Reversing Premature Aging Under the Eyes By Reducing Eye Bags and Improving Fine Lines

Author: Amiya Prasad, M.D.

Thank you for your question! You stated in your question that you’re 24 years old and because of the bags under your eyes and the lines and veins under your eyes that you feel like you aged 15 years in the past 2 years and you sent several photos to help provide me with information to help you determine the best course of action. Well, I can certainly assist you. I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and reconstructive surgeon practicing in Manhattan and Long Island for over 20 years. As an oculofacial plastic surgeon, I actually focused on the cosmetic aspect of our specialty and I treat patients for under eye bags from around the world. So I can certainly understand your pain with these under eye bags. So let’s basically take a step back. I think you’ve done a very good job of analyzing your issues but I would like to give you a sense of how I approach my patients in my practice to help them overcome some of these issues that you described.

Let’s begin with what I see when I look at your photos. When I look at your photos, the dominant feature I see are the puffy under eye bags and those puffy under eye bags are caused by something called lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat pockets that are normally around your eyes pushes forward and creates these bulges and these bulges look like big bags under the eyes. Now I’m sure like many people and many of our patients, you’ve tried under eye creams, you’ve tried different topicals, you’ve tried methods that are recommended when you do search and certainly you’ve seen how none of them work. Well the reason is you have this volume of fat herniated and pushing forward, you really can’t get rid of them with any topical. Now in the context of that puffiness, you have to ask yourself, do the lines and the vein that you are concerned about contribute equally to the appearance of the eyes. The answer is no. It’s really the puffiness that’s the dominant feature.

Now that doesn’t mean that skin quality and texture doesn’t have value. We certainly approach those issues simultaneously when we perform procedures for the under eyes. What I would recommend for someone like yourself is a transconjunctival blepharoplasty. What that means is that I address the fat pockets from behind the eyelid and this way you avoid an external incision and an external scar and you are able to look as if you never had the bags. That’s a very important take away.

When people ask about different methods because we do research and they’ll learn about fat grafting, fat transposition and fat resection and very often, they’re overwhelmed with information and they want to know what’s the best approach and my answer is, the best approach is the approach I’m going to take based on what I see. And I can do all those procedures but I also know that when I get down to it, this puffiness is a volume of fat and there has to be a reduction of that volume. And how to anticipate how it’ll look is based really just imagining what it’ll look like if you didn’t have the bags so you can squint your eyes. Sometimes you can push the fat pockets back and you can get a sense of what things would look like. Now, we routinely do something called platelet-rich plasma injection. Now this is something we use to help the skin quality and texture. Someone who is young, it’s not because of aging but very often, there’s an opportunity to help the skin quality which sometimes is lacking due to genetics as well as concurrent issues like allergies.

Reversing Premature Aging Under the Eyes By Reducing Eye Bags and Improving Fine Lines

So what we do is we draw your blood and we spin it and we concentrate the growth factors and healing factors and what we are able to do is stimulate collagen, stimulate blood supply and in the end improve skin quality. I think that once people see the fat pockets are addressed, they’re usually not as concerned about the fine lines of the veins. So I think that there’s a strategy of looking at things once the dominant issue is addressed. So I recommend that you meet with qualified, experienced cosmetic surgeons.

I know it seems a little bit young to have cosmetic surgery but we’ve operated in patients considerably younger than yourself because this is a genetic issue. It’s remarkable how bags under the eyes can affect people regardless of gender, ethnicity and age. It’s just a matter of how it affects you and with the same one family, I’ve operated in 3 generations. So again, meet with qualified, experienced cosmetic surgeons, explore your options. We perform our procedures under local anesthesia with LITE™ sedation. It’s been very successful for us. We avoid using general anesthesia and our patients recover much faster. This is something that I would like to inform you of so you’ll learn about your options for the anesthesia as well as the surgery itself.

So I hope that was helpful, I wish you the best of luck and thank you for your question!.

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