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  • Q&A with Australian Health Practitioners

    What cosmetic procedure is best for bags under the eyes?

    Related Topic
    Cosmetic Medicine
    Are there options besides surgery ? Or what does surgery involve? Is there someone on the Central coast nsw you could refer. Thanks
    • 2 answers
    • Dr Ehsan Jadoon
    • Dr John Mahony
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  • Dr Ehsan Jadoon

    Cosmetic Physician

    Hi, Bags under the eyes may become prominent  either due to the bulging fat pads or due to increasing hollowness of the tear trough (that makes the rest of the lower eye lid more prominent ).

    Lower lid surgery ( Blepharoplasty ) is the only true treatment for bulging fat pads. Nothing else is going to work in majority of patients. Dermal filler augmentation of tear troughs can improve the over all appearance of volume loss if that's the problem. I find HA fillers in Lower lids to be associated with bruising and swelling in some patients. 

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    Thanks

    Dr John Mahony

    Cosmetic Physician

    Dr John Mahony studied Medicine at Sydney University 1980-1984 graduating early 1985. Internship and residency years followed in the Illawarra, covering general medical and surgical … View Profile

    Ehsan is right, but I think relatively few patients have truly bulging fat pads. Most, instead, have experienced atrophy and/or descent of SOOF and malar fat pad, leading to volume loss inferior to the apparent “bag”. The “bag”  only becomes apparent because of the gap beneath it, not because it is itself protruding.

    Thus, repleting the volume loss in this area with a suitable filler, properly placed, brings about a substantial improvement in most patients with mild to moderate “bags”.

    Having said that, properly repleting this area with filler is a relatively new technique, not widely done well. As is the case with all filler treatments, two or three days of swelling is likely, to a lesser or greater extent, and bruising is never impossible when needles are involved. Still, the long duration of effect (often years) achieved in treating this relatively metabolically-inactive area with fillers makes the risk of a bruise a minor one as compared to the benefit. And surgery carries its own risk as well: in this case, permanent hollowing and scleral show.

    Most non-urgent medical problems are best treated first with the safest approach

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