Is there any way to remove this kind of eye bag/ dark circle?
My eye bags have two layers -- looks like I have double eye bags.
On a good day, I have only one.
I had these for years now and cream doesn't seem to help.
I was wondering if there's any way to remove them?
Maybe without surgery?
Thank you for your question!
You mentioned in your question that there are days where you appear to have double bags,
that you’ve tried creams and you want to try to eliminate the bag without surgery.
So, certainly, this is a question I am not stranger to.
I’m cosmetic oculofacial plastic surgeon practicing in Manhattan and Long Island for
over 20 years and the question you are asking is a question we get to deal every day.
So, we begin with education and understanding what is the basis for the bags.
In the photos you submitted, one was with your face relaxed and one was with you smiling.
And I think I’m interpreting it in the correct way when you described one bags as being from
the eyelid margin or the eyelashes to just below before the second bag begins.
And that’s space that become puffy is actually a muscle called the orbicularis oculi muscle.
Now this muscle is activated when you smile and so it has tendency to bulge kind of like
a bicep that bulges when it contracts.
For most people, that’s a scenario that we don’t really recommend doing anything
for.
Since it’s a muscle, you need.
The muscle supports the lower eyelid, it’s important.
We do periodically a trial of neurotoxin like botox which is non-surgical and see if it
contracts a little bit less.
But I think the challenge with an area like that is that you can’t relax too much otherwise
you are at risk for the lower lids sagging.
I also recommend that people reevaluate what they look like because although it appears
when you smile when the area is activated in terms of the muscle, it generally doesn’t
make someone look tired.
Now, it brings us to the next area which is the puffiness under that area and that area
which is puffy all the time and creams as you saw it, doesn’t help is due to something
called lower eyelid fat prolapse.
It’s very clear from your photos that there is a bulge of fat that has moved forward and
created this bulge.
The procedure for that is lower eyelid blepharoplasty.
I know you are looking for a non-surgical option.
If there was a non-surgical option then one of the top 5 surgical surgeries would stop
being that.
And although a lot of devices are market to try to non-surgically treat this area, people
try to camouflage this with all kinds of injectables but a certain point, none of those things
can really make a difference because the anatomy is very straight forward.
It’s fat that’s pushed forward.
MRI studies have actually shown this to be fat that’s actually increased in volume.
It generally runs in families.
So within the same family, I had the privilege of operating in 3 generations.
So my recommendation based on your photos would be to do something called a transconjunctival
blepharoplasty.
What this means that I would address the fat pockets from the inside of the eyelid to avoid
any external scar.
At the same time, reduce the puffiness and create a contour either through the removal,
sculpting and repositioning so that it looks like you never had the bags to begin with.
This procedure lasts for a very long time.
Those fat pockets don’t come back and we perform this surgery under local anesthesia
with LITE IV sedation in our Joint Commission facilities.
You see, over the 20 years, we’ve worked on developing systems and processes so that
people like you who have an aversion to surgery especially when you watch TV and you see all
the potential disastrous effects of surgery, we do everything to make people comfortable.
Lower eyelid surgery can be complex and unfortunately, many people do have some complications where
as a specialists, I get to fix those complications.
We get patients from around the world to have these procedures revised whether it’s residual
fat or fat transfer where fat was placed, we actually remove that; lower lid retraction
where the eyelid was pulled down and ectropion where the eyelid was everted out.
In spite of all those potential complications, it can be remarkably satisfactory surgery
when performed well in good hands and of course, you have to be always prepared for the things
that can happen.
Every surgeon has to deal with these issues no matter how good they are, how much experience.
So my recommendation is at this point is to meet with qualified experienced cosmetic surgeons
and determine for your comfort level the kind of doctor you feel has the level of expertise,
knowledge and experience that you trust to have your eyelid surgery performed.
Otherwise, you will be spending a lot of time and money on things that are not likely to
work.
Again, this is all based on photos and not on an actual physical exam which is the appropriate
next step for you is to meet with a doctor and have a physical exam and look at the tone
of the eye and the other things that are important in planning this type of procedure.
So I hope that was helpful, I wish you the best of luck and thank you for your question!