Will Lower Blepharoplasty Make Edema Under Eyes Worse?

Question

I have protruding fat bags under my eyes which needs lower bleph to correct. My question is, I have been getting fluid retention under my eyes for the last few years that happens about every morning. Some mornings are really bad and others or manageable, but over the course of the day do go down. After researching I think its edema of some kind and have tried natural diuretics and doesn't seem to help too much. Will lower blef complicate the issue and what can be done about the fluid retention?

Thomas Buonassisi, MD · Answer

Lower blepharoplasty can be very helfull in removing bulging fat from your lower lid. Fluid that accumulates each morning however is fluid within you tissues. This fluid is not in a single descrete pocket that can be removed. Surgery will likely make the fluid bags worse during the healing phase but should return to the pre operative state with time.

Toby Mayer, MD · Answer

Lower blepharoplasty and swelling are temporary and the bags should be gone after surgery. I would need to see photos to give you a proper answer to your question to see exactly where the swelling is.

A.J. Amadi, MD · Answer

If you are having a blepharoplasty done, it would be best if a transconjunctival approach is used.

	Making a skin incision approach will possibly damage the lymphatic drainage channels as well as adversely affect the eyelid muscle. This might lead to worsening "festoons".

	The blepharoplasty will not likely change the swelling aspect of your eyelid problem. If you have thin, crepey, redundant skin, I would recommend an Erbium laser skin resurfacing approach to tightening the skin, without actual skin excision.

	Posting a photo really would be ideal to get a better recommendation.

Joseph A. Eviatar, MD, FACS · Answer

With blepharoplasty, fat is removed and sometimes fluid can become worse. Unless fat really needs to be removed, filler under the eyes can be a better option than surgery. You should really consult with a surgeon who specializes in eyelid surgery (like an oculoplastic surgeon) to see if there is swelling and if surgery is necessary. The technique for removing the fat bags can make a difference, whether through the conjunctiva or through the skin. It is a possibility that the swelling may get worse.

William Portuese, MD · Answer

The primary goal of a lower blepharoplasty is to remove the puffiness created by the 3 fat pads in the lower lids that create the puffy or tired look on the lower lids. Malar edema, which is a fluid retention in the cheek pad, is not affected by the lower blepharoplasty. If malar edema is present, it will not get any better or worse with a lower blepharoplasty.

Will Lower Blepharoplasty Make Edema Under Eyes Worse?

Answers (5)