How to correct under eye bags and darkness caused by filler and Lupus? (Photo)

Question

I have never had bags under my eyes until a year ago when I had an emotional event in my life and my eyes swoll up with fluid. They never went back down so I had filler removed and put back in. I still had a little puffiness but not a lot, but the next provider I went to told me to remove it all and get a lower Bleph. Is this my only option? I am 41, on Prednisone for Lupus, and researching eye light ulta as an option. I am also using Hydroquinone for the darkness under eyes caused by laser burn

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about the challenges you're facing with under-eye bags and darkness. Given your medical history of Lupus and the use of Prednisone, along with previous treatments, it's understandable that you're seeking the best course of action.

Consultation with a Dermatologist or Oculoplastic Surgeon: It's crucial to have a thorough evaluation by a specialist who can assess your specific condition, medical history, and previous treatments. They can provide a tailored approach to your needs.

Non-Surgical Options: There are several non-surgical treatments that might help with under-eye bags and darkness:

Topical Treatments: Continue using Hydroquinone for hyperpigmentation, but ensure it's under the guidance of a dermatologist to avoid potential side effects.
Microneedling or Laser Therapy: These treatments can help improve skin texture and pigmentation. However, given your history of laser burn, proceed with caution and consult a specialist experienced with patients who have Lupus.
Injectable Fillers: Sometimes, hyaluronic acid fillers can be used judiciously to smooth out under-eye bags. However, as you've had mixed results with fillers before, this should be approached cautiously.

Surgical Options: If non-surgical treatments are not effective, a lower blepharoplasty (eyelid surgery) might be considered. This procedure can remove or reposition fat and tighten the skin under the eyes. It's important to discuss the risks and benefits with a qualified oculoplastic surgeon, especially considering your autoimmune condition.

Lifestyle and Home Remedies: Simple measures like proper hydration, adequate sleep, and the use of cold compresses can sometimes help reduce puffiness and darkness.

Eye Light Ultra: This is a relatively new treatment and may offer some benefits. However, ensure you have a detailed discussion with a dermatologist or plastic surgeon about its effectiveness and safety, particularly in the context of your Lupus and medication use.

In summary, while a lower blepharoplasty is a viable option, it's not the only one. A comprehensive evaluation by a specialist will help determine the best approach for you, considering your unique circumstances.

Best wishes for your treatment journey.

James M. Economides, MD, FACS · Answer

It sounds like you're dealing with a combination of factors that make the under-eye area particularly sensitive, especially with your history of using prednisone for Lupus and the laser treatment. Here are some considerations based on your situation:

1. Lower Blepharoplasty:
Surgical Option: A lower blepharoplasty is often recommended for patients with persistent puffiness or under-eye bags that don't respond to non-surgical treatments. This surgery removes excess skin and fat to smooth out the under-eye area. It can be a permanent solution, but as with any surgery, it's important to weigh the risks and recovery time, especially considering your autoimmune condition.
Is It Your Only Option?: While it's a more permanent solution, it's not necessarily your only option. Some non-surgical treatments may still be viable depending on the extent of the puffiness.
2. Eye Light Ultra:
Non-Invasive: If you're exploring Eye Light Ultra, this might offer some non-invasive relief. It combines infrared light and radiofrequency to improve skin texture, firmness, and puffiness around the eyes by stimulating collagen production. It's a safer, non-invasive option compared to surgery, but the results may be more subtle and may require multiple sessions.
3. Prednisone Impact:
Fluid Retention: Prednisone can cause fluid retention, which might contribute to the puffiness under your eyes. This could explain why, after the emotional event, the swelling never fully went away. Managing the prednisone dosage with your doctor or finding alternative medications (if possible) might help reduce this side effect.
4. Hydroquinone and Laser Burn:
Hydroquinone for Pigmentation: If the darkness under your eyes is related to a laser burn, Hydroquinone can be effective for lightening pigmentation over time. However, be cautious with long-term use, as hydroquinone can cause irritation or rebound pigmentation. It's important to use it under a doctor's supervision, especially on sensitive areas like the under-eye skin.

Jacquelline Leva, DO · Answer

So the lupus makes you more at risk for any sort of inflammatory reaction to fillers, and anything really even lasers, so you have to be extremely careful. Due to the lupus depending which variant you have Can also have unexpected inflammation or clotting that can occurYou would have to talk with your doctor and see what is the expected inflammatory response with a blepheroplasty. It Might be better to just melt it with hyaluronidase understanding you may have unexpected more than usual inflammation initially underlying that will go down. I would not put anymore dermal filler. Mineral sun block every 2 hours and be really careful about choosing what makeup you put under your can have unexpected inflammatory response which can always lead to dark circles. If you suffer from allergies and lacrimate often may wany to consider seeing allergist to control allergies as irritation from allergies can worsen dark circles

Camille Cash, MD · Answer

Based on your photos and issues with previous filler treatments a lower blepharoplasty would likely give you the best results.  Be sure to discuss your medical history as well as the medications you take with your surgeon.  I've included a video on the procedure that I hope you find helpful.

How to correct under eye bags and darkness caused by filler and Lupus? (Photo)

Answers (4)

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