Lower Eyelid Bags & Dark Circles

The eyelid is one of the first places on the face that shows signs of aging. The thin eyelid skin, the underlying eyelid muscle and the fat around the eye are some of the many factors that lead to an aged appearance.

As we age the eyelid skin becomes wrinkled and thinned allowing the dark muscle under the skin to be more evident (dark circles under eyes). The eyelid fat also moves forward and downward to produce a heavy, swollen lower eyelid “bag.” The bags under eyes then produce shadows leading to even more evident dark circles and prominent tear troughs.

There are many ways to remove lower eyelid bags and dark circles under eyes depending on what factors are causing this appearance. Some patients may benefit from volume augmentation with a dermal filler such as Restalyne* to create a smoother transition from the eyelid to the cheek. If more volume is needed, an implant may be a better choice. Others may need improvement in the texture and quality of the skin on the lower eyelid by laser resurfacing, chemical peels or creams. Not all patients will need surgery since some patients will improve by using noninvasive techniques. There is no one right treatment for every lower lid and each patient’s treatment must be individualized. In our office we offer a variety under eye bag treatments and dark circle treatments to correct the appearance of the lower eyelids.

If you are a surgical candidate, we may offer you a lower lid blepharoplasty surgery (under eye bags surgery). Again, there are many ways to perform a lower lid blepharoplasty.

Traditionally both skin and fat were removed from the lower lid to produce a smooth and a less prominent lower eyelid. However, with time the lid may appear hollow and dark if excessive fat is removed. A more novel approach to the lower lid calls for repositioning of the fat over the cheekbone and into the tear trough. This technique augments areas deficient in volume to produce a rejuvenated appearance and a smoother transition from the eyelid to the cheek.

While under IV sedation and local anesthesia in the Cosmetic Center at Washington Eye Physicians & Surgeons, an incision in made in the inside of the lid to access the fat pads which will be repositioned. After the fat is addressed, any loose skin on the lower lid is removed. There are several ways to remove the skin on the lower eyelid which your oculoplastic surgeon can discuss with you. You will have a fuller more rejuvenated appearance and a smoother lid cheek junction after the fat is repositioned. After blepharoplasty surgery, most patients will have bruising and swelling since the eyelid tissue has many blood vessels. There are several ways to minimize swelling and bruising which can be addressed at our cosmetic center.

Correcting dark circles and bags under eyes require attention to detail and a high level of skill which is the premise for consulting with an oculoplastic surgeon with extensive experience in this area. Lower eyelid blepharoplasty is an outpatient procedure that can be performed in the Cosmetic Center at Washington Eye Physicians & Surgeons.