Bags are a bulging of extra fat under the lower eyelids that make the area appear puffy. “Bags are eliminated by removing the fat,” says Madison, WI, facial plastic surgeon Richard Parfitt, MD.
Hollows are a deep concavity in the area caused by a lack of volume (fat) that gives a darkness to the under eyes. Hollows always look worse when they’re sitting next to a bag. “It’s mostly the fat above it (the bag) that accentuates the hollows,” says Boca Raton, FL, oculoplastic surgeon Steven Fagien, MD. Hollows can be camouflaged with fillers or by surgically releasing the ligaments that cause them.
If you have hollows when you’re older, they may have existed when you were younger but may have been camouflaged since there was less or no herniated fat.
How To Fix It
Fixing the bags and puffiness under the eyes requires a surgery that doesn’t take longer than one to two hours. A small incision will be made in the lower eyelid that can’t be seen once you’re fully healed. It’s through this incision that excess skin is removed, fat is removed or repositioned and the muscle is tightened. “We’ve really moved away from taking all of the fat out from under the eyes,” says Dr. Fagien. “Fat still needs to be addressed, since it contributes to the appearance of bags and hollows, however, there are many other causes that can contribute to this that may also need to be addressed.”
If there’s loose skin under your eyes accompanied by bags, a lower blepharoplasty is the best answer says La Jolla, CA, plastic surgeon Robert Singer, MD. “Nothing else will produce the same results and the excess skin needs to be removed.”
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