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

An Exam would be required for best advice but a lower lid procdedure and a bit of filler of fat transfer is probably all you will need to look your best. Here is some general information: Of all the features on our faces, our eyes are the most prominent indicators of our mood, energy level, and youth. Sagging, drooping, or tired-looking eyes can make us look older than we really feel. Eyelid surgery, or blepharoplasty, is a plastic surgical procedure designed to improve the message our eyes send to those around us.Patients who would benefit from a blepharoplasty include those who experience:Excessive, sagging, or wrinkled upper or lower eyelid skin.Excess upper eyelid skin that interferes with vision.Loss of your natural upper eyelid creaseIf you have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance.Orbital Rim Show: visibility of the bone under the eye sometimes contributing to a dark ring or shadowing.Normally, everyone has a small amount of fat around the eyes. If the quantity of fat increases or the local tissues stretch and weaken, the fat begins to bulge producing “bags.” Occasionally this bulging is seen in young patients and is an inherited family trait, and not a result of aging. These changes have a profound effect on one’s appearance giving a tired or haggard appearance. An attractive face with these early signs of aging can affect a patient’s self-image, attitude and sense of well-being.

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.



This personalized
video answer to your question is posted on RealSelf and on YouTube. To provide
you with a personal and expert response, we use the image(s) you submitted on
RealSelf in the video, but with respect to your privacy, we only show the body
feature in question so you are not personally identifiable. If you prefer not
to have your video question visible on YouTube, please contact us.