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Lower Eyelid Lift Vs. Injectable Fillers

Posted: 3:50 p.m Friday, Jan. 12, 2018

By Anita Mandal, M.D.
Question: I’m 69 years old and have bags and hollows under my eyes. One plastic surgeon recommended surgery to remove the bags. Another said I could have the problem fixed with fillers in my hollows. It’s so confusing. How do I decide which surgeon is right?

Answer: While your eyelids can primarily age as a result of fat protruding into your lower eyelids or from hollowing under the eyes, there are many patients who experience both bulging fat as well as hollowing. An experienced facial plastic surgeon with a keen eye can recognize the difference.

Patients come into my office all the time asking about the bags under their eyes. While some do have bulging fat, you’d be surprised at how many patients actually have hollowing under the eyes which they describe as dark circles or fat bags.

While dark circles can be due to skin discoloration alone, they are commonly the result of hollowing and volume loss of the lower lids. In the latter case, treatment primary involves volumization fillers. While temporary fillers such as Restylane do work, long-term injectable fillers such as Bellafill or stem cells fillers are more cost effective and, quite often, more natural looking.

In cases of bulging lower lid fat alone, surgery to remove the fat through a procedure called blepharoplasty is quite effective and can often be done under local anesthesia alone. However, it is important to recognize patients who have significant hollowing as well. In such cases, removing the fat can worsen hollowing and make you look even more tired and aged.

Careful consultation with a Board Certified Facial Plastic Surgeon who understands the intricate facial and eyelid anatomy as well as the aging process is key to determining the correct procedure(s) for you and achieving the most optimal results.


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