I want to remove my under eye bags and I want to have no dark colour under my eyes. I am 20 years old. (Photo)

Doctor Answers 8

I want to remove my under eye bags and I want to have no dark colour under my eyes. I am 20 years old.

There are various options available.  The best long-term option is probably transconjunctival lower blepharolasty with fat bags repositioning, which removes the bags while filling the hollow area (dark circles). Other options include filler or fat injection. See an oculoplastic surgeon for evaluation.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

There are some good options to address your lower eyelids

Before I discuss any of your options to address the lower lids, I would like to make a couple of observations.  First, you are a very young lady, and assuming that you have no medical problems that could cause changes in your eyelids, the things that you are seeing are more likely genetic and anatomic in origin.  As such, you are not old enough to have age related changes to your tissues, and any treatment options must address your specific anatomy directly.  Anyone doing the treatments should understand that anatomy and how to address it in the least invasive way possible.  The second thing to note is that some of the things you are seeing have a good solution, while others may not.  Those without great solutions include the dark pigment under the eyes.  Dark circles under the eyes can be caused by shadowing from bulging fat pads, hollow zones devoid of volume, or other contour irregularities that can occur in the anatomy of the orbit, or eye area.  These kinds of things can be improved pretty reliably with certain treatments.  More about that in a minute.  On the other hand, especially in young people who don't have much bulging, hollowing, or other age or illness related phenomena, or in those of ethnic origins prone to having dark pigment in their skin, like Meditteranean/Middle Eastern people, Asian people - especially Indian, Pakistani, and other Southern Asian peoples, and some Latin people, the dark circles are usually caused by pigment in the skin and underlying muscle.  The eyelids have the thinnest skin of the body, and there is no fat between it and the underlying muscle to opacify it.  Thus, the dark circles are caused by the either the pigmented coloration of the underlying muscle and blood vessels showing through the thin skin, or dark pigment in the skin itself.  In either event, it is not something that is amenable to injection of any fillers or other products.  There are only two modalities that I have had any success with as far as managing this kind of pigment issue, and those are a special type of laser which can sometimes lighten the pigment in the muscle below the skin, or topical concealers.  Unfortunately, those are the only options that have had any success with this pigment in my hands.  As far as the shadowing and contour related changes, there are a variety of fillers that can be used to create a more even contour and get rid of the shadowing and hollow areas.  Each filler has its advantages and disadvantages in different people and in different parts of the face.  Each injector should know the strong points and the weak points of each filler and be able to use them appropriately.  Furthermore, each injector treating this area should have a good working knowledge of the entire anatomy of this area, as it is very complex, and injecting into the wrong structures, at best can cause worsening of a deformity, and at worst can be dangerous and cause things like blindness.  I personally favor someone with actual surgical experience for injection into this area, as those are the ones who will know this anatomy the best.  I believe that in a young person like you whose eyelids look like this, the safest and most reliable place to inject fillers is in the deep space against the bone of the eye socket, and you will want to find an injector who is comfortable with this technique. While not a requirement, I have also found that it is much easier, safer, and more reliable to perform these injections with a microcannula as opposed to a needle, and it is worth discussing this point with any injector you might consider for these treatments.  One other thought to keep in mind is that if you find that injection of a temporary filler improves things, and ultimately you want a more permanent solution, you can consider injection of some of your own fat to the area.  This has been highly effective in my experience, especially in younger patients, as those are the ones in whom I especially want to avoid surgery at all costs of possible.  This can be essentially a long term, if not permanent, solution to the problem, as your own fat cells become living tissues which remain indefinitely.  Try to locate a properly trained and credentialed plastic surgeon, facial plastic surgeon, or occuloplastic surgeon who has experience with both surgical and non-surgical treatment of this area.  They will be best equipped to provide you with all of your options and help you choose the best one for you.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

Under eye darkness

Thank you for the question and photos. Darkness under the eyes can be caused by 2 factors: under eye hollowness creating a shadow and skin pigmentation or combination of the two. It is certainly a difficult problem to fix but it can be improved. Fillers under the eyes can help with the hollowness and expose the area to light which makes it appear less dark. 'bleaching' depigmenting creams are available for those who have increased pigment in the area. Get a consultation for an in person exam for full assessment. As long as you are not expecting it to go away completely you may be happy with these options

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Under eye filler

Hi there, to get rid of the under eye bags and dark colour one option is fillers. The filler I usually use for this is Voluma, since it lasts up to 2 years. Unfortunately there is no cream or anything topical that will get rid of those bags. I do this procedure hundreds of times a year with good results. I would suggest an in person consultation with someone in GB to go over this with you. Voluma may be called something else in the UK, I am not quite sure.

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 19 reviews

Under Eyes

Thank you for your question. Based on photographs it appears as though you may have some hollowness under the eyes which can often respond well to an injectable dermal filler such as Restylane. An in person exam would determine if that is the ideal approach to address your concerns and goals as well as your candidacy. Best wishes. 

Leonard Lu, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 26 reviews

Under Eye Hollows/Bags - Lasers (Fraxel, Co2/Erbium, VIVA/Intensif, Aeroloase); Microneedling/PRP, Fillers/Belotero, TCA Peel

In treating under eyes, a combination approach is best. I use a combination approach of lasers, microneedling/PRP, fillers and skin care/peels which can improve this area. See an expert. Darkness is permanent as this is typically genetic but it can be improved with these combinations.  Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

20 Y/O and with eyelid bags

Dear Tajiy

You seem to have a noticeable amount of under eye bags. At your age

I will suspect there is a genetic predisposition. The bags are formed by

fat pads that are a normal part of the lower eyelid anatomy.They contribute

to the dark skin appearance.  I will suggest  an evaluation by an experienced 

plastic surgeon in this field and discuss your options.

Best wishes.

Fernando Colon, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Lower eyelids

You may be a candidate for lower eyelid blepharoplasty.  This type of surgical procedure will help with lower lid fullness and in some cases may help to diminish the appearance of dark circles.  Unfortunately, at this time there is no treatment specifically targeted to treat or remove dark under-eye circles.  

Undergoing any surgical procedure requires careful attention to detail and consideration for different options.  Consider obtaining several opinions before moving forward with any given procedure.

Trust your face to a board-certified facial plastic surgeon or a board-certified plastic surgeon with very extensive blepharoplasty experience.

William Numa, MD, FACS
Boston Facial Plastic Surgeon
5.0 out of 5 stars 7 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.