Dear Dr. Seckel- I am a 25-year-old male who has had hereditary dark circles under my eyes my whole life. I do not have “bags” per se, but my under eyes are sunken as well as darker in color. I recently consulted a surgeon who suggested a transconjunctival blepharoplasty to “get rid of excess fatty tissue”. I happen to disagree with him, however, being that my under eyes are sunken and, if anything, lack “fatty tissue”. From what I’ve read, transconjuctival belpharoplasties don’t allow for the removal of any excess skin, which worries me because when I pull back slightly on my under eye skin, my eyes look ideal. I am wondering what type of procedure you would suggest for a patient like myself. Thank you, Mark, Malvern, PA.
Dear Mark,
I agree with you. If you have dark circles under the eys and your eyelids are sunken in a Transconjunctival Blepharoplasty with fat removal would only make you look worse.
A Transconjunctival laser blepharoplasty with an Arcus Marginalis release and a fat graft or a tear trough implant to fill in the hollow would give the eyelid a more natural appearance and correct the dark circles under the eyes. I would have to examine you to be sure but I am guessing this would be the eyelid rejuvenation procedure which would satisfy you the most. I do this operation with a laser.
Following this procedure removal of eyelid skin is not usually necessary because the fat graft or implant puffs the hollow and tenses the skin for a nice youthful look.
If skin removal is necessary a small pinch blepharoplasty excision can be done from the outside corner-but at 25 years old I doubt very much if you need skin excision. I believe the reason you like the look when you pull the skin back is that you are tightening the structures underneath the skin and forcing the fatty inside the eyelid down into the hollow.
These operations are very complex, require experience, and especially in a young person like you it is essential that they be performed correctly.
For more information on eyelid rejuvenation, transconjunctival blepharoplasty, dark circles under the eys, and non-surgical facial rejuvenation read Save Your Face or contact me.
Thank you,
Boston, Massachusetts