How to treat under eye bags!

Hi my beauties! In clinic this week I saw a lot of you beauties that were concerned with under eye bags, so I thought this would be a perfect topic to talk about for this week's blog post! 

So what causes under eye bags? 

Under eye bags are caused by unevenness in the fat pad underneath the eyes. This can be due to general aging and retraction of the fat pad, wherein it retracts and bunches up under the eye and creates a sunken area in between the eye and the cheek, which we call a tear trough. This unevenness can also be genetic, but most times we see it as a person ages. Smoothness in this area is correlated with a youthful healthy look, so when this fat pad retraction happens it leads to looking tired or older. So what are our treatment options? 

Dermal fillers 

One of the best ways to restore youthfulness and smoothness to this area is by injecting a little bit of filler into the hollow area between the fat pad and the cheek. This helps to fill in the sunken area and smooth out the eye/cheek junction, leading to a more rested and youthful appearance. 

Please note that this is a high risk area for injection, so make sure that you go to someone who is highly skilled in this area. You also want to make sure your injector starts slow and doesn’t overfill the area, and pays close attention to keeping the balance in your face. Sometimes in order to maintain that balance you will need filler under the eyes and a little bit in the cheeks as well to maintain harmony in the facial structure. When done correctly dermal fillers in the tear troughs can yield amazing results! 

Resurfacing lasers 

Lasers work by tightening the skin, and when we tighten the skin on top of any issue it will always lead to better outcomes. You can use ablative, non ablative, or even light superficial fractionated devices like Clear and Brilliant in this area. Doing a resurfacing laser a few times a year will help stimulate collagen and elastin and tighten the skin that overlays the bags underneath. This treatment won’t necessarily get rid of the bags completely, depending on how severe they are, but tightening the skin and stimulating collagen and elastin synthesis will always help! 

Microneedling & tightening devices

Thermage is one of my favorite ways to stimulate collagen synthesis, especially in the eye area! There is a specific handpiece for Thermage that is designed for the eye area. It’s not painful, takes about 45 minutes and the results will last you about 5-7 years. 

As I’ve said before, I’m not a huge fan of microneedling, but it is a service that other providers offer so I want to mention it here anyway. I typically see less than optimal results from micro needling. A lot of times people will feel that they got great results from microneedling temporarily after the treatment (due to the swelling and inflammation right after) and then once the swelling goes down they are back down to their baseline. In the worst case scenario I’ve seen microneedling cause infection or post inflammatory hyperpigmentation, which will lead to looking worse than before you had the treatment! So for these reasons I always prefer lasers over microneedling. 

Chemical peels 

I’m not a huge fan of peels either, not because they’re not good but because I just prefer lasers and tightening devices. But again, this is a service that is offered elsewhere so let’s talk about it. When chemical peels are done under the eye area they stimulate collagen and tighten the area. Some providers have been using phenol peels under the eyes. This is the most aggressive type of chemical peel and requires cardiac monitoring during the treatment. So this isn’t something I perform in my office, but it’s getting a lot of hype in the community right now. 

Combination therapy 

You can do a combination of the above treatments to really maximize your results! I always recommend performing one treatment at a time. This way you can see which treatments give you the best results, and you can work upwards from there. I love to combine Thermage and Fraxel together, called Thermafrax, to stimulate collagen and tighten the skin under the eyes. It gives a beautiful tight and smooth look! 


Of course, surgery is always an option for those who need or want it! My one note for this is to make sure that when you are seeking out a surgeon to augment your under eye bags that you choose one that will use the new method. It used to be that all doctors would simply remove the fat pads from under the eyes, however, in time this leads to people looking sunken in or hollow later on. The ‘new’ way of performing under eye surgery is to simply reposition the fat pad, as opposed to removing it completely. This smoothes out the eye/cheek junction that gives a beautiful appearance without looking sunken later on. 

Eye serums 

It’s so important to make sure you are taking care of the skin under your eyes every single day at home! Make sure to use a high quality eye cream that is formulated specifically for the eye area with potent actives & sophisticated delivery systems. My MDAiRE Regenerative ECM Eye Complex is formulated to be extremely effective under the eye area, and I use it every day to maintain youthful looking eyes!

To find out what I’ve done over the years to maintain youthful under eyes check out my YouTube video below! While you're there leave a comment and subscribe to my channel so you never miss a Sunday skin video!


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