Hello Doctors, I have been battling with this bag under my right eye since I was about 21. That's when it started becoming more prominent. I am now 30, and the fat pad seems to have gotten worse. Upon feeling it with my index finger, I do indeed feel little pieces of "fat." They are soft & "squishy" (sorry) to the touch. The left eye has very little fat. What is my best option here? I am so self-conscious about it. People ask me if I'm tired, or if I got into a fight! Please help me. Thanks.
July 17, 2015
Answer: You look like you would benefit from eyelid surgery. The best approach for many is to do this surgery from behind the eyelid. This avoids a skin incision. The fat sitting in the lower eyelid is advanced into the top of the cheek. This reduced the volume in the lower eyelid and improves the hollow at the top of the cheek. Surgery is very comfortable and is generally performed under light iv sedation on an outpatient basis. There is no substitute for a personal consultation.
Helpful
July 17, 2015
Answer: You look like you would benefit from eyelid surgery. The best approach for many is to do this surgery from behind the eyelid. This avoids a skin incision. The fat sitting in the lower eyelid is advanced into the top of the cheek. This reduced the volume in the lower eyelid and improves the hollow at the top of the cheek. Surgery is very comfortable and is generally performed under light iv sedation on an outpatient basis. There is no substitute for a personal consultation.
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November 10, 2021
Answer: Your best option for the eye bag is to have the fat removed and sculpted, so it will appear like it was never there I’m a cosmetic oculofacial plastic surgeon, board-certified by the American Board of Cosmetic Surgery. I’ve been practicing in Manhattan and Long Island for the past 20 years and under eye bags is one of the most common issues we treat in our practice. Your eye bags are caused by lower eyelid fat prolapse. This means that the fat that is normally around your eyes pushed forward and creates a hernia. Once the fat pockets have pushed out, it pushes out even further as time goes on. There are numerous factors that can contribute to it getting worse but the fact that you have a significant asymmetry clearly draws a lot of attention and people asking you if you are tired. When you look for solutions for under eye bags, it’s likely that you’ve already tried the topical creams and moisturizers that are typically sold and of course, those don’t work. When you’re dealing with a physical volume of fat, nothing topical will make a difference. There are also options using various types of hyaluronic acid fillers to camouflage the fat. This is unfortunately not likely a benefit for you. In the absence of a physical exam, it seems pretty obvious from your photo that the bag is too prolapsed out to hide it or camouflage with a hyaluronic acid filler. In our practice, for someone who’s young, we typically address this problem through a procedure called a lower eyelid transconjunctival blepharoplasty. The reason why I use the term transconjunctival has to do with the approach. There are two ways to address fat pockets: from the outside called transcutaneous approach, and from the inside called the transconjunctival approach. For younger people, usually there is no issue with extra skin and therefore there is no reason from my perspective to go and make an incision on the outside. What we do is we address the fat pockets from the inside of the eyelids so there is no external scar. We also perform these procedures in our office facilities under local anesthesia with LITE™ sedation so you avoid general anesthesia. A lot of surgeons prefer general anesthesia. I have been doing this procedure for over 20 years and I have a lot of experience with it. I find that the experience of the patient is better when they avoid general anesthesia, and are able to recover a lot faster without the side effects of the medications. By avoiding all the stress of general anesthesia by using local anesthesia with sedation, most of our patients go back to work in less than a week. I recommend that you meet with qualified, experienced cosmetic surgeons and learn about the options. Get to know your doctor and get a sense of what that doctor’s aesthetic and style are. Get a sense of what you can anticipate your final appearance will be. What I explain to my patients is that when you have this procedure done, because you had puffiness for so long, it’s hard to imagine yourself without the puffiness and there’s a common concern of being over hollow. Our goal is to achieve a look as if you never had the bags. This means that the skin will naturally follow the contours as if there was no fat prolapse there. I hope that was helpful, I wish you the best of luck, and thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
Helpful 14 people found this helpful
November 10, 2021
Answer: Your best option for the eye bag is to have the fat removed and sculpted, so it will appear like it was never there I’m a cosmetic oculofacial plastic surgeon, board-certified by the American Board of Cosmetic Surgery. I’ve been practicing in Manhattan and Long Island for the past 20 years and under eye bags is one of the most common issues we treat in our practice. Your eye bags are caused by lower eyelid fat prolapse. This means that the fat that is normally around your eyes pushed forward and creates a hernia. Once the fat pockets have pushed out, it pushes out even further as time goes on. There are numerous factors that can contribute to it getting worse but the fact that you have a significant asymmetry clearly draws a lot of attention and people asking you if you are tired. When you look for solutions for under eye bags, it’s likely that you’ve already tried the topical creams and moisturizers that are typically sold and of course, those don’t work. When you’re dealing with a physical volume of fat, nothing topical will make a difference. There are also options using various types of hyaluronic acid fillers to camouflage the fat. This is unfortunately not likely a benefit for you. In the absence of a physical exam, it seems pretty obvious from your photo that the bag is too prolapsed out to hide it or camouflage with a hyaluronic acid filler. In our practice, for someone who’s young, we typically address this problem through a procedure called a lower eyelid transconjunctival blepharoplasty. The reason why I use the term transconjunctival has to do with the approach. There are two ways to address fat pockets: from the outside called transcutaneous approach, and from the inside called the transconjunctival approach. For younger people, usually there is no issue with extra skin and therefore there is no reason from my perspective to go and make an incision on the outside. What we do is we address the fat pockets from the inside of the eyelids so there is no external scar. We also perform these procedures in our office facilities under local anesthesia with LITE™ sedation so you avoid general anesthesia. A lot of surgeons prefer general anesthesia. I have been doing this procedure for over 20 years and I have a lot of experience with it. I find that the experience of the patient is better when they avoid general anesthesia, and are able to recover a lot faster without the side effects of the medications. By avoiding all the stress of general anesthesia by using local anesthesia with sedation, most of our patients go back to work in less than a week. I recommend that you meet with qualified, experienced cosmetic surgeons and learn about the options. Get to know your doctor and get a sense of what that doctor’s aesthetic and style are. Get a sense of what you can anticipate your final appearance will be. What I explain to my patients is that when you have this procedure done, because you had puffiness for so long, it’s hard to imagine yourself without the puffiness and there’s a common concern of being over hollow. Our goal is to achieve a look as if you never had the bags. This means that the skin will naturally follow the contours as if there was no fat prolapse there. I hope that was helpful, I wish you the best of luck, and thank you for your question. This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
Helpful 14 people found this helpful