I'm 25 and started getting under eye bags and they seem to be getting worse. How can
I get rid of them?
I started noticing the under eye bags and puffiness a few months ago and they are only
getting worse. What can I do to get rid of them? I hate them and feel so self-conscious.
Please help
Thank you for your question!
Your 25 years old and you have submitted several photos of different tints and lighting that
support or illustrate that your concern about bags under the eyes and you want to learn
more about what this issue is.
Well, to give you some background, I’m a cosmetic oculofacial plastic surgeon specialized
in surgery of the eyelids and the face, practicing in Manhattan and Long Island for over 20 years.
If you’re not familiar with cosmetic oculofacial plastic surgery, essentially my training was
first in eye surgery and then I specialized in plastic surgery of the eyes and face. I
deal with complex as well as straightforward issues related to the eyelids and certainly
bags under the eyes is quite a significant part of my practice.
So to learn about what we are dealing with, let’s learn a little bit about the anatomy.
The eyes sit in the space of the bone called the eye socket and referred to as the orbit.
And the fat that cushions the eyes and the structures of the eyes behind the eyes is
referred to as orbital fat. This fat is what is pushing forward under the eyes and creates
puffiness. It’s referred to often in our field as herniated fat. It means this fat
has pushed forward or herniated forward and it’s constantly there.
Very often, people make the natural conclusion that they’re tired or they’re not getting
enough sleep. So they sleep more, they have allergies, they treat the allergies and very
often they go to their local retailer and look for every under eye cream they can find
that’s guaranteed to treat under eye puffiness. Much to their frustration, they find that
these creams don’t work. And that’s because the actual issue is not in the skin. It’s
well behind the skin. The fat that is a physical volume is pushing forward.
In a 25-year-old, in my practice, what we generally do is to perform a procedure called
a lower eyelid blepharoplasty. Now in some patients, when there is only slight fat moving
forward, there is an option of trying to camouflage this to a non-surgical approach which is an
injection using something called hyaluronic acid. Now this is a material that is very
popular and it’s sold under different trade names such as Restylane, Juvederm, Belotero
and it can be of value in camouflaging. But since I can’t tell from a 3-dimensional
perspective with the absence of a physical evaluation, I think I’m just try to guide
you with a more definitive procedure. Unfortunately, a lot of people try to do this camouflaging
approach when the puffiness is too prominent and that creates more issues such as worsening
of the puffiness.
When we do this procedure, it is a surgical procedure done in local anesthesia with LITE™
IV sedation. That means you get a little bit of liquid valium equivalent type of drug that
can relax as you and it’s done in our private office surgical facility. This is a facility
that is equivalent to hospital operating rooms are managed in terms of safety, emergency,
processes and protocols and is certified by the same certifying body called The Joint
Commission. We do this procedure, basically definitively treats the issue of lower eyelid
fat prolapse.
We often do a supporting procedure such as the use of platelet-rich plasma. This is derived
from your own blood and is a concentration of the growth factors that are used for wound
healing to help stimulate collagen and improve skin quality and texture. If there is any
evidence of sun damage or any issue with the environmental effects of on your skin the
platelet-rich plasma has been a very effective technology in regenerative medicine that we’ve
used in conjunction with our lower eyelid surgery.
So I think that given this understanding of the issue, you need to move forward with meeting
with doctors and learning what your options are. In our practice, it is very high value
to our patients that the recover quickly and have their procedure done in the safest way
possible and move on with their lives. I can tell you that in 20 years of practice, puffiness
under the eyes can have such a dramatic impact on a patient’s life because looking tired
has a real impact on how you feel and how others treat you. And many of our patients
say that they’re tired of looking tired. So once they have this procedure, it can really
have a nice effect on your life and any concerns about the surgery and the anesthesia should
always be expressed to your doctor so that you feel comfortable moving forward.
So I hope that was helpful, I wish you the best of luck and thank you for your question!