Thank you for your question. You’re 18-years-old and you submitted a single photo demonstrating
under eye bags. And you state in your question that you’ve had these eye bags for about
a year and that it is affecting your confidence.
Well, I can certainly share with you my approach to evaluating patients like yourself who come
to my practice. A little bit of background, I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice
in Manhattan and Long Island for over 20 years and under eye bags is one of the most popular
things that we deal with in our practice. In fact, half of our patients for under eye
bags are men and it is really remarkable how under eye bags transcend who’s affected
whether it is age, gender, ethnicity. So, certainly I have a lot of experience and I
will guide you as to how I would approach a long-term, permanent solution for someone
like yourself.
To begin with, let’s understand a little bit about what has happened and why it has
happened. Well, what has happened is basically the prolapse or pushing forward of fat that’s
normally around the eyes. When that happens, it is referred to as lower eyelid fat herniation.
It means that the under eye bags are the result of fat pockets that have pushed forward. Now,
the cause of this, when we look at someone who is young, is generally genetics. Now it
doesn’t mean that either of your parents definitely has them but is something that
runs in families. In fact, in my practice, I have actually operated in the same family,
3 generations of people who have under eye bags. It’s very common and I’ve been in
practice for over 20 years, I’ve had the opportunity, certainly, to help people in
terms of their siblings or their children or their parents because of this familial
trait.
Now, the definitive procedure that I would offer on someone like you in our practice
is something that is a long-term solution, would typically be something called a lower
eyelid transconjunctival blepharoplasty. What this is a procedure we perform in our office
under local anesthesia where I approach the fat pockets from behind the eyelid. This way
we are able to avoid external or outside incisions. We are able to address the fat pockets by
reducing and sculpting the fat as is appropriate, repositioning as is appropriate and ultimately
improving the appearance of the eyes by taking away the under eye bags.
Generally, what we do is we do this procedure also with intravenous sedation which means
you are not under general anesthesia but rather you get an intravenous and then get a little
medication to help you relax. The procedure is generally done in less than an hour or
about an hour, give or take, and you are able to go home the same day. Our facilities are
certified by the Joint Commission so essentially what we have done is created a situation where
the safety and the staff are on par with what you receive on a top hospital but in the comfort
of a private office setting. The point of that is because people are very often hesitant
about pursuing certain surgical procedures because of what they perceive as very intimidating
circumstances such as going into a hospital or a surgery center and being one of a lot
of people waiting to have surgical procedures. In our practice, we actually have bypassed
that and allowed our patients to actually comfortably have these procedures very conveniently.
People come here all over the world for this procedure.
So, when you ask about a definitive procedure, again, I would recommend a transconjunctival
lower eyelid blepharoplasty performed under local anesthesia and LITE™ sedation. I recommend
that you meet with qualified, experienced cosmetic surgeons. Learn about their approach,
learn about your options. Look at some before and after pictures. It is very important to
get a sense of what the surgeon’s style is and what their approach is and if there
are any other supplementary or complementary procedures that would be of value. But I would
think more typically, I would just perform the lower eyelid blepharoplasty. Sometimes
I would combine something like platelet-rich plasma (PRP) which is derived from your own
blood and is a concentration of the growth factors for wound healing to help improve
the outcome of the procedure in terms of healing as well as to improve skin quality and texture
but that requires a physical examination and is a separate issue.
So I hope that was helpful, I wish you the best of luck and thank you for your question!