What procedure do you suggest for droopy lids and under eye bags? I am 55 (Photo)

I have read of many different options. Cheek fillers. Cheek implants. Upper and lower lid surgery. Brow lift.

Doctor Answers 9

Eyelids

It appears that you would be a very good candidate for upper eyelid Blepharoplasty as well as a transconjunctival lower eyelid blepharoplasty possibly combined with a chemical peel.  Be sure and see a qualified facial plastic surgeon or oculoplastic surgeon who has significant experience with cosmetic blepharoplasty surgery.


Lexington Facial Plastic Surgeon
4.8 out of 5 stars 14 reviews

What procedure do you suggest for droopy lids and under eye bags? I am 55

The primary goal of upper eyelid surgery is to remove excess and hooded skin creating the tired look. The primary goal for lower eyelid surgery is to remove the fatty deposits creating the puffiness look through a trans conjunctival incision on the inside of the eyelids. When patients have excess skin on the lower lids at rest, a small pinch excision of that skin can be removed and closed with tissue glue. Cheek implants are performed for patients who have  a flat  maxilla  and a flat cheek profile. A brow lift is performed on patients who have low-set eyebrows. For more information  and many  before and after examples of all these procedures, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Eyelid evaluation

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  You may benefit from upper/lower blepharoplasty, but an in-person examination is needed.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

What procedure do you suggest for droopy lids and under eye bags? I am 55

Great question, but need better pictures to really assess and would need a in person exam, make sure you find a BC PS that can perform these procedures under a local anesthesia, this will decrease costs and risks , god luck!!

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 70 reviews

Less is more.

So much comes down to your precise issues.  Do not have surgery that makes you look like a clown.  You want natural work that will hold up and not cause complication.  Many eyelid surgeons do very mediocre work.  Spend time really studying the work of potential surgeons.  Get more than one opinion.  Do not have the blue plate special where the surgeon proposes to do everything at once.  You likely will be unhappy with there result of that type of work.  Understand what is being propose.  You may need to travel to get the right work.  Please keep us posted about what you learn.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Droopy lids and under eye bags?

It is important to realize that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on very limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. 

Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

4 lid blepharoplasty

Tough to recommend with these photos as they are not close up and somewhat washed out.  However it looks like you have some extra skin in the upper lids which could be removed.  May also have some fat in the lowers which can be repositioned into the tear trough.  See an oculoplastic surgeon for a consult to evaluate the eyelids and muscles to determine what surgery would be best for you. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Eye Rejuvenation

From your photos it appears your upper lids could benefit from an upper lid blepharoplasty with skin and possible muscle resection. You would do well with this. It is hard to assess the brows as you are smiling in the photos. I would need to examine you to determine that. 

There are many causes of eye bags. Some are shadow issues, some are discoloration issues. 

1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat re-positioning. Can also be helped with fillers or auto fat transfer to the face but the ideal treatment in my hands is surgery for this issue.

2. Ezcema: much more common in young people with fair skin. The treatment for this is to hold off on makeup and any manipulation of the lower lid for a few weeks and try some topical anti inflammatory creams. If you have allergies those should be treated also.  A dermatologist is the best person to see for this. We have a multidisciplinary clinic with myself, a plastic surgeon, and my partner, a dermatologist which I think is ideal!

3. Fluid accumulation and/or redundant skin. Could be possible in young patients but would need a good facial analysis and exam to determine. A low salt diet (< 1000mg/day) and a warm compress can help.  I would consider treating with filler/fat transfer, lower lid fractional ablative laser and/or lower lid blepharoplasty.

4. Descent of midface cheek pad. This then causes the nasojugular ligament to become more prominent creating a demarcation and separation of the eye from the cheek subunit. Treated with mid face lift and fat transfer.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of these treatments. This can make a big difference as most people have a combination of the above that lead to the issue.

Hope this helps.

Best of luck,

DrC

Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Upper and Lower Blepharoplasty

Thank you for your question. For drooping upper lids and under eye bags I would highly recommend, Upper and Lower Blepharoplasty to remove unwanted skin and fat. I would recommend you see a specialist, and Oculoplastic Surgeon in your area to discuss your options. Best, Dr. Heffernan

J. Timothy Heffernan, MD
Seattle Oculoplastic Surgeon
4.4 out of 5 stars 8 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.