I am 19 and have permanently puffy lower eye bags. What is the cause, or a good treatment
for this problem?
I am 19 and have permanently puffy lower eye bags. I always get enough sleep and drink
lots of water, but they never go away completely. They show a lot more when I smile or look
away. These puffy bags are shattering my self-confidence and I want them gone! I haven't been to any
doctor about this yet, but I was hoping to get some tips on what it’s called, what
could possibly be the cause, or a recommended treatment without surgery or injections.
Thank you for your question!
You’re 19 years old and you described in wonderful detail and with the photos you submitted,
that you have these permanent puffy under eye bags. You mentioned in your question that
you haven’t seen any doctor as of yet and that you wanted to get some tips.
Well, I’ll certainly help you understand what your situation is based on the photos
you submitted.
I’m a cosmetic oculofacial plastic surgeon, I specialize in eyelid surgery. This means
that my background training was first in eye surgery and then super specialization is plastic
surgery of the eyes and face. Complex as well as straightforward cosmetic surgeries is something
I do a lot and have been doing this for over 20 years in Manhattan and Long Island so I
can certainly speak to you from my experience dealing with this situation.
It’s time to learn a little bit of anatomy based on your photos. What you are seeing
when you described these puffy bags is lower eyelid fat prolapse. Now what this means is
that the fat pads that are normally around your eyes actually push forward and become
herniated and create these bulges.
Now you may ask and wonder why at the age of 19, you have these bags when you may assume
that these bags are typically the results of aging. Well, the reality is, in my experience,
the majority of people who have puffy under eye bags tend to have a family history where
the under eye bags appear at all ages. In fact, under eye bags is probably the most
common thing we perform in terms of eyelid surgery in our practice. It transcends age,
ethnicity, gender and it just really is remarkable as people can be as young as 14 with significant
under eye bags as well as into the 80s and above. So when you think about your situation,
you may kind of want to look at your family history. I can tell you I’ve operated in
my practice in 3 generations in the same family for this exact issue.
So what you’re ultimately going to need some definitive procedure. The timing of the
procedure is when it’s right for you in terms of your comfort level. Typically, for
someone like yourself, at 19, you don’t have extra skin or excess sun damage and things
like that because you’re young. Your photos clearly don’t show anything significant
from the external aspects of your skin. But the puffy bags I would approach typically
in a method called transconjunctival blepharoplasty. Now that’s a long term but it basically
means we’re working from the inside of the eyelid to address those fat pockets. And by
sculpting those fat pockets, we’re able to make the eyes look as if you never had
those fat pockets pushing forward.
It can be a very dramatic improvement in the appearance of the eyes. I always say that
the eyes really brighten up and the face brightens up as well. Many people who come to us for
under eye bags frequently complain that they’re tired of looking tired. So in a situation
like yours, that would be mostly likely the approach that I would use.
I think that any other approach given the degree of puffiness that it appears to be
with those photos you submitted, is not likely to be successful. A lot of times, a lot of
people try to hide and camouflage the puffy bags by adding filler and unfortunately, the
filler makes the eyes look puffier. And we spend a lot of time in our practice helping
those patients who come to us from everywhere to just dissolve that filler. There’s a
very popular filler called hyaluronic acid that goes under the various brand names like
Juvederm, Belotero, Restylane and we use an enzyme called hyaluronidase to melt that hyaluronic
acid away. So I would discourage that based on the photos you submitted.
I think that it’s important that you meet with qualified experienced cosmetic surgeons
and learn what your options are. At 19, you may be able to do this procedure under local
anesthesia with LITE™ sedation. We have done this procedure for patients as young
as 14 who was being teased in school for being on drugs because puffy bags under the eyes
make people look like they’re tired or they’re not sleeping enough and it’s just a natural,
unconscious communication.
So meeting with doctors, learning about their approach, learning about the style by looking
at before and after pictures, learning about how frequently the doctor does these procedures.
I’m a strong believer in specialization and focus in certain areas that is reflective
in my own style in my practice and has certainly been very successful for me. I think that
you want to maximize the chances are for a good result and a result that you’ll be
satisfied with by using these parameters to help guide you. So again, meet with qualified
experienced cosmetic surgeons and move forward. I think, in spite of your young age, that
the puffy bags must have a significant impact on your appearance.
So I hope that was helpful, I wish you the best of luck and thank you for your question!