Will Eyes by Thermage Help Reduce Puffy, Baggy Eyes?

There are many causes of eye bags. Some are shadow issues, some are discoloration issues.  So you are right that must people have a multifactorial issue, meaning that there are a few different issues going on. Successful treatment of eye bags requires recognizing this. Thermage can help. I do not think it will make you 100% happy though. It is good as the downtime is little and the risks are smaller than surgery, but the results will also be less.One option that is good for this issue, particularly in young people, is fat transfer to the periorbital area.  This can give great results for patients. Below is a list of some of the most common causes of eye bags. I also included some of the treatments that in my hands get the best results. There are a few videos attached also explaining my treatment process.

1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat transpositioning. 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. Eczema: 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/or 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

Thank you for your question.  Results of Thermage are very unpredictable.  More importantly, this can result in damage to the skin of the eyelid through a burn injury.  Most of the time, puffiness is related to fat herniation and NOT retained fluid.  Non-surgical options can be used to treat eye bags. Oftentimes a dermal
filler can be injected to smooth the contour of the lower eyelid or
tear-trough region. In addition, chemical peels or laser can also be
used to smooth the texture of skin. The issue is that these results are
often not permanent, and over time repeated treatments can be costly.
Factoring in the cost of a peel and filler every 6 to 8 mos, in about 2
years, you would have paid for the cost of a permanent fix.Surgery is
really the gold standard for fixing eye bags. With minimal invasive
techniques (such as a trans-conjunctival blepharoplasty), swelling is
short-lived and downtime can be minimized. This is certainly worth a
discussion with your board-certified plastic surgeon who is experienced
in eye bags treatment. Bets of luck to you! Dr. Pacella

Your best bet is going to be seeking out a physician who is comfortable dealing with the periocular region, specifically the puffiness below your eyelids. There is no solid evidence that Thermage is going to do anything to improve your lower eyelid fluid retention.If the puffiness is due solely to allergies, those need to be treated aggressively before any judgments can be made. Sometimes something as simple as just a low salt diet can help reduce that swelling, or edema, of the lower eyelids. To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.