“Doctor…I want to get rid of the bags under my eyes.” This is a common statement that I hear from new patients on an almost daily basis. In order to determine how to fix these “bags” we must first discover what actually causes them. Are they really bags?
The “bags” under the eyes are commonly caused by protrusion of fat from within the eyelids. This is fat that we all have for our entire lives. As we age, two major things happen to cause the lower eyelid fat to protrude: 1) The ligament that holds this fat within our eyelids actually weakens and 2) We lose volume (fat/bone/muscle) from around our eyes and cheeks.
Traditional surgery for lower eyelids often involves cutting out or removing the fat from the lower eyelid. However, I just told you that there were two main reasons for why those bags form. Neither of those reasons mention that our eyelids got fatter! The unfortunate consequence of removing fat from the lower eyelid is that in some cases, too much fat is removed, and the eyelid can actually appear to be hollow.
In most cases, instead of removing the fat, I reposition or place the fat back into the lower eyelid, where it came from. The best analogy is that of treating the fat like a hernia. It herniated out so we reduce it back into the eyelid. Only minimal fat is removed if any at all.
The next step is to fill in the volume that was lost over the years. This is done using the fat from your own body, called fat grafting. The fat is distilled/purified and then injected in very small amounts back around your eyes and cheeks. This is a long lasting/permanent fix to the lower eyelids.
Treating the “problem” will lead to the most natural looking results. I avoid the “surgical look” by following this principle. In the patient above, I treated her lower eyelids with the above mentioned procedures. She also had laser to reduce the wrinkling under her eyes and the crows feet. She is several months after surgery and notice how she looks like a markedly younger woman in the after picture.