Under-eye bags: how to diminish them?

Another aesthetic medicine technique for reducing under-eye bags is radiofrequency. Non-invasive, this method uses electromagnetic waves that generate heat in the deep layers of the skin, thereby stimulating the production of collagen and elastin. Radiofrequency is generally considered a gentle alternative to hyaluronic acid injections. It can be performed on various parts of the face, including the delicate area around the eyes to reduce bags. Several sessions may be necessary to achieve satisfactory results.

The effects of radiofrequency in combating signs of skin laxity have been evaluated through several studies. Regarding its effectiveness in the case of under-eye bags, we can cite recent work carried out by ROTSZTEJN and his team. 23 patients received five sessions of radiofrequency at one-week intervals. The measurement of the biomechanical properties of the skin showed a 25% increase in the tension of the upper and lower eyelids. Moreover, out of the 6 patients with under-eye bags, 3 of them observed a reduction in the swelling of their lower eyelid. While radiofrequency is primarily known for its effects on wrinkles, it also appears to have an impact on under-eye bags.

Significantly more invasive, blepharoplasty, or eyelid surgery, is a surgical technique that allows for the removal of excess fat found in cases of adipose pouches. Performed at a minimum under local anesthesia, it sometimes requires spending the following night in the clinic to prevent the risks of post-operative swelling. The blepharoplasty procedure is as follows: the surgeon makes a small incision in the lower eyelid to access the subcutaneous fat and remove the excess. The wound is then closed with sutures.

Blepharoplasty typically yields very good results. A 2011 review evaluated the satisfaction of 50 patients who underwent this procedure and a satisfaction rate of 96% was measured. However, blepharoplasty can lead to complications. Most commonly, it causes edema, which usually subsides after a few weeks. Occasionally, blepharoplasty can also cause an infection, tear secretion disorders, an inability to close the upper eyelid, or more or less permanent scars. Fortunately, most of these inconveniences can be corrected by the surgeon in the days following the operation.

Finally, it is possible to camouflage small fat pockets under the eyes using hyaluronic acid injections. This is injected just below the bags, which allows to fill the hollow present under the swelling and thus visually reduce the bags under the eyes. Hyaluronic acid injections are performed at the dermis level using a cannula with a round tip. Although rare, side effects are possible, ranging from simple redness, bruising or temporary edema to tissue necrosis, including bacterial infections. Rapid intervention can limit the risk of long-term sequelae. Lastly, it should be noted that, as hyaluronic acid is a biodegradable molecule, the results obtained are temporary and last on average between 6 and 24 months.

A recent study has highlighted the benefits of non-crosslinked hyaluronic acid injections in reducing under-eye bags in 55 young women. These patients were monitored for a year and their satisfaction was evaluated: one declared herself "unsatisfied", 9 considered themselves "satisfied", and 45 were "very satisfied". Furthermore, the progression of under-eye bags was observed throughout the year and the improvement was quantified immediately after the procedure, three months later, and six months later. The results are compiled in the table below.