Ask Dr. Man- Eyelid Surgery

Dear Dr. Man, I’ve always had dark puffy bags under my eyes- my mom and grandmother have it as well. My eyelids also have a lot of excess skin and it makes it difficult to apply eye makeup. As I age (I’m 39 now), I find that the problem is getting worse. I’ve tried every cream and potion you can imagine but nothing has worked. I’m ready to have surgery, but I’d like to know why this happens and what treatments are available. Signed, Puffy in Boca Raton

Dear Puffy, Many people consider the eyes the focal point of the face. Your eyes give clues about your age, your mood and whether you are tired or rested. When it comes to facial rejuvenation, eyelid surgery is a good starting point because the eyelids are often the first part of your face to show the signs of aging, sun exposure, gravity and smoking.

Fatty tissue that protrudes from the eye sockets causing bulging above or below the eye can also be a genetic trait that shows up early in life; however, it can also be a result of gravity and aging. This can happen in both men and women, old and young. Sun exposure over the years can have a direct effect on the weakening of the elastic fibers that keep the eyelid skin taut.

We tend to especially notice sagging and bags under our eyes when we are tired. However, as we get older, they can become more noticeable. Bulging fat pockets result when fat pads that cushion the eyes begin to fall forward, pull away from the bone of the lower eyelids, and sag. The skin and muscle of the eyelid tend to thin and stretch over time.

Another effect of aging is when the upper eyelids become heavier and fuller and may even form a ‘hood’ over the eyelashes. As you have experienced, many women find that they have trouble applying eye shadow, or that mascara winds up getting on the upper eyelids. The hooding may also result in decreased peripheral vision, for example, when driving or playing a sport. You may also feel an added heaviness to the upper eyelids as a result of the bulging fat pockets and excess skin.

An eyelid lift, otherwise known as blepharoplasty, can help get rid of hooded or droopy eyelids. It can also help eliminate protruding fat bags above and below the eyes. The goal of eyelid rejuvenation is to remove excess skin, reduce fat deposits, tighten loose eyelid muscles, and re-establish a natural crease in the upper eyelids. Eyelid surgery does not directly correct dark circles under the eyes, but it can help eliminate the shadowing effect caused by bulging fat pockets and loose skin.

During surgery, excess fat and skin (and muscle if necessary) are removed from the upper and/or lower eyelids (depending on the specific type of eyelid surgery you get). The effects of cosmetic eyelid surgery generally lasts many years; and surgery often does not need to be repeated.

Since the eyes are such an important part of the face, rejuvenating them is a key step in maintaining a youthful appearance.

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Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.