I have hereditary puffiness under my eyes. I am considering lower eyelid surgery. Will it resolve the issue?

My eyes are very sensitive and react to allergies, lack of sleep, crying, etc. If I have the fat removed from under my eyelids, what will happen to the sensitivity in my eyes? Also, is it safe to have this procedure if I wear contact lenses every day?

Doctor Answers 6


  • It depends on what is causing the puffiness under your eye whether or not you would need surgery. It could be as simple as water retention which can be managed topically or an excess of the fat pad that would have to be removed surgically. Either one a good consultation with a Doctor can make that determination. 

Fayetteville Facial Plastic Surgeon
4.7 out of 5 stars 117 reviews

Lower eyelid puffiness and blepharoplasty

All the above issues can lead to excessive puffiness of the lower lids which include allergies, crying, lack of sleep in addition to thyroid problems and  salt intake. Contact lenses have no effect on the eyelids themselves and should be left out of the eyelids for at least 14 days after the procedure.
The primary goal of lower eyelid blepharoplasty surgery is to remove a portion of the herniated 3 fat pads in the lower lids that creates the puffiness look. If there is excess skin noted on outside of the lower lids, a small incision and pinch technique of the lower lids is accomplished  with an incision at the lash line. This incision was closed with tissue glue.
For many examples of  upper and lower blepharoplasty, please see the link below to our eyelid photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Puffiness under eyes

Hello and thank you for your question.
It depends on what is causing the puffiness. As a rough guide, puffiness that does not change much can be treated. There are a number of ways to treat this, surgically and non-surgically, and a face-to-face consult with a Plastic Surgeon(called Board Certified Plastic surgeon in US and Plastic Surgeon trained and registered with RACS here in Australia) will give you the best range of options for you.
Even with the best of intentions I do not believe we can give you a firm opinion in an online forum, without meeting with you, talking this through and seeing your eyes.

It sounds like you need to first work our if this puffiness is Allergy related. Our treatments do not directly deal with Allergies, although they certainly can deal with that tired look that many people show under their eyes.

Contacts may need to have glasses substituted for a few days if you have treatment with a Plastic Surgeon.

Mark Edinburg, MBBCH, FRACS
Sydney Plastic Surgeon
4.8 out of 5 stars 27 reviews

Treatment of lower eyelid puffiness

If the puffiness of your lower eyelids changes, then it may be more due to fluid retention due to allergies, etc. Surgery will not correct this.  However, if the puffiness does not change, or if it is still there even on your "best" days, then it is likely due to fat and only appropriate surgery can remove or re-position the fat so that it is less prominent.

One simple test can perhaps point you in the right direction:  apply some iced compresses to your eyes for 10-15 minutes and then see if there is any substantial change.  Transient improvement may indicate fluid retention and not fat; no improvement may indicate the presence of fat which requires surgical treatment.

Yes,, it is safe to have this procedure if you wear contacts, but be aware that you may not be able to wear contacts for a week or so while you are healing -- you will need to use glasses instead.

Good luck!

Elliot Jacobs, MD, FACS
NEw York City

Elliot W. Jacobs, MD
New York Plastic Surgeon
4.4 out of 5 stars 34 reviews

Puffy Lower Eyelids and Allergies


If your lower eyelid "bags" are the result of swelling and fluid shifts rather than bone and fat anatomy, you will need to realize that surgery will not fix this issue.  Fluid shifts into and out of the lower eyelid area should be treated by addressing the cause of the fluid shifts.  In other words, lifestyle modification, allergy medications, diet modification, and so forth.  Some people will even move to a location where their allergies are not so much of an issue.  On some occasions thyroid conditions contribute to issues in the lower eyelids.

I would caution you about having fat removed from your lower eyelids.  While it is appropriate in some people, it generally is not.  Fat removal is essentially permanent and can result in a premature aged/hollow appearance.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

I have hereditary puffiness under my eyes. I am considering lower eyelid surgery. Will it resolve the issue?

Typically, if the puffiness under your eyes is from fatty tissue, then a blephroplasty will address the problem.  It is OK to have the surgery if you are a contact lens wearer.  I would see a plastic surgeon or eye surgeon and discuss this in person.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 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.