Dear Dr Seckel, How can you tell if the puffiness under your eyes is due to fat pads or sagging skin? Are the fat pads located right where the puffiness is or where the lash line is close to the tear duct. Can a blepharoplasty be done just to snip the small amount of sagging skin if the skin is taut? Miriam, Boston, MA
Dear Mariam,
Put your finger on the bone of your eye socket above the cheek–above this bone any puffiness is eyelid fat, which is removed or repositioned during a blepharoplasty. Any puffiness below this bone is on the cheek and is called a festoon and is not improved by blepharoplasty. Puffy eyelids are caused by protrusion of the fat beneath the eyeball against the eyelid skin
Skin can be snipped during the plastic surgery operation called a blepharoplasty–but I rarely need to do this. Laser Blepharoplasty, which I do, is through a tiny incision on the inside pink portion of the eyelid called the transconjunctival laser blepharoplasty–thus no scar–produces beautiful results. Today during eyelid rejuvenation procedures, less fat is removed and often fat repositioning is done to fill the dark circles under the eyes. Using this technique, eye bags are removed and removal of eyelid skin is usually unnecessary.
For more information on transconjunctival laser blepharoplasty and plastic surgery read Save Your Face or contact me.
Thank you,
Boston, Massachusetts