Concerns about the recovery time after surgery for under eye bags often motivates people
to pursue the use of fillers as a more convenient option.
In this video, I’ll help you understand how I help my patients make the choice between
injectable fillers, surgery or a combination of the two and minimize downtime.
I’m Dr Amiya Prasad.
I’m a Board Certified Cosmetic Surgeon and Fellowship Trained Oculofacial Plastic and
Reconstructive Surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years.
I’m Dr Amiya Prasad.
I’m a Board Certified Cosmetic Surgeon and Fellowship Trained Oculofacial Plastic and
Reconstructive Surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years.
Why I can answer this question (establishing experience) :
Helping people with the appearance of under eye bags, hollows and lack of cheek volume
has been a significant area of focus in my practice throughout my career.
From the beginning, I’ve always customized my approach to help my patients achieve the
most aesthetic result with minimal risk and downtime.
A common concern for patients who come to us, is the appearance of under eye hollows
which is frequently accompanied by the presence of under eye bags.
In fact, many times, people don’t realize that the reason they perceive hollowness under
their eyes is because they have puffiness which makes the hollowness appear so deep.
It’s actually the contrast of the puffiness which is like a hill and hollow below it creating
a valley.
How I evaluate the patient:
When I examine a patient, I look at certain aspects of their appearance:
The degree of prominence of the under eye bags - it’s important to recognize that
the under eye bags are caused by fat pockets which are normally around the eyes.
These fat pockets under the eyes push forward resulting in what is called herniated fat.
I look at the area called the tear trough and infraorbital rim - this represent the
bone structure which is often also lacking in volume
I also look at the projection of the cheekbones.
It is often, that hollowness under the eyes is accompanied by lack of projection from
the cheekbones.
The relationship of the cheekbones to the eyes is often missed during examination resulting
in a less than ideal appearance after treatment.
Once I complete the evaluation, I discuss treatment options.
Looking at the eyes alone, the question which needs to be answered first is whether to approach
the problem with surgery, non-surgically or with a combination strategy.
The decision is based on the anatomy and the degree of prominence of the fat pockets.
In a situation where the fat pockets are not very prominent and there is a space in the
area called the tear trough for the placement of filler, a nonsurgical approach can result
in significant improvement.
I routinely perform this type of procedure in a way with instruments such as blunt cannulas
which results typically with no bruising.
In situations where a nonsurgical approach is not going to be optimal, surgery is appropriate.
Often, the surgical option is concerning for patients because they’re afraid of anesthesia,
scars, bruising and swelling as well as prolonged healing time.
As I stated earlier, from the beginning of my career, I’ve focused on helping my patients
avoid these issues commonly seen with traditional plastic surgery.
I perform surgery in my private operating facilities which are within my offices which
helps people feel more comfortable with an environment that is more familiar than a hospital
or surgery center.
I perform surgery under local anesthesia with light sedation in contrast to general anesthesia
which is preferred by many of my colleagues.
I usually perform surgery for under eye bags through a transconjunctival approach which
means there are no scars on the outside.
These techniques allow my patients to go back to work in one week with little to no bruising
which means that downtime is minimal.
Although my approach to filler placement under the eyes is generally without bruising, many
people have come to our practice recounting their experience getting fillers done elsewhere
under the eyes with multiple injections which resulted in bruising and swelling that lasted
for weeks.
This is interesting since I routinely perform surgery where there is minimal to no bruising.
The take home message is to understand that injectable fillers can be performed with minimal
bruising and downtime.
Now you know that surgery for under eye bags can also be performed with minimal bruising
and downtime.
I hope you found this information helpful...thank you for your question.