The eyes, often deemed the “windows to the soul,” are the most noticeable feature on your face. However, when under-eyes appear tired, puffy, and swollen, it’s like these windows are obscured by worn-out curtains, adding unwanted years to your appearance. Fortunately, there are ways to rejuvenate this delicate area.
New York plastic surgeon Dr. Mokhtar Asaadi emphasizes the complexity of the under-eye region. “The area below the eyelid rim is divided into three main categories: the malar mound, malar edema, and festoons,” explains Dr. Asaadi.
Understanding Under-Eye Bags
Chronic puffiness in the malar mound can give eyes a tired appearance, often present since childhood. “This is usually congenital and may run in families,” Dr. Asaadi notes. “The primary cause is a fat collection under the lower lid, either beneath or over the orbicularis muscle.”
Puffiness above the cheekbones is typically related to malar edema, caused by fluid accumulation that can worsen with allergens. “Malar edema is common in people with hypothyroidism, often referred to as Hashimoto’s Thyroiditis,” Dr. Asaadi adds. This condition is diagnosed through pressure and lateral pull tests to see if the puffiness subsides.
Loose skin under the eyes, known as festoons, results from aging. “During a lateral pull test, the festoon disappears completely, indicating muscle laxity,” explains Dr. Asaadi.
The Risks of Temporary Solutions
Dr. Asaadi warns that the delicate nature of the under-eye area means that improper treatments can worsen the issue. “Many patients have tried fillers, fat grafting, lasers, or heat treatments, which often lead to disappointing results,” he says. “About 65 percent of my patients have had previous treatments that exacerbated the problem.”
Incorrect treatments can lead to subdermal fibrosis, a buildup of scar tissue that disrupts the lymphatic system, causing more puffiness. Even surgical solutions can fail if not properly executed. “Ectropion, or lower lid retraction, can occur if the surgery is not strategically planned,” Dr. Asaadi cautions.
Finding a Permanent Solution
To correct eye bags effectively, understanding the role of anterior septal fat is crucial. “This fat can be very adherent to the muscle, and its removal can significantly reduce post-surgery swelling,” Dr. Asaadi explains. Each patient requires a tailored approach, as the amount of this fat varies.
Dr. Asaadi shares success stories of patients who have struggled with unsuccessful treatments. “I’ve treated patients who underwent multiple blepharoplasties or received numerous filler injections without success. With meticulous care and detailed attention, you can achieve remarkable results,” he says. “Many patients feel like it’s a miracle.”
For those who have struggled with under-eye bags, Dr. Asaadi’s insights offer hope for a more youthful and refreshed appearance.
Related topics:
How to get rid of bags under eyes with ice?
How to fix bags under eyes botox?
What can I put under my eyes for bags?
