I have been considering doing something to refresh my look. When I look in the mirror, I feel I have a very tired appearance. My eyelids have a puffy appearance, like bags. I have seen a couple of physicians. One recommended having filler injected and the other recommended surgery. I am confused and don’t really understand which is the best way to proceed.
Your condition is very common as well as you confusion. With so many physicians from different specialties performing cosmetic procedures, this is almost commonplace. First, let’s talk about what is going on with your lower eyelids. The eye is inside a “box” or socket. It is surrounded with fat in order to protect it from impact. With time, some of the fat underneath the eyeball starts to come forward. This fat that “bulges” is what is commonly referred to as “eyelid bags” The only treatment to completely eliminate these is to remove them, with a procedure called a blepharoplasty. This is done by removing the fat and then removing some of the skin. Recovery is about a week and can be done with IV anesthesia. The other procedure that you were offered, injecting a filler underneath the eye aims primarily to fill the valley that runs from the inner corner of the eye to the cheek, known as the “tear trough.” One procedure does not exclude the other, as there are people that may benefit from both a blepharoplasty and a filling of the trough. However, you should have the blepharoplasty done first if your are considering both. The filler in the eye can make the surgery very difficult. If the “bags” are primarily what bothers you, surgery is the procedure of choice.
Andres Bustillo, MD