Medical Minute: Why Do Men Get Eyebags with Age?

August 28, 2017



Today we’re going to talk about how men age, and the ways to treat lower lid bags in men. The aging process affects both men and women. One key area of the face that aging affects is the eyelid region. Heavy upper lids and baggy lower lids can make a person appear tired, sick, older, and sometime even drunk. In men they can make us appear less virile as well.

The eyes are surrounded by fat pads that cushion and support the eyeballs. As we age, the membrane that holds back the lower lid’s fat pads starts to attenuate, or bow forward. Additionally, the eyeballs descend or fall as we age due to relaxation of the ligaments in the eye sockets, and deeper bony changes as well. These factors lead the lower lid fat to shift forward into the lower eyelid space. This is one reason that we see lower lid bags in men as they age.

The second condition affecting the eyelid region with age are eyelid festoons and malar mounds. These also can make a man appear sick or tired. They are usually related to facial sun exposure over the course of our lives. The sun can damage the fragile skin of the lower eyelid and cheek region, fracturing elastic fibers in the skin and leading to eyelid festoons and malar mounds.

Fortunately, there are options to help these conditions and restore men to a healthy, refreshed and vibrant appearance. Surgically, it’s possible to remove or transpose lower lid bags. My preferred way to do this is through the back of the lower eyelid. This is known as a transconjunctival approach. It allows the incision to be hidden on the inside of the lower eyelid and reduces the chance of eyelid malposition after surgery as compared to incisions made through the skin. For lower eyelid festoons and malar mounds, I use lasers to tighten the skin from the outside in. This results in new healthy skin with a large improvement in the lower eyelid festoons and malar mounds.

Aging isn’t kind to our appearance, or to how others perceive us. This affects many men, but there are options to take tired, sick, old-looking eyelids and restore them back to a younger, healthier and more virile look.