Cosmetic Surgery Blog

I know someone very close to me who has pretty bad under eye bags, and they seem to worsen when they get no sleep. I swear some days they are very minimal, and others—goodness! But how do you tell someone that they need surgery, much less non-surgical remedies for something they probably don’t even know they have, or care?? Unfortunately, eye hollows (like I had) are easier to treat than eye bags. Short of surgery, what are you going to do about them?

First, it depends upon the reason.  Are you simply swollen?  Do you have visible lower fat pads due to thinning skin and volume loss? Do you you have loose skin and excess fat?  As you age your skin thins, your face’s supportive structure becomes weaker and the fat pads fall slightly away from the tear trough area.  Volume loss in the tear trough area, and thin skin create a definitive demarcation, thereby making the eyebags all the more obvious. First, determine the reason yours are visible before going with any option.  I suggest several consultations with different plastic surgeons, including an Oculoplastic surgeon.

Non-surgical

• Injectable Fillers: If you are lucky enough to get away with simply filling the tear trough area with an injectable filler such as Restylane or even have fat grafting, surgical resuspension is an option.  I get this with Restylane about 1 - 2 times a year.

Surgical

• Blepharoplasty:  A blephoraplasty surgery can be performed with the incision made inside the lower lid (Transconjunctival) or with an external incision.  Blepharoplasty was a very common procedure to address eye bags.  Now, many times, the surgeon preserves the existence of the lower fat pads and redistributes the fat pads.    Usually the fat pads can be lifted and readjusted, and not removed entirely. Removing fat pads which can otherwise be rejuvenated, can cause eye hollowness if you’re not careful.  But some patients do, in fact, need fat removal.

Other

• Lasers: Some surgeons use Lasers applied directly to the eye fat using an incision within the eyelid.  This method melts the fat and seems to tighten the surrounding as well. 
• Radiofrequency: I have to say, I don’t like this idea. Ponder this.  RF is used to tighten the skin on the face, and now the hands, tummy, buttocks, etc.  RF is also used to burst fat cells—the same machine in fact.  I won’t say which machine but how can you use it on the face ands not expect some fat loss?  Especially that they now use the same machine for reduction of the eye bags and buccal fat (fat in the lower cheeks), and even submental (underchin) fat as well!  Be careful with this option.  I do not feel that one can control the exact amount of fat reduction one will receive.
• Mesotherapy: Some agents can be injected into fatty areas to burst the fat cell or to cause the fat cell to empty its contents without destroying the membrane.  Although I personally feel that it is difficult to control what the injection agent permeates, I do know it can help.  One study suggested that the “Results showed that appropriately selected patients benefited from the procedure, with 90 percent of the patients reporting improvement in their lower eyelids, although only 62 percent of physicians noted a difference.”  I have had something similar to reduce the scar tissue and some fat from a prior injection below my tear trough, however the agent used was 5FU.  It has significantly reduced the fat and scar tissue.  I can’t even tell you how indebted I am to my doctor, Jonathan Hoenig, MD.  He has been treating me for about 2 years and the result is honestly like night and day.  I used to be self conscious about it, especially that an elective procedure I chose to undergo caused more harm than good.  I don’t have to feel that way anymore.

At Home Treatments

• Preparation-H: I kid you not!  Actually Boudreaux’s Butt Paste seems to be mentioned repeatedly as the best for puffy eyes.  Okay, I have never used this, but I have heard it mentioned on the beauty forums a LOT. I was told that the Prep H stinks and isn’t pleasant to place around the eyes and that the Butt Paste is more mild.  Whatever the case, I don’t get puffy eyes but I can experiment on someone, hehe.
• Cold Tea Bags:  I have used cold tea bags under the premise that the caffeine somehow shrinks the extra baggage, as does the cold.  I never noticed much success though.

What Can You Do on a Day-to-Day Basis?

Sleep with your head elevated, avoid alcohol and salty foods, get plenty of sleep.  That’s about all you can do unless you want to try any of the more invasive options above.  If you have any additional tips, let me know!