What can be done to smooth out the bags under my eyes? (photos)

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:
temporary fillers, micro-fat grafts, blepharoplasties, and combination of procedures. Each has
benefits and drawbacks and depends on desired outcome and individual anatomy.There are no "needling" procedures that will improve the eyelids.

Following the advice of anyone who would presume
to tell you exactly what to do 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).
You should discuss your concerns with that surgeon in person.Fees
vary depending on the extent of the procedure, location of the surgical
practice, and experience as well as the reputation of the surgeon.

Robert Singer, MD FACS

La Jolla, California

I’m a cosmetic oculofacial plastic surgeon and I have a background
training in eye and cosmetic surgery. Eyelid and eye bags surgery is something
I do every day. When puffiness under the eyes is constant and is always puffy, that
puffiness is actually fat and not fluid. We call this condition lower eyelid
fat prolapse. This means that the fat that is behind the eye or surrounds the eye
pushes forward and becomes a hernia. The reason why a lot of people confuse
this with fluid is because allergies, sinus problems and eye rubbing are caused
by fluid and can make eyes look puffy. When you have bags that are always
there, then it's probably not due to fluid.



In our practice, we would typically address your problem by physical
examination and confirm the puffy bags are caused by fat. We perform a
procedure such as a transconjunctival lower eyelid blepharoplasty. This is a
procedure which is performed from the inside of the eyelid to address the fat
pockets. That means resection or removal and repositioning when appropriate. In
addition, we use platelet-rich plasma (PRP) which is derived from your own
blood and helps improve the quality of your skin by generating collagen and
blood supply. It also improves the health of the skin because the eyelids skin
is the thinnest skin in the body, and improving the skin quality is very
beneficial. Sometimes we also do fractional CO2 laser to help the external skin
structure and to reduce the fine lines and wrinkles.



At this point, I think that you should meet with qualified experienced
surgeons and learn about the options. The thing we can’t do with a photo is a
physical exam. It’s very important to understand the function and the support
structure of the eye before undergoing lower eyelid surgery. As a specialist, I
deal with complications of lower eyelid surgery every week and people come to
us from all over the world for resolution. Performing a physical exam including
a snap test to see how well the lower eyelid is supported is critically
important. I always say that lower eyelid surgery is deceptively oversimplified
by many doctors, and unfortunately it results in the eyelid being pulled down
or everted. I hope that was helpful, I wish you the best of luck, and thank you
for your question.



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Either you have misunderstood the service you are describing or someone is scamming the public.  There are a number of ways of addressing these types of issues: Fillers, chemical peels and lasers, and lower eyelid surgery.  I am not a fan of lower eyelid fat grafting although some on this forum do advocate this approach.  Ultimately there is not substitute for a personal consultations with a surgeon who is very experienced in periocular aesthetic surgery.  Your potential surgeon should do a very through assessment and take time to explain options, alternative, and likelihood of success, complications, and potential risks.