Laser Eyelid Surgery for Puffy Eyes?

Hi, I am 27 and I wake up with puffy eyes almost every day. Some days are good but as I get older it seems like it's getting worse. I've tried gels, creams, cold compress, everything--you name it, but nothing worked. Would laser eyelid surgery help for puffiness caused by fluid retention? Also, I stay away from eating salty food. Please help.

Doctor Answers 12

Consider a consultation with an eye plastic surgeon

Dear Puffy Eyes

It definitely sounds like you may have an issue. Dr. Gear is correct that what you are describing may be blepharochalasis, an intermittent inflammatory process that takes its toll on the eyelid skin. However, there are other potential issues. So the best option is to be assessed by an oculoplastic surgeon. This is a board certified ophthalmologist who has done an ASOPRS approve fellowship in oculofacial surgery. The American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) maintains a website that can help you identify fellowship trained oculoplastic surgeons in your area. This way you can be certain you are seeing a well qualified individual.

Regarding, laser surgery, some surgeons use lasers for incisional eyelid surgery. There is no clear advantage to using a laser for this purpose. Laser skin resurfacing is done to tight eyelid skin. Only a personal consultation can determine if this option is right for you.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Puffy eyes

I would like to see a photo of you in the morning, to better localize and differentiate among different culprits (fat, fluid). It sounds like you are describing festoons, which can be difficult to treat. Decreasing salt intake, sleeping on your back, and trial of water pill may help. There are also some procedures that may improve the situation or at least camouflage it (using fillers to fill around it). Laser doesn't usually address it, unless if perhaps done aggressively.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Puffy Eyelids

It's important to understand that puffy eyelids can be caused by a variety of medical conditions including allergies. It's essential that patients with large eyelid bulges be evaluated for coexisting medical conditions before proceeding with surgery.

In many cases, this evaluation will ultimately determine the type of treatment utilized. It's, therefore, important to consult a board certified plastic surgeon with experience performing eyelid surgery. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

In office consultation is necessary

There are several conditions that you may have. Dermatochalsis, Blepharochalasis, Eyelid Edema, Allergies, etc. It is best to have a consultation with an oculoplastic surgeon who is familiar with all of these conditions and can treat them appropriately. 

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

Surgical options for puffy eyes

There are three fat compartments in the lower lids, which make the eyelids look puffy and swollen. This is made worse from allergies and fluid retention. Make sure those are under good control prior to embarking on a lower blepharoplasty. Lower blepharoplasty addresses removal of the portion of the lower lid fat bags to give natural contour to the eyelids. A transconjunctival incision on the inside of the lower lids will remove the excess fat bags. This is done with traditional instruments. The surgery can be performed with a laser, and one needs to be very careful as blindness can occur if the laser gets into the retina.

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

Puffy eyes

 If puffy eyes are due to fat herniation, then a blepharoplasty would be reasonable.  If you have puffy eyes due to edema then very little if anything can be done to improve it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Eyelid puffiness treatment

Lasers are good to treat the wrinkles underneath the eyes, not necessarily excess skin. You may want to consider getting blepharoplasties as this will help with the excess skin and any "herniated" fat underneath the eyes to improve their appearance. This can be done as an outpatient and is very well tolerated. Good luck!

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 202 reviews

Puffy Eyes in the Morning

Hi Puffy,

Even Preparation H didn't help?

In addtion to the other answers here, have your internal medicine physician check on your thyroid hormone levels. Some times this is an easy non-surgical fix to the problem.

Fraxel repair laser may help selected patients with malar bags, and it will tighten lax eyelid skin.

Send photos for more complete answer.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

It depends...

First of all, I am not sure what "laser eyelid surgery" means.

The term may relate to laser resurfacing around the eyes. I doubt that this will provide you with meaningful improvements.

On the other hand, some doctors use a laser to make an incision for lower blepharoplasty. To me, it does not matter how an incision is made; rather performing a good eyelid lift is important.

Lastly and most important, an examination is in order to determine if the puffiness is due to fat or fluid. Fat can be removed, fluid is more challenging. See an experienced facial plastic surgeon for your private consultation.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Puffy eyes

Unless you have allergies, it sounds as if you have excess fat aorund the eyeball that can be removed. Whether or not your surgeon uses a laser to assist in excising or vaporizing the fat is up to your surgeon. It is an individual choice. Laser resurfacing on the skin itself is psrobably not the answer. Sometimes simply fat removal will not cure the puffy eyelids and your surgeon should analyze your anatomy carefully.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 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.