What Treatment Do You Recommend for Yellow Cholesterol Deposits in Under Eye Area?

doctor feels fairly confident that there will be minimal scarring and the shape of my eye will not change. My fear is, if the shape of my eye is changed,can it be corrected?I am nervous about the procedure and skeptical that valium and local anesthesia wld b enough to calm my nerves and have been offered propofol (drug that killed micheal jackson)Is it ok to use this drug for such a short and minor procedure? I had propofol before with no problems for a colonoscopy.

Doctor Answers 15

Cholesterol Deposit Treatment

The treatment of Xanthelasma (cholesterol deposits) is fairly easy and painless. A quick injection of Lidocaine to numb the area usually only hurts for 20 seconds. Valium may be given if you feel very anxious. There is usually only minimal bruising and scarring afterwards. The shape of the eyelid should remain the same. Please see your primary care physician to check your cholesterol level. Good luck.

Xanthelasma treatment

These cholesterol deposits around your eye are called xanthelasma. There are many options to treat them including local distraction indirect excision. Local construction can occur with many different modalities, including several lasers.

There are other problems that can look like this, so first off make sure you have the proper diagnosis.

Overall, treatment should not be uncomfortable and your concern over local anesthesia is not one that should limit you having the procedure if you desire to have these removed.

Make sure you see a doctor who is concerned with more than just your cosmetics as well, as these may indicate elevated cholesterol levels that may need addressing for your cardiovascular health.

To guarantee you're receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Cameron Chesnut, MD, FAAD, FACMS, FASDS
Spokane Dermatologic Surgeon
5.0 out of 5 stars 18 reviews

Xanthomas Under Eyes

Dear zany28,


The cholesterol deposits you are referring to are benign growths known as xanthomas. They can be excised in the office with local anesthetic. Hope this helps!

David Cangello, MD
New York Plastic Surgeon
5.0 out of 5 stars 7 reviews

Xanthelasma (cholesterol deposits)

In my experience, full thickness excision of xanthelasma is a good option for patients.  Typically people do not scar badly following this procedure but I would make sure that you go to an oculoplastic or facial plastic surgeon that is familiar with the periocular are and taking care of this problem.  It is always possible that these deposits return.  I have done this procedure both under conscious sedation and valium/local and patients do well with either.  Typically the scar is a fine line and it is better than the appearance of the deposit which can get bigger with time and require a larger surgical scar.

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Cholesterol Eye Bags Treatment

Thanks for your question.  There are several methods to treat these, most commonly, they are treated through direct excision or through laser under local anesthesia.  I understand your concerns about using propofol.  I would be concerned as well. Propofol is one of the most effective and common medications for relaxation during surgery, but it should be used with extreme caution!  Only with careful monitoring of your vitals signs AND under the care of a board certified anesthesiologist or CRNA. Best of luck to you!  Dr. Pacella in San Diego.

Xanthoma treatment

These cholesterol deposits can be excised or cauterized in the office using topical and local anesthesia. The treatment should not change the shape of your eye.

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 71 reviews

How to treat Xanthelasma or Yellow Deposits in the Under Eye Area?

Xanthelasma are due to leaky connections in the capillaries in the eyelid region. They can form in the upper lid or lower eyelid. They can occur with normal blood cholesterol, high blood cholesterol, or even low blood cholesterol. They are frustrating because they act as a contrast to the normal surrounding skin. They occur in all skin types and are most noticeable when patients have darker skin surrounding light colored xanthelasma.

They often extend deep beneath the skin into the underlying muscle layer called the orbicularis muscle. 

One option for treatment include surgically cutting them out which results in a small scar. In terms of changing the shape of the eye, if it is very close to the eyelid margin, then it can change the eye shape and possibly result in something called an ectropion or out turning of the eyelid margin. 

In my practice, I have had success using my Dual Pulsed Erbium laser to plane down the xanthelasma layer by layer until they are gone. The skin then regrows itself over this area but this time without the xanthelasma. 

Although the removal process with surgical cutting or laser can both be effective, new xanthelasma can occur in the same area or different areas in the future. I hope this explanation was helpful. 

Adam Scheiner, MD
Tampa Oculoplastic Surgeon
4.5 out of 5 stars 20 reviews

Yellow cholesterol spots around eyelids

The best treatment for yellow cholesterol spots around eyelids is direct excision. Usually this can be done without significantly changing the shape of the eyes, but sometimes it can't. Only your surgeon can determine that. Also these spots can sometimes come back after removal even if cholesterol level in the blood is well controlled. 

James Motlagh, MD
Tyler Plastic Surgeon
4.5 out of 5 stars 33 reviews

What Treatment Do You Recommend for Yellow Cholesterol Deposits in Under Eye Area?

 Local excision of the Xanthelamas (cholesterol deposits) are a minor procedure.  Local injections plus Profofol seems enough of an anesthetic for this type of surgical procedure.  If a small amount of skin is removed during the xanthelasma removal, the shape of the lower eyelid should not be affected.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 14 reviews


These cholesterol deposits are called xanthelasmas. Though we always recommend that you have your cholesterol checked, often your cholesterol will be normal. You should have it checked however as it is something that is treatable.

Whether you have a high cholesterol or not, if you are predisposed to getting xanthelasmas, they may recur, though not necessarily in the same location.

Treatment can be excision if the lesion is small enough, and not widespread, or laser resurfacing. If excision is done, you will end up trading the yellow spot for a very fine linear scar, which in most cases is a very good trade off. And it is unlikely going to change the shape of your eyes. Valium and local anesthesia is usually enough, though every patient's anxiety is different.

If it is a very large lesion or there are widespread lesions all around the eye, then laser resurfacing is a good option as well, as long as your skin type is not too dark. The laser resurfacing will fade the spots, though it might not be complete as some of these lesions are relatively deep. As I mentioned before, the spots may recur in a few years and repeat treatment may be necessary.

If you post a photo, we could recommend which option might be better for you.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.