Q: Dr. Eppley, I have very thin skin under my eyes and they are puffy 🙁 I always look so tired and worn out) Just curious if surgery could correct this ?! 🙂
A: The puffiness under your eyes is a common problem and is due to intraorbital fat that is now sticking out. This is a typical development that occurs as we age. Normally the fat around the eyeball is contained behind the eyelids by certain supportive tissues. As we age these tissues weaken and the fat begins to protrude against the lower eyelid. This creates the classic lower eyelid puffiness or bags that many people have. With time these lower eyelid bags can become quite pronounced. Because fat has a high content of water, this is why these eye bags may be bigger in the morning or after eating foods with high salt contents. While some people have these bags naturally even as early as their teens, most people develop them to varying degrees after the age of 40 or so. This fat removal is a common component of most lower eyelid blepharoplasty procedures, If one does not have any or too much loose skin, the fat can be removed from inside the eyelid. (transconjunctival lower blepharoplasty) When loose and sagging skin needs to be removed and tightened as well, an external transcutaneous lower blepharoplasty technique is used. (traditional method) Both techniques can result in a significant change that removes that tired look.