I am 27 and have always suffered from puffy eyes since highschool. Makeup helps but does not heal! I went for a consultation and it was about 8 minutes so I did not feel comfortable enough to do it the cost was about $2800. He suggested a transconjunc… I just want to know what direction I should be going in. Please help I would like to get this done asap.

Dr A’s Answer:
You Have Tear Troughs.

Your problem is not puffy eyes, it is the groove under the “puffiness”. This situation should be addressed by filling the groove and taking some of the fat that is producing the puffiness and allowing it to blend down into your cheek. You certainly do not need skin removed from your lower eyelids. You are only in your 20’s and you do not have extra stretched-out skin. Furthermore, removal of skin can put you at risk of a pulled or outward turned lower eyelid.

There is no benefit for you in skin removal and there is risk, plus you will have a scar.Your problem has nothing to do with aged or stretched tissues. It is because of how your genetics shaped your face. The lower eyelid fat is protruding out in front of the bone of your cheek. A tear-trough implant will bring the bone further forward to match the location of the fat and at the same time the fat should be smoothed into the cheek. This is a very long lasting way to address the problem and is reversible in the unlikely event you change your mind.

Simply removing the fat is another option, but as you age your eyes will look hollow, especially as you get into your 50’s.

Also fat transfer is an option. This is where fat is liposuctioned from elsewhere on your body and injected into the groove. I am not a proponent of this procedure because of very inconsistent results (the fat may not survive the transfer).

As a temporary solution, Restylane can be injected into the groove.