Blepharoplasty - I have allergic rhinitis and because of the congestion of blood I have those big bags under my eyes.

Is a blepharoplasty a good choice to remove them?

Doctor Answers 4

Under eye bags and allergies

Allergies can certainly be a cause of under eye bags/puffiness and under eye discoloration. Fortunately, there are a lot of great medical treatments (nasal sprays, pills, allergy shots) that an allergy specialist can further discuss with you. Once the allergies are controlled, a more accurate exam can be conducted to see if you are a candidate for a blepharoplasty. In general, there are several excellent options are available for rejuvenating the eyes, and a proper physical exam is necessary to determine which treatment is best for you. To address the tear trough area, using an injectable soft tissue filler is a minimally invasive option that may delay surgical treatment for years. A “lunchtime blepharoplasty” is achieved by placing filler such as Restylane into the recessed area under the eye, or the so-called tear trough area to help camouflage the eyelid bags.  Another excellent nonsurgical option is laser skin resurfacing to the upper and lower lids. The fractional CO2 laser works very effectively with minimal downtime (most patients can apply make-up in 5 days). Resurfacing procedures stimulate the wound healing mechanisms of the body to rebuild collagen, remodel the skin, and eliminate fine lines and wrinkles. Surgical options to rejuvenate the lower eyelids include the transconjunctival technique and the transcutaneous (skin) incision technique. The transconjunctival approach involves an incision inside the lower eyelid with direct access to the fat.  This approach is ideal for patients who have bulging lower eyelid fat pads. A transconjunctival approach will not leave any discoloration or scarring in the lower lids because there is no skin incision. With the transcutaneous technique, a skin incision is made just below the eyelashes. Either lower blepharoplasty approach (transconjunctival or transcutaneous) is minimally invasive and can be performed in about an hour. In order to determine if any of these procedures are best for you, a proper physical exam is necessary. And controlling your allergy symptoms is step #1. I recommend… visiting a board-certified facial plastic surgeon to learn more about your various options.

Chicago Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Allergic rhinitis and bags under the eyes

Active allergic rhinitis can definitely make bags under the eyes look worse. I would recommend getting your allergies under control as this can make a big difference. Allergy treatments have come a long way. Once your allergies are controlled you can be re-examined. You could potentially benefit from filler, blepharoplasty, fat repositioning, or fat transfer.  I recommend a consultation to determine which options are appropriate for you. Safety comes first. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Lower lid bags

The size of the bags is mostly determined by the amount of lid fat present. There is a minor contribution by surrounding edema-congestion. If the bag is large, the fat is removed. If there is a significant tear trough depression, then some of the fat is repositioned over the orbital rim to fill in the depression. This needs to be done by an expert surgeon to avoid permanent double vision.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 31 reviews

Lower eyelid surgery for fatty bag removal

Allergic rhinitis can make the fat bags in the lower lids more prominent. It's important to get your allergies under control  with cortisone nasal sprays, antihistamines, or even allergy testing. Once the allergies are under control and the fatty bags are still present in the lower lids, a trans-conjunctival approach can accomplish removal of them. This involves an incision on the inside of the lower lids, so that there are no external incision. For more information  and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 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.