Non-surgical solutions for droopy eyelids, bags, and other lower eye problems: Part 2

Hello, 6 months ago I had fillers under my eyes. These fillers looked great for three months, until one day I woke up with swollen eyes. Once the swelling had gone I was left with hard lumps under my eyes. I have had 5 lots of injections to try and dissolve the filler but I am still left with hard lumps. Some days the lumps look smaller but other days they can go bigger with some swelling. I am not to sure what to do next.

To the reader above, it really matters which exact filler was used, can you find that out and then write to me again? On a broader note, lower eyelids are trickier for even a good surgeon than upper eyelids. The patient satisfaction rate with lower eyelid surgery is less than that for upper eyelid surgery. Why? It’s because the anatomy of the lower eyelid is more complex and because alterations of even 1 mm in the eye size or eye shape are visible to most people. Upper eyelid surgery generally affects the eye shape less, thus being less. We humans are programmed for thousands of years to “read each others eyes.” We can see fear, sadness, happiness, danger/aggression and love by just looking into someone’s eyes. Pretty amazing!

If you read the first post here about upper non-surgical treatments for droopy eyelids, you already know that eye creams are mainly for prevention of signs of aging, not so much fixing problems. Do USE one for prevention, but don’t expect it to turn back your clock 10 years. Are there non-surgical options for lower eyelid drooping and other common lower eyelid problems? Yes, here are my best suggestions:

Some suggestions for droopy eyelids, bags, and other lower eye problems

  1. Crepey skin.  There are two treatment approaches for creepy skin under the eye. One is to tighten the skin a little with radiofrequency. Thermage has the only FDA approved radiofreqency for the eyelids (I wrote an in-depth resource on this treatment, how it works, effects, costs, etc here). Fractionated lasers also help with texture and tightening. Fractionated CO2 is the most effective, but if you only have a weekend of downtime, book the Fraxel eye tip. The Fraxel eye tip is the only fractionated laser with an approved eye tip.
  2. Sagging of the lower eyelid skin. Same options as above will work well for this, too. Think about surgery if you have a lot of excess skin. If not, the Thermage eye tip, done correctly, and the two lasers above will be most helpful.
  3. Hollow area over the bone under the eye. This makes us look tired. This can be filled with filler if done carefully (see my article on fillers, how they work, costs, and more here). Ideally it’s done either with a canula injection technique, or with very tiny, tiny needles that place about 0.01 of material with each injection and use a “BD” syringe. Experts only please! This area is prone to problems and complications. This is also FDA off-label.
  4. Dark Circles. This makes us look tired. If the problem, is mostly # 3, please go that direction first.  Otherwise dark circles are either brown pigment, fine purplish blood vessels, or both. Lasers are best for this, but please consult an expert clinic. Again, safety around the eyes is critical!
  5. Brown spots. With eye sheilds in place in the eye, the actual eyelid can be treated. Around the eyes, generally the Fraxel Dual FDA approved eye tip with the 1927 wavelength will help.


The skin around the eyelids can be treated with an over the eye plastic cup or sticky laser shields, if the skin is pulled down over the bone (orbital bone).

Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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