I do not want eye surgery. Are there non-surgical options to help fix fluctuations in upper eyelid fat prolapses?

Question

I like the way my eyes look on a "good" day; morning fat prolapses in my upper lids make my lid platform appear to be a different size on any given day, and the prolapses stay in that position for the entirety of the day. On the days my eyes look less swollen, I like the size of my lid platform, and therefore I do not want surgery. But my lid becomes almost invisible when my eyes are quite swollen, and on those days I can't get rid of the swelling. The pictures show differing amounts of swelling

Kenneth D. Steinsapir, MD · Answer

This is slightly more pronounced on the left side.  You also have a very heavy subbrow area that is very important to make you eyes beautiful.  Between the tendency of the upper eyelid fold to rest on the upper eyelid platform and the slight ptosis of the eyelids, you have a compensatory brow lift.  A Microdroplet botulinum toxin brow lift would help.  Eventually these types of eyelids are benefited by very precise eyelid surgery to help maintain the eyelid appearance.

Theda C. Kontis, MD · Answer

You have noticed that fact that body fluctuations in fluids can make orbital fat swell because those fat pads love water! Other than watching your salt intake, sleeping with your head elevated, ice compresses in the morning, there is not much else you can do. Maybe try Botox to elevate the brow slightly so the upper lid swelling doesn't obscure your upper lid fold.

Ryan Mitchell, DO, FAOCO · Answer

Hello, Thank you for your question.  I tend to typically write lengthy answers to realself
questions but I am going to try my best to give a more succinct answer to your more
complex question.  You are going to need medical evaluation(s) regarding
your intermittent eyelid swelling.  There are many potential causes for
fluctuating "puffy" eyelids.  More common causes for
fluctuating eyelid swelling include influences from allergy, diet (e.g. too much
salt), lack of quality sleep, contact dermatitis from make-up or skin care
products, hormonal fluctuations, medication side-effects and genetics.  In
addition to appropriate medical evaluation, it is critical for you
to act as your own advocate and detective by keeping a strict journal or log of your daily
activities, diet, medication and vitamin/herb use and daily stressors.  If you
are still menstruating, the time of month is also important.  You may very
well find a connection between your puffy eyelids and factors associated with
these important attributes.  Your doctors are going to ask you about your
medical history and lifestyle and they will be much better able to assist you
if you present with detailed documentation of your history and lifestyle.  Also,
I do not believe that only "changing fat prolapse" is
the sole cause of your "eyelid platform" changes.  In addition
to the eyelid fat pads (the primary cause of eyelid bags), you must also consider fluctuations in the skin itself including the subcutaneous fat (fat
below the epidermis and dermis and separate and distinct from the eyelid fat
pads) as contributing factors to your swollen eyelid state.  Allergies,
contact dermatitis, fluid retention and hormonal fluctuations in addition to
other contributing factors affect the swollen eyelids as much as or even more so than changes in the eyelid fat pads.  The eyelid fat pads that you are referring to are not necessarily the
primary cause of daily fluctuating puffy eyelids.  I would start with an
ophthalmological consultation.  Allergy, dermatological and general
practice evaluations are also important in order to diagnose the causative
factors of your fluctuating puffy eyelids.

I do not believe there is a "cosmetic
treatment" that will fix your problem.  There is not an injection or
laser etc. that will fix this issue.  In fact, there may not even be a surgical cure for your problem.  A blepharoplasty will allow you to see
your eyelid better for sure, but you will very likely still suffer from daily fluctuations
of eyelid swelling until you identify and treat the underlying condition that
is responsible for your eyelid swelling.

Your best starting place is to immediately initiate a log of your every move as
mentioned above. Try to discover a pattern of behaviors associated with your eyelid "bad days".  If you figure that out then you may very will have your
answer. Consulting with the appropriate medical doctors will also be important and will likely include some bloodwork in order to help solve the mystery behind your fluctuating
eyelid swelling.  I think this is the right place to start.  The
plastic surgeon and his or her armamentarium of gadgets and gizmos will not
likely help cure your issue.  I hope my answer assists you in solving your dilemma.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and photos. The minimal fluctuations might be lessoned with cold compresses or Benedryl if the puffiness worsens from allergies. In general, surgery is required to improve upper eyelids. See a specialist for evaluation and appropriate guidance. Good luck,

Manish C. Champaneria, MD · Answer

Thank you for your question.Based on your photographs, there is only slight variations in your eyes that may be more noticeable to you, than to others around you. These variations are normal, and can vary based on your genetics, amount of sleep, stress, fluid intake, etc. There are no nonsurgical methods to help with the "fat prolapse" or the swelling you are speaking of.

I do not want eye surgery. Are there non-surgical options to help fix fluctuations in upper eyelid fat prolapses?

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I do not want eye surgery. Are there non-surgical options to help fix fluctuations in upper eyelid fat prolapses?

Answers (5)

Answer: Is there a nonsurgical method for treating extra skin or fat in upper eyelids?

Answer: Is there a nonsurgical method for treating extra skin or fat in upper eyelids?

Answer: Nonsurgical methods for upper eyelid

Answer: Nonsurgical methods for upper eyelid

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Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.