Thank you for your question.
You submitted your question with a photo and you state in your question that you’re 29-years-old
and you’re ready to do some surgery for the bags under your eyes.
You’re looking for guidance as to what type of surgery to have.
Well, I can certainly share with you my opinion about this type of question which we deal
with every day in our practice.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
And helping people with under eye bags is pretty much the most common procedure that
we do surgically in our practice and has been the case for years.
This is a very common problem that transcends age, race, ethnicity.
It really is remarkable.
In fact, in the same family, I’ve done the same type of surgery in 3 generations.
So I can certainly give you a lot of guidance.
To begin with, we want to first help you understand what exactly is the issue.
The under eye bags represents an anatomic issue called lower eyelid fat prolapse.
Lower eyelid prolapse means that the fat pockets around the eyes has pushed forward.
And in many cases, it has actually increased in volume very often as a genetic trait that
causes this bulging and look of tiredness that makes a person feel like, people are
always asking them if they’re getting enough sleep or are they sad or upset about something.
So, when it comes to a surgical solution for under eye bags, the procedure is called lower
eyelid blepharoplasty.
And when it comes to the details of the solutions, there are two different approaches: one is
called a transcutaneous approach which is to approach the under eye bags from an incision
in the skin from underneath the eyelashes and the other is called a transconjunctival
approach and that’s doing the eyelid surgery from the inside of the eyelid.
Well, I can tell you that it has been my experience and it’s something that I’ve always advocated,
although the standard perception for most general plastic surgeons is to do eyelid surgery
using a transcutaneous approach, I realized that many years ago, early years of my career
that when we’re dealing with a wide variety of ethnic skin types, it’s actually better
to avoid an external incision because of the potential issues related to not just the incision
but with the shape of the eye that occurs after this type of procedure.
So I actually wrote an article years ago called “Ethnic Considerations on Eyelid Surgery”
and it became something that I’ve always referred to because the principles remain
essentially the same.
The question to ask is if you’re going to do an incision on the outside, why are you
doing that?
What’s the advantage?
So when you ask that question, reality is that there is no advantage.
Some doctors will say, well, I’m going to remove a little bit of skin but I can promise
you that, certainly at 29, you don’t have excess skin.
To simplify things, what I would do, my approach would be a transconjunctival lower eyelid
blepharoplasty.
Transconjunctival blepharoplasty is, as I said, performed from the inside of the eyelid.
We go into the fat pockets and basically, are able to shape, remove, reposition, as
is appropriate for the individual patient.
That is a very definitive approach.
The shape of the eye remains stable.
The recovery can be almost minimal.
Essentially, with most people going back to work in a week.
And we sometimes combine transconjunctival blepharoplasty with a procedure of using platelet-rich
plasma.
PRP or platelet-rich plasma is derived from your own blood and it helps to improve the
skin quality under the eyes, as well as in many ways, it helps expedite the healing,
at least, it has been my observation and minimizing the bruising.
So, essentially it is very straightforward in my mind as to what is to be ideal for you.
So, learn more about transconjunctival blepharoplasty.
Look at before and after pictures of your prospective doctor.
Get a sense of the level of experience and ease in which they do this procedure.
Again, a lot of general plastic surgeons prefer the incisional approach, on the outside, coming
for a tradition of treating mostly older Caucasian women.
It’s important to understand that that’s very different from a young Asian male.
So I think that’s very important to factor that in.
I think there’s growing awareness and I do my best on my part to help people understand
that difference.
So I hope that was helpful, I wish you the best of luck and thank you for your question.