Bags Under Eyes – Causes and Solutions

The lower eyelids are a common problem area; bags and dark circles can make you appear chronically tired regardless of how much rest you’ve had.  There are several different causes for both bags under the eyes and dark circles, and each has a different treatment.

“Bags” under the eyes stem from two causes: protruding fat and excess skin.

  • There is a thin layer of connective tissue that stretches from the cheekbone to the lower eyelid.  Behind this connective tissue is fat which protects the eyeball.  This connective tissue weakens and stretches as we age, allowing the fat to “pooch out”, resulting in bags under the eyes. The diagram below is a cross section of the eye. The big circle on top is the actual eyeball, or globe.  The cheekbone is highlighted in orange, and the lower eyelid is highlighted in green (this is actually the tarsal plate, a firm supportive layer of the lower eyelid, but for our purposes calling it the lower eyelid is close enough).  The blue line highlights this connective tissue layer, the orbital septum.  You can see the fat behind it, highlighted in light yellow.
lower blepharoplsaty

Original photo from emedicine.com

  • Skin stretches as we age, and the excess skin contributes to bags under the eyes as well.  The solution for both excess skin and protruding fat is a lower eyelid lift, or blepharoplasty.  The excess skin and a small amount of fat are removed, smoothing the contour of the lower eyelid.

 

Dark circles also have several potential causes:

  • The lower eyelid skin is very thin, so the capillaries and blood vessels show through, causing a purplish shadow.  Sleeping with your head elevated on several pillows and using cold compresses can help constrict these capillaries and improve the appearance of dark circles.
  • In darker skinned individuals the dark circles may be caused by excess skin pigmentation over the lower eyelid.  If this is the case, laser treatments may help even out the pigmentation.

Increasing the amount of collagen in lower eyelid skin may help alleviate dark circles as well.  Topical treatments such as RetinA will help increase levels of collagen.  And laser treatments such as Profractional or Fraxel can also increase the amount of collagen.  Dark circles can be fairly resistant to treatment, however, so you still may find that a good undereye concealer gives you the best improvement.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Can I save money on Botox if my doctor buys it from Canada?

Our practice receives at least one unsolicited fax a week offering cheap Botox® and fillers.  The companies often describe themselves as “outlet” or “online” sources.  And they all have one thing in common: their products are imported from outside the country.

Neurotoxins such as Botox® Cosmetic and Xeomin®, botox bottle and soft tissue fillers such as Juvederm® and Restylane® are a high profit industry.  There is significant competition among practitioners for patients, and offering a lower price will usually bring in more patients.  But the cost of the product itself limits just how low a physician can drop the price and still be profitable.

Medications cost more in the U.S. than in other countries- up to twice as much.   There are a couple reasons for this.  In countries with a public healthcare system, such as Canada and the U.K., the government determines how much it will reimburse for a medication. Private insurance companies just don’t have this type of bargaining power. Another reason is advertising- companies in the U.S. market directly to the consumer, and we pay the cost for this additional marketing.

Foreign companies capitalize on this problem by offering neurotoxins and fillers at huge discounts.  This is not only illegal, however, it is also dangerous.  According to the National Association of Boards of Pharmacy:

Many websites selling prescription drugs are unlicensed, operating illegally, or operating from foreign countries where medicines shipped to the United States are unregulated. Thus, there is no way of knowing whether the medicine you receive is contaminated, sub-potent, super-potent, expired, or counterfeit, or whether it has been stored and shipped under proper conditions to maintain its effectiveness. And that Canadian online pharmacy with the cheaper prices? It may be calling itself a “Canadian pharmacy,” but it may actually obtain its medications from countries in Asia, South America, or Eastern Europe, where quality standards are more lax and counterfeit medications more widespread. 

 

The FDA has sent warnings to as many as 350 medical practices to warn them they may have purchased counterfeit Botox,  so this practice is relatively widespread.  If you are considering treatment with neurotoxins or fillers, I strongly recommend asking your practitioner where he or she purchase medications.  The answer should be: directly from the company, within the United States.

 

What has the biggest impact on your decision making when it comes to cosmetic procedures- is safety most important to you, or are you always looking for the lowest price?

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.