I HATE my under eye bags. They are genetic. I want to have them fixed. My aunt had it done but 10 yrs. later she has hollow, sunken orbital area. I don’t want that so I am considering having a filler put in my tear troughs, but I’ve heard horror stories. I’ve tried every type of cream, home remedy, etc.

I’m 39 and I don’t want to look like I’m in my 40’s. I’m attaching a pic taken with light over my head so you can see the bags well. Suggestions?

William Bruno, MD answers: Blepharoplasty or filler in the tear trough?

A: Lower blepharoplasty with fat preservation

Based on your photo, a lower blepharoplasty would be the best procedure for you; not a filler. The type of blepharoplasty would preserve your fat and reposition the fat; not remove fat. This can be done through an incision on the inside portion of your lower eyelid with no external scars or incisions. You do not need any skin removal either. The lower portion of the eyelid which is causing this appearance (septum) needs to be tightened with sutures, this will create a natural appearance and transition from your lower eyelid to cheek.

Please consult with a board certified plastic surgeon who is experienced in this particular type of lower eyelid surgery.

Best wishes,

Dr. Bruno