Q: Dr. Eppley, I am an active lady just turned 80 and I have a small amount of normal puffiness under my eyes. My concern is that I have puffiness in the corner of my eyes between my eyelid and nose bridge. It looks like a lump or a swollen gland and is puffy. Is there anything I could apply that would reduce that puffiness cosmetically or is this a surgical issue? Would cold or hot compresses reduce the size of this area of the eye? Could the fat behind the eyeball be causing this area to swell? What works best? Thanks for any suggestions you might have for this problem.
A: Undoubtably the puffiness that you see between your nose and your eye is not swelling. That is actual tissue, a combination of skin and fat, that is causing the bulge. Your assumption is correct that it is bulging eye fat. It will not be remedied by any type of external compression. Rather it is going to require surgical excision to remove the now protruding and excessive upper eyelid tissue. This can be done through an upper eyelid incision. (blepharoplasty)
Dr. Barry Eppley