The lower eyelids and cheeks are common areas of concern by patients, especially those who may complain of dark circles or eye bags. Appearance of this facial area may be a concern before other areas, such as forehead wrinkles. Patients complain of appearing tired despite adequate sleep and energy levels. Even millennials can have bags and dark circles, which is not from age alone.
Plastic surgeons use a variety of terms to describe this region of the face, including the infraorbital rim, tear trough, and mid face. Dark circles, bags, wrinkles, and flat cheeks may negatively draw one’s attention to this facial area. Fortunately, this area can improved with a variety of aesthetic treatments, both surgical and nonsurgical.
Eye bags and dark circles contribute to a tired appearance and commonly treated by facial plastic surgeons. – Houtan Chaboki, MD
Nonsurgical treatment of Eye Bags with Facial Filler
The nonsurgical option with facial fillers is to add volume to the “valley” of the lower eyelid, commonly referred to the tear trough and infraorbital rim by cosmetic surgeons. Facial fillers (ex. Restylane®) or fat injections are used to plump up this area, help camouflage the eye bag, and improve facial contour.
Facial fillers are made of a hyaluronic acid gel, a natural component of the skin, and used by plastic surgeons as part of a liquid facelift for a variety of purposes, ie. plump lips, soften facial wrinkles, and augment cheeks. Examples of hyaluronic acid fillers include Juvederm®, Restylane®, and Belotero®. Eye bag treatment with fillers is performed in the office vial local anesthesia and takes a few minutes by experienced injectors.
How much Facial Filler is needed?
Improving symmetry and balance, while appearing refreshed, will vary due to many factors. The primary factor that determines how much facial filler is required to achieve desired results will be an individual’s anatomy. How much fat is present? Where is fat relatively excess and insufficient? What is the quality of the bone? What is the condition of the skin? etc
During the active phase of treatment, several treatments may be required to build up lost volume and contour the face for correction. The active phase may be over one to three months timeframe and require several syringes of facial filler. One can consider the active phase informally as mild, moderate, or advanced level of treatment. Dr. Chaboki helps patients during consultation to determine the appropriate level of treatment.
Once a desired level of improvement is achieved, a maintenance phase requires less frequent treatments and less facial filler. The maintenance phase may involve approximately one to two syringes every six to twelve months. Patients may combine filler treatments with Botox® or Dysport® injections at the same time.
Surgical treatment of Eye Bags with Blepharoplasty
Lower eyelid plastic surgery (blepharoplasty) is required for those appropriate candidates who want a permanent change for dark circles and eye bags. Cosmetic surgery of the lower eyelid may remove or reposition excess fat, remove sagging skin, and/or tighten eyelid muscle as necessary.
What is the best treatment for Eye Bags?
As with all facial cosmetic surgery, a plastic surgeon will perform an examination and help determine possible options for each patient and help the patient choose the “best” option for them. For those who who have mild eye bags and don’t have the time for recovery, then a nonsurgical liquid lift of the cheeks and lower eyelids may be more appropriate. For those who want a permanent change and have severe eye bags, then lower eyelid surgery (blepharoplasty), fat injections, or cheek implants may be better options.
Facial plastic surgeons typically don’t recommend cosmetic lower eyelid surgery in young patients as the first option. However, each patient is unique and circumstances may vary. Age alone is not a determining factor if a person is a surgical or nonsurgical candidate.
What questions do you have regarding lower eyelid bag or dark circle treatments? Share your questions below and request a consultation.