Recommended Treatment for Hereditary Puffy Eyes?

The skin under my eyes is always puffy, and I'm wondering what procedure would best remedy it.

I am 40, and my father and aunt also have this puffiness, so I know heredity plays a big factor. Would you recommend fillers or surgery?

Doctor Answers 4

Best treatment for puffy lower eyelids

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In order to answer your question, it may be helpful for you to review some old pictures when you were in your 20s or early 30s. When reviewing those pictures pay attention to the shape of lower eyelids, and also to the contour of soft tissues below the eyelid.

I suspect the fat herniation of the lower eyelid is similar to what it has been. It's probable that the eyelid appearance is bothering you because of the visible depression below the eyelid, which is called a tear trough deformity. Based on your observations you may choose the most appropriate treatment.

If the eyelid herniation is the true bother, then choose surgery. If the tear trough bothers you, choose filler injections.

New York Facial Plastic Surgeon

Puffy eyes

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From your photo, it lookw like you have herniated lower lid fat, and a "double bubble" look to the lower lid cheek junction.  Just looking at the photo and not examining you in person, you may be a candidate for a lower lid blepharoplasty.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Perfect Candidate For Surgery

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Dear TPrz,

Patients with hereditary fatty bags under their eyes would reap the benefits of doing a lower eyelid fat transposition procedure. This procedure does not remove the fat but rather moves it inferiorly to fill in the shadow or tear trough below the lid. Preservation of the fat is key to prevent future hollowness to your lower lids as you age.

Leslie H. Stevens, MD
Beverly Hills Plastic Surgeon

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Puffy eyes

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Hi, based on your photo it looks like surgery would be a better option for you. However, you should visit a surgeon to be assessed for any issues such as allergies, history of dry eyes, that might make surgery less of an option. I would recommend seeing either a board-certified plastic surgeon or an oculoplastic surgeon. Good luck, /nsn.

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.