Lower eye bags: Too little or too much fat?

Lower eyelid bags develop from a variety of factors. One factor is excess fat around the eye itself. A majority of plastic surgery patients gain eye fat naturally with age. Signs of excess eye fat may first appear in the 30’s and progress gradually with time. Some patients are born with relatively excess eye fat and have lower eyelid bags early in life.

A second factor of lower eye bags is actually too little fat in the area beneath or under the eye bag itself. This insufficient facial fat volume is gradually lost or shrinks with time. We all loose fat in our faces, in addition to muscle and bone volume, as we get older. The contrast between relatively excess fat within the eye bag and the insufficient fat below the bag are usually the main factors of the eye bag in patients.

Lower eye bags are due to multiple factors, including the quality and amount of skin, fat, and muscle of the lower eyelid – Houtan Chaboki, MD

Other factors contributing to lower eyelid bags include the qualities of the lower eyelid skin and muscle, which sag with age. So how do plastic surgeons improve the lower eyelid? Essentially a lower eye lift (blepharoplasty) will reduce and add volume in the appropriate areas. Fat reduction around the eye is only performed with eyelid surgery (blepharoplasty), while adding volume below the eye can be performed with plastic surgery, fat injection, or office facial fillers (ex. Restylane). Ultimately, your eyelid plastic surgeon will tailor the specific treatment based on your specific anatomy and personal preferences. There isn’t one “best” method to reduce eye bags.

This patient is an example of combination treatment to achieve the patient’s desired results. He underwent lower eyelid surgery via an incision hidden behind the eyelid and fat injection. Recovery was relatively quick with minimal discomfort. Share your thoughts below.