Any suggestions for eye fat pads (Always Tired)? (photos)

You are a good candidate for blepharoplasty with fat transposition or fat transfer to the periorbital area. The cost is about the same at my practice ranges from 3000-4500 depending on where the fat is moved to etc. This will help to make a smooth transition from your eye to your cheek. The eye subunit should not be so well demarcated from the cheek subunit. We call this compartmentalization and it happens when we age. Some people sooners than others. In your case it is most likely genetic.Below are some common causes and treatments for this issue. Most people have an aspect of multiple causes. So the key is to make sure we treat everything that is leading to the issue for the best results.1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat transpositioning. Can also be helped with fillers or auto fat transfer to the face but the ideal treatment in my hands is surgery for this issue.

2. Eczema: much more common in young people with fair skin. The treatment for this is to hold off on makeup and any manipulation of the lower lid for a few weeks and try some topical anti inflammatory creams. If you have allergies those should be treated also.  A dermatologist is the best person to see for this. We have a multidisciplinary clinic with myself, a plastic surgeon, and my partner, a dermatologist which I think is ideal!

3. Fluid accumulation and/or redundant skin. Could be possible in young patients but would need a good facial analysis and exam to determine. A low salt diet (< 1000mg/day) and a warm compress can help.  I would consider treating with filler/fat transfer, lower lid fractional ablative laser and/or lower lid blepharoplasty.

4. Descent of midface cheek pad. This then causes the nasojugular ligament to become more prominent creating a demarcation and separation of the eye from the cheek subunit. Treated with mid face lift and/or fat transfer.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of these treatments. This can make a big difference as most people have a combination of the above that lead to the issue.

Hope this helps.

Best of luck,

DrC

Lower lid bowing and scleral show and bone deficiencyYou have a negative vector meaning too little cheek bone.you eyeball appear to bulge forward.  removal of fat will make this worseYou need a filler , or implant and have your eyes checked for graves disease

Hello, I would recommend not removing the fat pads of your lower eyelid. Why? You have volume loss in the midface region and a deep tear trough (the crease just under the bag). If you just remove the fat you risk looking overly hollow in the under eye region, and this will only worsen over time. In my opinion the best and most cost-effective procedure for you over the long term is a lower blepharoplasty with fat repositioning. Here, instead of removing the fat, we relocate it from the bag into the tear trough (we call it "moving the mountain into the valley"). This helps to create a smoother transition between the eyelid and cheek.You can see examples in the link below. Also, many plastic surgery practice accept CareCredit for financing.Good luck!