Removing Eye Bags With and Without Surgery

February 25, 2016 3:10 pm 30 Comments

Nobody likes eye bags. They make us look tired and older than we really are, and too often, they don’t get better with more sleep and a better diet.

Fortunately, there’s more than one way to remove eye bags. As oculoplastic and cosmetic surgeons, we’ve been helping Philadelphia area patients get rid of the bags under their eyes for over 25 years.

In this article, we’ll discuss the major causes of eye bags as well as how to treat them. You’ll see that we use two approaches for treating bags under the eyes: non-surgical dermal fillers and a type of lower eyelid surgery that we’ll call “eye bag removal surgery.”

What Causes Bags Under The Eyes

To understand how under-eye bag treatments work, it helps to know what causes the bags to appear in the first place. There are several factors that can cause someone to have eye bags, and many times, more than one of these factors contribute to eye bags simultaneously. We will discuss three of the most common factors here.

The most common cause of eye bags is a loss of fatty tissue in the upper cheeks, right below the eye bags. This fatty tissue, which resides just below the skin, is present throughout the face. As you age, it breaks down, or “deflates,” in your cheeks at a much faster rate than it does just below your eyes. As a result of this uneven deflation, your eyes are left with elevated or protruding bulges of fat beneath them; these are the eye bags.

Another leading cause of eye bags is a weakening of the orbital septum. The orbital septum is a membrane that “holds” fat under the eye, where it is tucked away from the skin. Normal aging can cause the orbital septum to weaken, and as it does, the fat behind it tends to bulge outward and press on the skin. This bulging of fat causes, or adds to, the appearance of eye bags.

In addition to these causes, some people are genetically predisposed to have extra fat under the eyes; it’s just the way they were born. This, too, is a common cause of eye bags.

Non-Surgical Treatments for Bags Under Eyes

Dermal fillers are typically the treatment of choice for eliminating eye bags without surgery. Dermal fillers are gels composed of a substance called hyaluronic acid, a substance found naturally in the body that can restore lost volume (or add new volume) to facial soft tissue.

For patients whose eye bags are caused by cheek deflation, dermal fillers can restore the smooth transition from the under-eye to the cheeks, thereby eliminating the appearance of bags under the eyes. Some patients with excess fat under the eyes can benefit from this treatment as well, depending on their facial anatomy. Here at the offices of Dr. Swartz and Dr. Cohen, we most frequently use a filler called Voluma for this treatment, although we also use Restylane and/or others in certain situations.

Before and after photo Voluma in upper cheek to smooth away eye bag

Voluma smoothed the contour from eyelid to cheek to diminish this patient’s lower eyelid bags. It was also used to restore youthful fullness to her cheeks.

Before and after photo Voluma and Restylane Silk to get rid of eye bags

This patient’s lower eyelid bags were removed by smoothing the transition from the cheeks to lower eyelids with Voluma and Restylane Silk.

After a non-surgical eye bag treatment, most patients can return to work the same day or the following day, looking their best. Some patients may experience slight tenderness, redness, and/or swelling during the first 7-10 days following their treatment, but this is less common.

Removing Eye Bags With Surgery

For patients whose eye bags are caused by bulging or excess fat under the eyes, Drs. Cohen and Swartz typically recommend a surgical procedure to get rid of the bags.

In an eye bag surgery, the doctors remove and/or adjust fat under the eyes to eliminate the bags. Some patients also benefit from the removal of excess skin under the eyes during this procedure.

Before and after photo lower eyelid surgery to remove eye bags

This patient received lower eyelid surgery to remove her eye bags, and upper eyelid surgery to treat drooping eyelids.

Before and after photo lower eyelid surgery and lower eyelid dermal fillers to remove bags under eyes

A lower blepharoplasty and lower eyelid fillers removed this patient’s under-eye bags.

Most patients resume the majority of normal activities one week after eye bag surgery. Full recovery usually takes four to six weeks, and depends on your body’s natural healing pace and how closely you adhere to the doctor’s post-surgery instructions.

Having A Consultation For Your Eye Bags

A consultation with a cosmetic surgeon is the best way to determine for sure whether you need dermal fillers or surgery for your eye bags. Different surgeons may have different opinions about the best method for treating you, so it is important to find an experienced surgeon that you can trust.

During consultations at our practice, we listen to your concerns about your eye bags, determine what is causing the bags, and work with you to decide on a treatment plan that fits your unique needs and facial anatomy. We will show you before and after images of patients who have had eye bag treatments, and tell you about the procedure so that you know what to expect.

If you receive dermal fillers to smooth away your bags, you may choose to have the treatment performed during the same appointment as your consultation. This treatment is usually only 15-30 minutes in length. If surgery to remove your eye bags is the best course of action, you will have the option to schedule the procedure at the end of your consultation or later. However, at our practice, there is never any pressure to schedule a treatment with us.

When it comes to removing under-eye bags, you may have more than one option for treatment. We wish you luck, and hope that our article has brought you closer to feeling good about your eyes again!

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