Take a look in the mirror. Do you notice any bags or dark circles under your eyes? These unattractive imperfections can make you look exhausted, stressed out, and older than you really are. While inadequate sleep, salty, processed food, poor health and stress can makes bags and dark circles worse, there are usually some anatomic factors that can’t be addressed with healthy living alone. The good news is that we have identified the true cause for those annoying bags, along with a very effective way to treat them!

Why Do I Look Tired?

Under-eye bags naturally draw our focus. Look a little closer and you’ll notice there are indentations and shadows surrounding them. These areas of sunken skin and dark shadows may be adding to the aged appearance around your eyes.

Many patients looking to resolve under-eye issues are often faced with choosing between lower lid blepharoplasty and non-surgical treatment options with dermal filler. Although both are aimed at “fixing” bags under the eyes, we find that the advantages of dermal filler far exceed those of surgery.

What Is Lower Lid Blepharoplasty?

Lower lid blepharoplasty is a surgery that removes fat (and sometimes skin) to decrease the appearance of under-eye bags. An incision is made either through the skin or inside the eyelids. Fat is then removed in an effort to make the area under the eyes flatter.

Lower lid blepharoplasty is a 60-minute procedure that is usually performed under general anesthesia. The risks include scarring, injury to vision, sunken eyes, and changes to the shape of the lower eyelid.

Learn how Dr. Mabrie customizes dermal filler treatments to reveal Your Perfect Face—the one that looks great from any angle, in any light.

Your Treatment Starts Here

Fillers Are The New Gold Standard

When I finished my surgical training at Stanford and Johns Hopkins more than a decade ago, lower lid blepharoplasty was the go-to procedure for treating under-eye bags. A non-surgical solution for such a significant cosmetic issue was thought to be impossible.

That was then, this is now. Incredible advancements in filler materials and the discovery of new techniques have completely changed the landscape of cosmetic surgery for the better.

Dermal filler treatments are now the gold standard for tear trough deformities, dark circles, and (of course) those pesky under-eye bags.

Having spent years performing both lower lid blepharoplasty and dermal filler treatments, I’ve found that fillers improve the appearance of under-eye bags 90% of the time. This is one of the many reasons why my practice is focusing solely on non-surgical procedures.

If you are one of the rare cases that might still require surgery to fix your bags, I’ll refer you to some of my most trusted colleagues – who also happen to be among the best in the business.

“Why Shouldn’t I Just Get a Lower Lid Blepharoplasty Once Instead of Dermal Filler Injections Over and Over Again?”

Great question! Glad you asked.

-Fillers give better results.

Even though removing fat from beneath the eyes may decrease bulging, it doesn’t fully solve the problem of volume loss and sunken skin the way fillers do. Fillers also address the tear troughs and low cheekbones; lower lid blepharoplasty doesn’t.

-Volume loss continues with age (unfortunately).

Despite our most valiant efforts, our faces will continue to change over time without exception. Sadly, there’s no one-time magical procedure that will last forever. Applying fillers once or twice a year is a great investment in preserving your beauty because you’re able to keep up with the slight changes and shifts that naturally happen to your face. The versatility of dermal fillers is quite remarkable in that way, unlike traditional “one and done” surgical methods.

-The changes are reversible.

Although rare, scarring does occur in a small percentage of lower lid blepharoplasty patients. Once skin or fat is removed it can’t be put back, making scarring very difficult to treat. However, the application of Restylane® under the eyes provides significant effects that are fully reversible. Occasionally, dermal filler may be injected too close to the skin causing some unevenness. If the filler needs to be reduced or adjusted, an enzyme may be placed to dissolve the filler. This ability to reverse or adjust and start over is a huge advantage of fillers.

“What About Bumps, Looking Puffy, Overdone, or Artificial From Fillers Under the Eyes?”

Another great question!

-Treating the tear trough area is technically challenging, so choose a specialist.

The area under the eyes is extremely anatomically complex and aesthetic goals are not always obvious. I feel very comfortable treating this area because of my background as a facial plastic surgeon. I performed hundreds of lower lid blepharoplasties before I began to inject with fillers. This broad knowledge of the anatomy, comfort with surgical techniques, along with my extensive experience with injectable fillers has helped me develop my unique non-surgical approach to treating under-eye bags.

Dr. David Mabrie

For more than a decade, Dr. David Mabrie has been perfecting his technique for optimizing facial beauty with dermal fillers. He is the only facial plastic surgeon in San Francisco whose practice is focused entirely on injectables.

To meet with Dr. Mabrie in San Francisco to discuss blepharoplasty (eyelid surgery) and your non-surgical options for under-eye rejuvenation, request a consultation online or call us at (415) 445-9513 today.