeks. You still will have eye bags, but they won't be as prominent. This gives the illusion rather than addressing the problem, however it works! Technically challenging, but layering of fillers is what I would advise. 

I do not recommend transconjunctival removal of fat bags at this stage, as you will have recession of your orbit and this will be worse with age- at that stage only implants will help.

Challenging ....

Hope this helps


Dr Davin S. Lim 
Consultant Laser and Aesthetic Dermatologist

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 77 reviews

Rasiesse Helps with Bags under Eyes

The eye sockets have a cushion of fat for your eyeballs called peri-orbital fat which is held in place by an orbital septum in your eyelids. Typically age weakens this septum and allows the fat to fall into the lower lids. The shadowing is due to a hollow area below the eyelid, the tear trough. You can seek treatment to build up this hollow area to bring this skin into the light stopping the shadow formation. This can be accomplished with fillers such as Radiesse. Radiesse will last in between 12 to 18 months depending on your natural level of collagen.

Edward E. Dickerson, IV, MD
Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 120 reviews

Under eye bags in the 20's

  Non surgical options such as treatment of the under eye hollows with Restylane should be your first option.  If you are not satisfied, then you could consider conservative transconjunctival lower lid surgery.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 134 reviews

Undereye bags


Well you have two options.  One is to take the fat prominence of the lower lid and translocate (shift) it into the hollow below - this will improve contour and appearance.  The non-surgical option is filler.  I prefer Restylane. 



Dr. Massry

Guy Massry, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 50 reviews

Eyelid bags and treatment

Dear Suz1,

What you are seeing in your lower eyelids is often seen in Asian eyelids with herniated fat pockets.  You have a physicially noticable orbicularis muscle just below your eyelashes. Addressing this is difficult and I would more focus on the larger herniation below which is the orbital fat that you are seeing.  Given your age and texture of your skin,  you may very well be a good candidate for a hyaluronic acid filler to help treat this area.  My filler of choice here is Restylane. It is safe, well tolerated, and reversible if the results do not resort to be optimal. However, it needs to be placed in the correct depth so that it won't be visible or palpable given your apparent thin skin.   You need to make sure you see a physician that has alot of experience treating lower eyelids with fillers.  A blepharoplasty is also another option, one that is obviously more long lasting. 

Christopher I. Zoumalan, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 104 reviews

Lower Lid Surgery

I would recommend a Trans-Conjunctival blepharoplasty. This procedure would remove any excess fat under the eye and does not require any sutures.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 93 reviews

Eyelid bags and treatment

Dear Suz1,

I believe a good place to start with a hyaluronic acid filler like Restylane for that area.  It will hide the bags and give a nice result that should last 18-24 months.  I would hold off on surgery until you are a little older and see how things come together down the road.


Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Eyelid surgery, #blepharoplasty, #tiredeyes, #fatgrafting, #restylane, #beauty

Dear Suz1

thank you for your question.  'Under eye bags' are common and can arise from the genetics in your family or with age. They can be treated with surgery or with injections.  Injections are done with Restylane- placed on the deep layer- this will eliminate the hollow under the eye, take away the tired appearance and give a nice shape to your cheek bone.  Surgery can be done through a variety of techniques- they would involve some removal of the puffing fat and some micro fat grafting to buiid up the shape of the cheek bone and eliminate the hollow under the eyes.

With Warm Regards

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 118 reviews

It is helpful to understand normal eyelid anatomy.

Dear Suz1

I understand how you feel about the lower eyelids.  It is important to understand the structure described as the first bag is a normal eyelid structure of the orbicularis oculi.  It is normal and the groove just below it is the lower eyelid crease.  This is a normal structure and removing the lower eyelid crease does not look right.  Below this is fullness from a small amount of so-called herniated orbital fat.  This fat can be addressed with a surgery called an arcus marginalis release which is performed from behind the lower eyelid with no skin scar.  The fat that constitutes the full area is rotated as a living graft into the top of the cheek.  This can be done under local anesthesia in the office for many patients or in the surgery center under a little intravenous sedation.  My website has examples of this type of surgery.  There is also an excellent alternative to this surgery which is to fill the circle with Restylane.  This type of treatment involves an office visit and might need an adjustment afterward.  This type of treatment will last well over a year, and possibly longer.

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