Any suggestions for eye fat pads (Always Tired)? (photos)

Mac201 Thank you for the photos and questions.    A complete consultation is necessary to come up with your best course of action.  From your photographs, it appears that your lower eyelid "bags" are more noticeable because of flattening and descent of your cheek.  why is this important, you may ask?  Because if your fat pads are removed alone, this may cause a  hallowing of your lower eyelids which can actually make you look older and not rejuvenated! It is important that the ocular Plastic Surgeon  that you choose looks at your entire face as the eyes are framed by the surrounding structures. make sure you ask or discuss:Where is the surgery going to take place?  In the office or a sterile environment like an operating room?Will there be an anesthesiologist to make you comfortable or the doctor giving you the " relaxing" medicine?Will the doctor be utilizing a scalpel blade and making a skin incision or a laser and no skin incision at all.  My preference is No skin incision, no stitches, no scalpel blade.Will the doctor tighten the underlying skin by removing it  or tightening with a laser?How and if the cheeks will be addressed? Fat Transfer, filler or not at allFinancing is available and can be checked even prior to coming into the doctor's office.Good Luck  Dr B

You are a good candidate for blepharoplasty with fat transposition or fat transfer to the periorbital area. The cost is about the same at my practice ranges from 3000-4500 depending on where the fat is moved to etc. This will help to make a smooth transition from your eye to your cheek. The eye subunit should not be so well demarcated from the cheek subunit. We call this compartmentalization and it happens when we age. Some people sooners than others. In your case it is most likely genetic.Below are some common causes and treatments for this issue. Most people have an aspect of multiple causes. So the key is to make sure we treat everything that is leading to the issue for the best results.1. Prolapsed orbital fat through the orbital septum: treated with lower lid blepharoplasty and fat transpositioning. Can also be helped with fillers or auto fat transfer to the face but the ideal treatment in my hands is surgery for this issue.

2. Eczema: much more common in young people with fair skin. The treatment for this is to hold off on makeup and any manipulation of the lower lid for a few weeks and try some topical anti inflammatory creams. If you have allergies those should be treated also.  A dermatologist is the best person to see for this. We have a multidisciplinary clinic with myself, a plastic surgeon, and my partner, a dermatologist which I think is ideal!

3. Fluid accumulation and/or redundant skin. Could be possible in young patients but would need a good facial analysis and exam to determine. A low salt diet (< 1000mg/day) and a warm compress can help.  I would consider treating with filler/fat transfer, lower lid fractional ablative laser and/or lower lid blepharoplasty.

4. Descent of midface cheek pad. This then causes the nasojugular ligament to become more prominent creating a demarcation and separation of the eye from the cheek subunit. Treated with mid face lift and/or fat transfer.

It is all about the balance of this transition from the orbit to the cheek. There are many ways to treat this and they vary by the underlying cause. I recommend seeing a surgeon who also does a lot of these treatments. This can make a big difference as most people have a combination of the above that lead to the issue.

Hope this helps.

Best of luck,

DrC

Lower lid bowing and scleral show and bone deficiencyYou have a negative vector meaning too little cheek bone.you eyeball appear to bulge forward.  removal of fat will make this worseYou need a filler , or implant and have your eyes checked for graves disease

Hello, I would recommend not removing the fat pads of your lower eyelid. Why? You have volume loss in the midface region and a deep tear trough (the crease just under the bag). If you just remove the fat you risk looking overly hollow in the under eye region, and this will only worsen over time. In my opinion the best and most cost-effective procedure for you over the long term is a lower blepharoplasty with fat repositioning. Here, instead of removing the fat, we relocate it from the bag into the tear trough (we call it "moving the mountain into the valley"). This helps to create a smoother transition between the eyelid and cheek.You can see examples in the link below. Also, many plastic surgery practice accept CareCredit for financing.Good luck!

Despite your youth, you do have prominent lower eyelid fat pads.  You also have volume loss in the central portion of your face.  Surgical blepharoplasty would be your best option but you may achieve optimal aesthetic outcomes with subsequent addition of filler to the midface region.  Soft tissue fillers alone are not likely to be effective in camouflaging

A temporary solution involves injecting filler into the hollow beneath the bags to improve the contour to the region and provide disguise. Alternatively, you can have a fat transfer procedure where your own fat is harvested from another area of your body and it is prepared like a filler that can be injected to the hollows under the eyes.However, in your case I think you would benefit most from a lower blepharoplasty. Financing options are available at most offices. Make sure you consult with an experienced facial eyelid surgeon. Good luck!

The best solution continues to remain lower eyelid blepharoplasty with removal of the fat.  In some cases a filler can be used in the nasal jugal groove also known as tear trough and can also be injected into the lateral orbital rim to hide the bags.  However, the results of never great or long lasting.Financing is usually available to most cosmetic surgery or plastic surgery offices.  Third party lenses are used such as care credit and prosper.RegardsDr. J

Your best option is a transconjunctival blepharoplasty in which the fat is removed from the inside of your eyelid so you do not have any scars.  It is surgery with light anesthesia (sedation) and the cost can be financed. 

Unfortunately the only solution for your problem is blepharoplasty.  Fortunately, it should give you complete relief of you problem.  You plastic surgeon can advise you about finance options.

 The primary goal for lower eyelid blepharoplasty is to remove the excess herniated fat in the lower lids. A trans-conjunctival approach( inside the eyelid incision) is performed for the removal. Most plastic surgery offices have many options for third-party financing available for their patients For many examples, please see the link and video below