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Lower Eyelid Surgery for Under Eye Bags / Dark Circles

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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!

Featured Cases

Case 377

ABOUT OUR PATIENT This patient of mine, a young woman from the South Bay in California, wasn't feeling too happy with her profile, or the dark circles that were creeping up beneath her eyes. She came to my San Francisco office for a consultation, specifically asking about the possibilities that Dermal Fillers could provide. The first thing I noticed during our examination was that she had v...

Case 348

ABOUT OUR PATIENT This particular case is one that I'm very excited to share with you. This patient had been seeking help around San Francisco for non-surgical rejuvenation when he found our practice online. He knew he wanted to look more refreshed to reflect his charismatic personality, but he wasn't sure what kind of treatment would help him accomplish this. DR. MABRIE'S TREATMENT PLAN During...

Case 343

ABOUT OUR PATIENT Ever since she could remember, this patient had laugh lines that distracted from her graceful good looks. Last year, after searching around for non-surgical laugh line reduction in San Francisco, she was referred to our practice by one of her good friends. Soon after, she stopped by my office for an in-depth consultation.  DR. MABRIE’S TREATMENT PLAN  The...

Case 317

ABOUT OUR PATIENT This young Bay Area woman had previously received a non-surgical Juvederm treatment to address the circles that were appearing under her eyes, but she wasn't exactly satisfied with the results. After reading some of my patient reviews online and noting my unique approach and focus on non-surgical facial sculpting, she decided to come in for a consultation at my downtown San Fran...

Case 314

ABOUT OUR PATIENT This patient of mine is an African American man in his 20's. He started becoming interested in non-surgical cosmetic procedures after deciding that he wanted a more defined nose and enhanced facial appearance. After seeing some of my YouTube videos online, he came into our San Francisco office for a consultation to find out how using facial dermal fillers could significantly tra...

Case 241

Background: This young woman consulted with Dr. Mabrie about her eyes, which were slowly looking older. She was noticing more wrinkles above and below the eyes and met with Dr. Mabrie to discuss upper lid and lower lid blepharoplasty. Importantly, she wanted to preserve the general shape of her eyes and was concerned that surgery might change how her eyes looked. Dr. Mabrie's Assessment: "Th...

Case 230

ABOUT OUR PATIENT Developing bags under your eyes is a common sign of aging that can be easily remedied with the use of facial Dermal Fillers. This particular patient of mine, from Northern California, approached me about the bags she started seeing beneath her eyes. She visited my office located in the San Francisco Bay Area, and we discussed non-invasive, non-surgical cosmetic solutions. DR....

Case 171

ABOUT OUR PATIENT A successful hair stylist in San Francisco, this patient came in to see me about persistent dark circles under her eyes. These circles caused her to look tired no matter how much sleep she tried to get every night. This is a common concern for most patients who come to see me for a consultation, so I had plenty of non-surgical solutions to offer her. These dark circles were bei...

Case 170

ABOUT OUR PATIENT This woman, from the Bay Area, asked me about her lips when she came in for a consultation at my office in downtown San Francisco. We discussed the many benefits and options for Lip Augmentation, and determined which ones would give her the ideal results she wanted. I found this patient to be another perfect candidate for dermal filler injections. While we were going over the p...

Case 119

ABOUT OUR PATIENT When this particular patient, a San Francisco businesswoman, first came in to talk to me about the possibilities of plastic surgery, she wanted to know how to remove the wrinkles that were starting to show in different areas around her face using non-surgical methods. We also talked a little bit about adding more definition to her cheekbone area. This case interested me quite a...

Case 39

Background: This Bay Area woman had long noticed bags under her eyes. She had considered blepharoplasty in the past but had been reluctant, worried about possible complications. She consulted with Dr. Mabrie about cosmetic surgery options for her eyes. Dr. Mabrie's Assessment: Looking at the preoperative image, one may see that she has very prominent lower lid bags. This is caused by a protrusion...

Case 23

Background:  Bay Area professional woman who had slowly noticed a heavy appearance of her upper eyelids.  She also had started to develop bags under her eyes.  Being very professionally and socially active, she consulted with Dr. Mabrie about surgical options to rejuvenate her facial appearance. Dr. Mabrie's Assessment: There is heaviness of the upper eyelid, particularly on the ou...

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See All Before & After Photos

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Dr. Mabrie's innovative treatment process uses fillers to reveal the rockstar version of you.

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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.

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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.

Treating Dark Circles with Non-Surgical Cheek Augmentation

January 2013

"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).

Your Perfect Face

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Dr. Mabrie uses his expertise to combine treatments that target each of your cosmetic concerns for total rejuvenation.

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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.

San Francisco Facial Plastic Surgeon David C. Mabrie M.D., F.A.C.S.

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The Surgeon

Dr. David Mabrie offers:

  • Double board certification
  • Excellent training & experience
  • Specialization in the face and neck
  • A trainer's skill in injectable filler techniques
Why Dr. Mabrie
Request a Consultation

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.

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Mabrie Facial Cosmetic: David C. Mabrie, MD
166 Geary Street
13th Floor

San Francisco, CA 94108
Phone: (415) 445-9513
Monday–Friday 8:30 a.m.–6 p.m.