How Non-Surgical Procedures Can Treat Under Eye Wrinkles, and Why Removing Eye Bags Require Surgery

A young woman has extra skin and wrinkles on top of fat pads under her eyes. She has tried many things like Botox but it causes swelling on her fat pads. Fillers and chemical peels also didn't help at all. She wants to know if surgery would be the best solution to her problem.

Puffiness under the eyes that doesn't go away regardless of sleep, allergy and sinus management is basically a problem called lower eyelid fat prolapse. This occurs because the fat around the eyes pushes forward and like a hernia. When fat prolapse is first manifested, the use of fillers such as Restylane or a hyaluronic acid-type of filler can help. Once it is beyond a certain threshold, one has no choice but to consider a surgical procedure.

Dr. Amiya Prasad, an oculofacial plastic surgeon, routinely performs a procedure called transconjunctival blepharoplasty. This is a procedure where the fat pockets are sculpted behind the eyelid. The results look natural with no outside incision.

To deal with the lines under the eyes, Dr. Prasad recommends a quick recovery type of procedure called fractional CO2 laser. This is applied to the skin and creates columns of thermal energy that stimulates collagen which causes a contracting effect that tightens the skin.

In addition, Dr. Prasad employs a cutting edge called platelet-rich plasma. This is done by drawing the patient's own blood, spinning it down and separating out the active healing component of the blood called the platelets. This stimulates better circulation and collagen to the skin that removes the static wrinkles under the eyes. He would probably supplement and maintain with a treatment such as Botox or Dysport in order to minimize the activity of the muscle so that those wrinkles can be kept under control.

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