Pouches in the corner of the upper eye lid. Treatment options? (Photo)

I have visible pouches in the corners of my eyes for the last two years. My eye lids are heavy as well but the pouches are especially noticeable. I am 49 y.o smoker, don't really have any deep wrinkles yet, some jowls sagging that's in my family. Is there a non surgical option for removing these pouches or Blepharoplasty is the only effective option? Sorry for ugly pictures. Thank you.

Doctor Answers 13

Pouches in corner of upper eyelid

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Your photos demonstrate the issue at hand perfectly.  The "pouches" are actually small collections of fat that used to live further back in the eye socket when you were younger.  You also have some extra skin in your upper lids.  These things generally have a genetic component.  The problem is easily corrected with a small incision placed in your upper eyelid crease for optimal scar camouflage.  The excess skin is removed and the fat pocket is also removed.  The procedure can be performed under local anesthesia with oral medications or under general anesthesia depending on doctor/ your preference.  It is a brief operation and healing time is usually 1-2 weeks though some swelling may remain longer.  In my opinion, there are not any non-surgical options for addressing loose skin and excess fat in the eyelids.  Smoking will delay the healing process, so if you can quit (at least for a few weeks before and after surgery), it would be preferable.  I wish you well!

New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Upper Eyelid Fat Removal

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The pouches in the inner areas of your upper eyelids is herniated orbital fat. It can only be removed by surgery. This can be done alone or combined with skin removal for a more rejuvenative effect.

Pouches in corner of upper eye lid

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Dear Olgaa65,

Thank you for submitting your photos. From your clinical description and via the pictures, it does appear that you have a noticeable swelling un the upper inner aspect of your upper lid. It sounds as though you have a hereditary, familial trait to heavy upper lids and this can be made worse by more protuberant fad pads under the skin in the inner upper aspect of the eye. In general, there are very few good, non-surgical options to treat these. Occasionally, the use of soft tissue fillers, such as Restylane® or Juvéderm® can be used to camouflage this, but may make the heaviness worse. As this is hereditary in nature and has progressed through the years, sometimes an upper lid blepharoplasty is the best option.

I have been performing exclusively cosmetic facial plastic surgery for 20 years and upper lid blepharoplasty is one of the most common procedures performed. Usually, it can be performed under local anaesthesia with relatively short recovery periods and, in general, excellent aesthetic results for these types of anatomical concerns. The goal to create natural-looking, rested and smooth upper lid contour can usually be achieved. At this point in time, it may be my best advice to seek a consultation of experienced and certified plastic surgeons with a lot of upper lid and lower lid blepharoplasty experience and results and review your treatment options.

To find out more, please review the link below.

I hope this information has been of some assistance and best of luck.

R. Stephen Mulholland, MD
Certified Plastic Surgeon
Yorkville, Toronto

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 101 reviews

Upper eyelid fullness

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You are a wonderful candidate for upper blepharoplasty. I believe in a conservative approach--too much fat should not be taken out to prevent a hollowed out look. 

There really isn't any non surgical solution, however, upper blepharoplasty is very straightforward and can be done under a local anesthetic.

I hope that helps.
Best wishes,
-Dr. Asaria

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 139 reviews

Pouches in the corner of the upper eye lid. Treatment options?

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Thanks for your question and photos. AND for the honesty about your smoking. Upper eyelid puffiness is a result of generous fat pads that can be reduced surgically. The heaviness of your lids is corrected at the same time. This is upper blepharoplasty surgery and it is an easy out-patient procedure that can be done under local anesthesia with or without sedation. The recovery is fairly quick. Seek the advice of an experienced board certified plastic surgeon, facial plastic surgeon or oculoplastic surgeon (or two) to determine your options. Stop smoking for the best results. Best wishes.

Kevin L. Smith, MD, FACS
Charlotte Plastic Surgeon

Blepharoplasty : Eye Pouches

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I agree with the other doctors who have answered so far. There are no good non surgical options unfortunately.

Surgery is called an eyelid lift or eyelid tuck. The medical word is Blepharoplasty. Doctors often say upper Blepharoplasty or upper "bleph" for short. This is a straight forward operation most of the time. It has high success and with low complications. Pain is minimal. Many people take no pain pills at all.

See a plastic surgeon who will help you with this problem.

I'm sure you will do well. 

Hope this helps.

Dr Chris Saunders

Christopher Saunders, MD
Wilmington Plastic Surgeon
4.8 out of 5 stars 78 reviews

Pouches in the corner of the upper eye lid. Treatment options?

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THe fullness of the upper inner eyelids is from fat tissue that protrudes and the only effective remedy is surgical removal. This is actually quite easily performed with minimal recovery time.

The eyelid surgery is the biggest bang for the buck as the eyes are the most expressive feature of the face.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Pouches in the Corners of the Upper Eyelids

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Those pouches are caused by a combination of excess skin, underlying tissue laxity, and herniation of pockets of fat that surrounds the eye socket. There is no good noninvasive/minimally invasive means to correct this. Upper blepharoplasty is the treatment of choice that will give you lasting results and correct the problem. The good news is that this procedure can be performed safely under local anesthesia in an office setting and doesn't require a prolonged recovery time.

Mark Gaon, MD
Newport Beach Plastic Surgeon


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Your eyelid heaviness and medial fat pad are very common, and the two problems that patients voice when they see me for a upper blepharoplasty. I know of no nonsurgical treatments that will resolve either of these issues. This is a short procedure done with local only or local with sedation. Good luck.

Upper lid pouches

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Surgery is really the only good option to consider.  The excess fat in your upper lids could be removed in 20 minutes under local anesthetic.

Michael Kreidstein, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 33 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.