How Allergies and Water Retention can Affect Eye Bags, but the Major Cause is Fat Under the Eyes

By Adem Lewis / in , , , , , , , , , , , , , , , , , /

Thank you for your question. You submitted a photo and you state that you’re
40-years-old and that you have been dealing with under eye bags and periods of swelling
that you feel are related to water retention. You underwent allergy testing and it came
out negative and you’re looking for possibly a surgical solution and you have the typical
questions that most people have when they are frustrated with under eye bags. So I’m
going to offer you some ideas of how I approach situations like yours in my practice. A little bit of background, I’m a Board-certified
cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have
been in practice in Manhattan and Long Island for over 20 years. Under eye bags and eye
rejuvenation is one of the most common procedures in our practice with a wide range of solutions
and certainly, your situation is extremely common. First, I’m going to give you some idea of
understanding the situation of the bags under your eyes as it appears in your photos. The
puffiness under your eyes that you feel that always makes you look tired represents something
called lower eyelid fat prolapse. Lower eyelid fat prolapse means that the fat that’s normally
around your eyes pushes forward and actually creates a bulge and that bulge is subject
to variability to water or fluid in this area. So, allergies, sinus problems, salt intake,
depending on individual hormonal situations have some degree of affecting the expression
of the level of puffiness. However, the underlying most significant anatomic issue is fat pockets
and this is why, commonly, people first try over-the-counter creams and miracle solutions
that don’t work because frankly, these fat pockets are much too large to be dealt with
under eye creams. So there are basically two options when someone
has under eye bags these days. If it’s slight under eye bags, then we can actually soften
their appearance by creating volume in the valley of the area known as the tear trough
using a filler such as Restylane or Juvederm. In your situation, just in the photos alone,
I suspect that you might not benefit as much with that less definitive procedure which
is putting the filler. The more definitive procedure which I would
typically do for someone like yourself is something called a transconjunctival blepharoplasty.
Transconjunctival blepharoplasty is a surgical procedure where the fat pockets are addressed
from the inside of the eyelid. What we do is we reduce them as well as reposition them
and reshape them. And the point of doing that is to address the contour so that the under
eye area has a natural continuity and you don’t have the bags under your eyes. Now,
this is a highly successful procedure and works very well. In addition, we commonly combine this procedure
to help the skin quality with something like platelet-rich plasma (PRP) as well as laser.
Platelet-rich plasma (PRP) is a concentration of the growth factors and the wound healing
factors from your own blood that stimulates your collagen. People have been becoming more
and more aware of this PRP or platelet-rich plasma and it does a nice job of helping skin
quality at the same time of doing this procedure. Now this procedure in our office is typically
done under local anesthesia with LITE™ sedation. This means that you avoid general anesthesia,
you avoid having to go to a hospital surgery center. In our office, we have these facilities
that are certified by the Joint Commission so that we meet the same standards of safety
like a hospital and provide the convenience of an office setting. This is something that
I think would most likely help you. Now, beyond that, I still advise my patients
that if you have allergies, manage the allergies. I know you went through allergy testing but
if seasonal allergies or pollen, trees, grasses, other things that cause allergies should be
optimally managed. If it’s a sinus issue, manage the sinus issue. You have to be aware
of what causes the area around the eyes to swell. You state that your upper lid also
swells. So there may be some other issues underlying. If there is any question, you
should at least see an ophthalmologist, get a proper eye exam, maybe see a medical doctor
or an endocrinologist just to rule out any other issues that could be aggravating the
situation. But generally speaking, this is fairly straightforward and as long as there
are no other medical issues concurrently, this is a procedure that people come in and
go back to work in less than a week. So I think it’s important that you now look
for qualified, experienced cosmetic surgeons and learn about your options. There are different
ways to approach this problem. I can tell you from my perspective, this is the least
traumatic, most expeditious approach where local anesthesia, LITE™ sedation, address
the fat pockets, go back to work in less than a week, looking considerably better and having
this nice long-term solution has been very successful in a career that’s over 20 years.
So again, meet with a doctor that you feel comfortable with who will give you some guidance,
show you some before and after pictures so that you understand what their aesthetic style
is and then move forward. So I hope that was helpful, I wish you the
best of luck and thank you for your question.

6 thoughts on “How Allergies and Water Retention can Affect Eye Bags, but the Major Cause is Fat Under the Eyes

  1. I am 42 yrs old ……i m not having puffy eyes, bt after swimming my eyes seems to be puffy …no redness no iching etc …can u pls tell me its reason….

  2. Hello Sir, please help here…i am 30from Mumbai India…I have eye bags/puffy eyes…I had been done sinus surgery last year April 2018…also I have some types of Allergies…if I manage allergies then it can get rid by Some cream/serum etc…please can you suggest me on that problem…

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