Hello, I'm 24 years old and I have dark circles/bags under my eyes.
These will not go away with make-up as I have shadowing under my eyes under certain lighting
that make them look worse.
I was looking at lower eyelid blepharoplasty as an option.
I've come to realize that there are different ways of doing eyelid surgery.
I'm just wondering, whether anyone can help me answer, do I need fat removed from underneath
my eyes OR excess skin removed by an incision near the lash line?
Thank You for your question!
The age of 24, you have done a good job of learning about your options and you're asking
very reasonable questions.
You recognize you have puffiness and dark circles under your eyes and you want to know
what are your best options is to do the transconjunctival blepharoplasty approach or the incisional
approach from the outside . So let me help you understand what the situation is about
your eyes and how I make my decision of by which procedure to do.
First let's do to help you understanding again what the puffiness is about.
The puffiness is lower eyelid fat prolapse.
This means that the fat that's normally around your eyes pushes forward and creates ad bulge.
Now lower eyelid fat prolapse is typically a genetic issue.
So people who come to me in their 20s and 30s have said, "I have this bags under my
eyes since I was a teenage" and it's very common to hear that and it can happen anytime
in your life.
And again, depending a lot on your genetics but in addition to that, environmental factors
such as sinuses and allergies can also accelerate, eye rubbing, these things can cause puffiness
to occur.
So at the age of 24, I think that it would be safe to say especially looking at your
photos., that there is no excess skin.
And so in my practice, I make the decisions to do the procedure from either the inside
also called transconjunctival blepharoplasty versus the outside based on a few factors.
One of which is relative excess of skin.
You see, lower eyelid puffiness, think of it as a convexity or a bulge pushing forward.
When the puffiness is addressed, whether it is ressected or whether it is repositioned,
whatever is done to make the area of the bulge inward, now you need the same amount of skin
to cover the same surface area and a classic technical issue is when plastic surgeons go
in from the outside because that's what they are comfortable with and they trim a little
bit of skin and it causes to eyelid to pull down or round out.
I can't begin to count out how many patients have come to me for revisional surgery who
found that the lower eyelids are pulled or called the hound dog eyes when they have their
skin removed.
So I would say to you that from my perspective, your best options is a transconjunctival blepharoplasty
which means going from the inside.
In our practice, we also added something to our regimen.
I spent a lot of time focusing on regenerative medicine.
We use a material called extracellular matrix in our hair procedures and this material derived
from pigs bladder has become a game changer in the world of hair loss.
Well when we use this, when we apply this material we actually use a vehicle called
platelet-rich plasma so we are not going to talk about this material specifically but
the concept of regeneration.
You see from being in the practice for 20 years, I have seen how the different trends
in our field and you know 80s to 90s, the trend was about pulling and laser where we
are heating up skin or removing.
Well.
I feel aware of this stage and I've been active in this area of regeneration.
So what I am talking about is something called platelet-rich plasma where we would inject
platelet-rich plasma under the skin to stimulate new collagen.
Platelets are the cells in your body that are responsible for healing when you get a
cut.
So in other medical fields such as oral surgery or orthopaedic surgery, platelet-rich plasma
is always used to accelerate healing for things such as joint injuries.
And so in aesthetics, I've been able to is to was take platelet-rich plasma and help
improve skin quality.
It's as if we are healing the skin so that the skin has a healthier look.
Dark circles which is a whole other discussion dark circles are typically ethnic based on
pigment as well as environmental such as what happens in smoking or with sun exposure and
as well as the skin thickness.
You see, when the skin is thin, you can literally see thru the skin and look at the muscle and
the blood supply underneath.
So again, someone who is 24 who has darkness in the skin, we have a lot of success using
platelet-rich plasma to help improve the skin quality.
So again, to recap my recommendation, it would be, in a typically patient who like yourself
who come into our practice, we would do a combination of transconjunctival blepharoplasty
with the injection of platelet-rich plasma under the eyelid skin to improve the skin
quality and texture.
So I hope that answer is helpful to you and I wish you the best of luck and thank you
for your question.