I have eyebags. Though the standard procedure seems to be surgical blepharoplasty and its variants, I have a few questions:

1. What are my options if I want to
   consider non-invasive forms of therapy?
2. Can you give me a summary of the pros and cons of each treatment?

K.K.

Dear K.K.,

1. If you have a tear trough (a deep groove below your eyes due to the bony orbit becoming more obvious as the tissues sag), then using a soft hyaluronic acid filler to fill the groove can improve your appearance. This is somewhat analogous to filling the valley so that the mountain appears lower.
   Periorbital laser resurfacing, i.e. laser treatment around the eyes, will rid the fine lines and tighten the skin slightly.

   These options are not going to be effective if you have prominent herniated fat, as this needs to be dealt with surgically.

BeforeAfter

2. Results with hyaluronic acid fillers are temporary and can last around six months. More viscous or permanent fillers cannot be used around the eyelid area as the skin around this region is very thin and these fillers can produce a ‘sausage roll-look’ under your eyes. As the eyelid area is rich in blood vessels, bruising and swelling can occur after injections with fillers and can take up to a week to settle.

   The possible complications of laser resurfacing are hypo- or hyperpigmentation around the eyes (where skin turns lighter or darker than usual). Hypopigmentation is often permanent. Colour changes like these are more common in individuals who are darker skinned. Hyperpigmentation, on the other hand, is often temporary but can take up to a year to subside.