No clue how to remove bags. Doctors say my eyes too dry to do Lowe bleph. Any suggestions? (photos)

What can I do for these eyes I can't sleep more than 3 hours with medication 10 years now Doctors say mystery My eyes are severely dry But I can't have anyway of getting rid of my under eye bags I'm 27 It's really destroying my self esteem I'm becoming hopeless over it

Doctor Answers 11

No clue how to remove bags. Doctors say my eyes too dry to do Lowe bleph. Any suggestions? (photos)

Thank you for your question regarding removal of lower eyelid bags with dry eyes. Yes, it is still possible to remove the bags, which as you know, are fat deposits.  One technique will not affect your dry eyes at all, and that is placing small incisions over each of the three lower lid bags through which the excess fat is removed.  This leaves a faint scar, which is usually imperceptible, and this can be done under local anesthesia with minimal downtime.  Thank you for your very interesting question and photographs.

Lower Eyelid Surgery

As previously stated, using a trans-conjunctival lower eyelid approach should not worsen the dry eye. The surgeons you saw may all be using a trans-cutaneous approach. I would seek out a specialist who uses the trans-conjunctival technique.

David S. Felder, MD
Fort Lauderdale Oculoplastic Surgeon
4.9 out of 5 stars 77 reviews

Dry eyes and lower lid surgery

It is possible to remove your lower lid bags without worsening your dry eyes. If your surgeon or you see a surgeon who does the transconjunctival approach, you can have the excess fatty tissue removed from behind your eyelids without affecting your tearing function. This is called a transconjunctival lower blepharoplasty and we do the procedure all of the time. It can be done without removing any lower lid skin and just the puffiness is treated and no affect is done to your lower lid position. Good luck in your area.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Lower blepharoplasty

thank you for your question  Lower eyelid surgery involves removal of the fat bags from the lower eyelid.  Surgery typically takes less than one hour. Pain is minimal. Recovery is fairly quick. One needs to be evaluated by a plastic surgeon  before surgery to determine if the patient is a candidate for surgery.  I send my patient for a pre-operative eye exam .  One of the test evaluates dry eye.  I hope you find this  helpful

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 54 reviews

Lower lid bags

Even with a dry eye you can do a lower lid surgery.  You should do a trans-conjunctival approach with fat repositioning.  This moves the fat down into the tear trough to avoid hollowing post-op.  This will not affect the lid position so shouldn't increase the dryness.  See an oculoplastic specialist as they can take a look at your cornea to assess the dry eye as well. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

Dry eyes, lower lid fat bags

It is unusual for young men to have such dry eyes that it makes it difficult to sleep. Often times, patients have Allergic Conjunctivitis and are using the wrong medications. 
If your eyelids are such a big issue that it is affecting your self esteem, then before going to a surgeon to fix it, I would recommend patients talk to their primary care doctor to talk about it first. But your doctor is doing you a favor. Don't have eyelid surgery until your eyes are more comfortable and under control. Once things are more comfortable, consider getting a consultation with an oculoplastic surgeon in your area. 

Dan Landmann, MD
Ridgewood Oculoplastic Surgeon
5.0 out of 5 stars 33 reviews

Lower eyelid bag correction for patient with dry eyes

Thank you for sharing your question and photos. When performed conservatively, blepharoplasty should not increase the dryness of the eyes. See an eyelid specialist for comprehensive evaluation and discussion of treatment plan.  Good luck.

How to remove bags under eyes?

In general, there are two options to help improve bags under the eyes.  One method would be to inject a filler under the bags to help camouflage them.  The other method would be surgery to address the protruding fat.  The result from surgery would be much longer lasting than the result from an injection of a filler.  Lower eyelid surgery should not worsen an issue with dry eyes.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Trans-conjunctival fat removal lower blepharoplasty

A conservative fat removal from an incision on the inside of the eyelid should not affect dryness in the eyes.  This is known as a trans--conjunctival approach.  We have been using this approach for eyelid fat removal for over 25 years. For many  lower eyelid before and after results using the trans-conjunctival approach, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Generally the transconjunctival lower blepharoplasty has minimal impact on dry eye status.

With the use of aggressive lubrication immediately after surgery, you should do fine.  The only exception is there is a rare patient with dry eye so severe from active inflammation that the risk is not reasonable.  Let me stress that this is rare.  Please in this situation have constant gritty sensation, light sensitivity, etc.  I think it is appropriate to be conservative and I would strongly recommend that you not let a surgeon use a skin incision to perform lower eyelid surgery.  Also, there is no substitute for an actual in person consultation.  Another option for you would be under eye fillers which would help you and avoid surgery altogether.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 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.