The Under-Eye-Bag Dilemma

This column first ran in Valerie Monroe’s newsletter, How Not to F*ck Up Your Face, which you can subscribe to on Substack.

You might think it’s weird, but I happen to like under-eye bags; I think they add character to a face (including my own). But for those less enchanted with them, there are options.

Q: I hate my what’s going on under my eyes. I consulted with a cosmetic dermatologist who uses an Agnes brand RF micro-needling device to treat that area. Price tag: $4,500. Yikes! Is it worth the money? Do your experts have an opinion on this device and/or other viable options?

A: Under-eye bags aren’t on my “to undo” list. But I understand they can make you look tired when you’re not and even festooned when you don’t feel like celebrating. You’re not alone in your predicament, dear Reader: According to the American Society of Plastic Surgeons, there’s been a 13 percent increase in blepharoplasty (surgery to remodel the eyes) between 2019 and 2022. I asked HNTFUYF DermDiva Heidi Waldorf, M.D., for her best advice about solutions. “Any resurfacing procedure that’s deep enough can tighten the skin, reduce creepiness, and make lower eyelid bags look less obvious,” said Waldorf.

A procedure like what? Like what?!

Calm down, people! Dr. Waldorf explains: “That includes treatments using radio-frequency (RF) micro-needling or peeling (ablative RF), and carbon dioxide, erbium, or thulium lasers among others.”

However. (Imagine that word weighs 400 pound.) “The only way to eliminate under-eye bags is with surgery. A lower blepharoplasty (surgery on the lower lids) may include the removal or repositioning of fat pads and removing excess skin.” You can read more about what the surgery involves here.

“If you you want to explore only noninvasive treatment for now, go ahead with the RF micro-needling,” said Waldorf. “But maintain realistic expectations. If you’re on the fence, arrange a consultation with an oculoplastic surgeon who can tell you whether you’d be a candidate for blepharoplasty and what that would entail.” The more information you have, the easier it should be to make a decision.

My two cents: Among my five-ish or so friends who’ve opted for a facelift, they made that choice because they “hated” something about their face or neck. Hate is a strong word about strong feelings. And because you said you hate your under-eye bags, I think Waldorf’s suggestion about seeing an oculoplastic surgeon might be the quickest route for you to decide your facial fate. If you find yourself backing out of the office with alacrity, you can always opt for a less invasive procedure equipped with the knowledge that the dent in your wallet might be a bit greater than the dent in your dissatisfaction.

Originally published on February 27.