Thank
you for your question.
You submitted 2 photos.
One of yourself and your mother and you state that you are dealing with under eye bags that
are genetically caused and you are looking for a non-surgical solution to prevent your
under eye area from looking like your mother’s and you submitted 2 very good photos to help
illustrate your concern.
So certainly, I can give you some guidance about the issues related to under eye bags.
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 the aesthetics around their eyes is a big part of what I do in my day to day practice.
So, when I look at the photos you submitted, I have to at least break down a little bit
of what you are describing as under eye bags.
So where I typically look when someone questions me about having under eye bags is usually
in an area that’s above the bone structure or the rim where the eyes would look puffy
and have large pockets which are typically referred to as lower eyelid fat prolapse.
In your situation, the photo you submitted of your mother, I don’t see those things.
What I believe you are probably referring to is actually the area right below the eyelid
margin where the eyelid skin appears to bulge a little bit especially when you smile and
very often people do come in and refer to that area as under eye bags.
The differentiation between this area for you and your mother is that for your mother,
it appears to be a little bit more prominent and you see a few more lines.
So in terms of management in this area, it is very important to first understand what
the basis for this concern is.
Well, if it’s when you are smiling or even when, baseline, not smiling, there is a little
bit of a ridge there.
That ridge represents a muscle called orbicularis oculi muscle and this is a muscle that is
important for the support of the lower eyelid.
In general, this is not something that really responds well to most non-surgical options
and the definitive one or the most common or popular one being an injection of a neurotoxin
like Botox® or Dysport®.
What that’s doing is to relax the muscle slightly so that the muscle doesn’t bunch.
Basically, when you smile, the orbicularis oculi muscle contracts and when it contracts,
it causes a ridge to form.
So it is possible to put something like micro Botox® or very small number of units of Botox®
in your mother’s situation more than in yours.
Now, there is also an opportunity sometimes to at least explore the area below called
the tear trough.
And in this tear trough area, there may be a little bit of contrast that we are not appreciating
with the photos you submitted where it may look relatively hollow compared to the area
just above it which might have a slight degree of puffiness.
Now this tear trough area is a relative hollow that can be addressed with the use of fillers
such as Restylane or Juvederm or basically hyaluronic acid filler that can fill this
area and we often combine that with something called platelet-rich plasma (PRP).
Platelet-rich plasma (PRP) is derived from your own blood and consists of a concentration
of the wound healing and growth factors that are necessary when you have an injury or a
wound.
So what we are basically doing is we are trying to improve the tissue quality as well as the
skin quality to help stimulate collagen, blood supply and overall fill this area.
Now, this solution would probably be more appropriate for your mother than for yourself.
I realize that you are trying to do everything you can to try and prevent the aging process
to be as significant for you but unfortunately, there isn’t always so much that you can
do.
Now it doesn’t mean that there are things you can’t do to take action but it doesn’t
necessarily mean procedures.
What I am referring to is healthy lifestyle, avoiding excess sun exposure, eating a good
diet, getting enough sleep, minimizing stressors.
But otherwise, the genetics of aging, there is an opportunity, maybe when you are a little
bit older, to do things such as platelet-rich plasma(PRP) and fillers to try to minimize
some of the signs of aging.
However, I think it’s a little bit early for you to do anything that is more invasive
based on the photo you submitted.
Now if there is a level of dimensionality that is not being appreciated, certainly it
is always valuable and beneficial to at least meet with a doctor who can guide you and your
mother about options.
It is not unusual for me in my practice to take care of people in several generations
because of this genetic tendency to have these types of issues but at the same time, it is
also the role of your physician to guide you when to do something and what to do as what
not to do.
So meet with doctors who you feel comfortable with.
Learn about your options, understand the distinction, the anatomic issues as well as the strategies
and then figure out what is worth pursuing and what is worth deferring until later.
So I hope that was helpful, I wish you the best of luck and thank you for your question.