What if Anything, Can I Do About the Fat Pockets Above my Eyes? (photo)

Ok, I asked this once, but I think I should have been more clearer. I have these fat pockets above both my eyelids. One fat pocket is smaller and less noticeable than the other, but they are both there. They definitely make my eyes look more closed than they should. If I slightly elevate the area where the fat pockets are its a huge difference. I am 20 yrs. old, is that too young for surgery? What are the other alternatives? Would I need orbital decompression surgery?

Doctor Answers 11

Prominent Lacrimal Glands

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It's not unusual for patients to develop prominent fat pads around their eyes with normal facial aging. Sometimes when these fat pads are laterally positioned, they can be confused with prominent lacrimal glands. Although your pictures are helpful, it's virtually impossible to make this differentiation without a physical exam.

When patients have prominent lacrimal glands, a simple procedure can be performed to re-suspend the gland to correct this aesthetic deformity. In contrast, prominent fat pads usually require a formal blepharoplasty. Although there are no strict age criteria for blepharoplasty, this procedure should be approached with caution in someone who's only twenty.

If you're concerned about the aesthetics of your periorbital area, it's appropriate to consult a board certified plastic surgeon. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Fullness in upper eyelids: what can be done

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Fullness in upper eyelids: what can be done
An exam to see if this is fat or gland would help.  You have deep set eyes. Another consideration is lowering the fold unless you like the deep set appearance

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Fat removal with blepharoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for sharing your question. Many young people are bothered by the extra fat in their upper or lower eyelids. After 20 years old it is reasonable to have a blepharoplasty performed. This is the removal of excess fat and skin from the eyelid. It has about a 2 week recovery time and usually yields excellent results. I hope this helps you and others with similar questions.

Outide corner or inside corner?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If its the inside corner, then fat may be the issue, if its the outside corner, it likely is the lacrimal [tear] gland that is prolapsing for the orbit [eye socket].

This is not unsual in African-American patients, as their orbits are a bit shallower and their eyes are often a bit more prominent.

This can be addressed surgically but resuspending the gland. Although there are many experience surgeons that can provide this expertise, ASOPRS trained Oculoplastics surgeons may have the most experience.

You can find one close to you on the ASOPRS dot org website.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Removing fat pockets on the upper eyelids...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fat pockets within the upper eyelids can be reduced by simply placing incisions in the crease of each eye and surgically decreasing the amount present.  When you have fullness on the outer part of the eyelid, it may represent a droopy lacrimal gland (the gland that produces tears).  This can be lifted up and sutured down during the same procedure.  This procedure is normally done under local anesthesia, but can be performed under general anesthesia as well.  Fine sutures are used to close the incisions.  The procedure takes about an hour, and you are able to go home the same day.  There is no age criterion - the anatomy dictates what needs to be done, but I would make a consultation with a board certified facial plastic, plastic, or oculoplastic surgeon to discuss all of your options. Good luck.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

Treating fat pockets above the eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Fat pockets located in the inner corners of the upper eyelids can be easily removed through a small incision in the eyelid crease.  Usually the fat pads are removed at the time of an upper blepharoplasty incisions are then closed with dissolvable sutures.  The goal of an upper blepharoplasty is to remove excess skin and medial fat pockets and is often performed under brief general anesthesia.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I do not think your age alone would disqualify you from surgery. I thought you were pretty clear on your first post and this post does not change my answer to your first post. I don't see any need for orbital decompression.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Prolapsed lacrimal glands

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

What you are describing may or may not be your lacrimal glands. It is best to get a personal consult and examination by an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Fat pockets above eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Mz Understood.  The fat pockets above your eyes are located towards the outer aspect and probably represent your tear producing glands (lacrimal glands).  These need to be repositioned behind the bone above the 'fat pockets' which  is accomplished by way of a standard upper eyelid incision.  You should arrange a consultation with your local plastic surgeon.  Good luck!

Joseph N. Togba, MD
Oakland Plastic Surgeon

You do not need an orbital decompression.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

What you need is a consultation with a fellowship trained oculoplastic surgeon.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory that will help you find a highly qualified surgeon in your area (asoprs dot org).

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.