Dear Doctor Column, July 22, 2002
Question:
Is there a way to treat bags under your eyes without surgery?
Answer:
You should first make an appointment with your family physician to make sure there is not a medical condition contributing to puffiness or bags under your eyes, such as allergies. Treating any underlying medical problem can help eliminate bags under your eyes.
According to paramedical aestheticians (trained skin-care specialists who, under the direction of dermatologists or plastic surgeons, offer personalized skin regimens and cosmetic services), there are things you can do to help reduce or conceal bags under your eyes, including the following:
· Get enough sleep on a regular basis (sleep experts recommend eight hours a night), and sleep with your head slightly elevated. When you are lying down, gravity can cause fluid to collect in your lower eyelids, where your skin is soft and elastic.
· Place a cool compress over your eyes and relax for about 15 minutes.
· Camouflage puffiness with makeup. Visit a beauty counter in your favorite department store for suggestions and to help you select the correct color of concealer and other products based on your skin type.
· Change your eyeglasses. Straight-line bifocals tend to magnify the area behind them, making circles or swelling more prominent. Progressive bifocals have a less noticeable effect.
· Drink a minimum of eight glass of water a day. Avoid alcohol, since it causes fluid retention.
The only permanent solution to eliminating bags under the eyes and tighten the lower eyelid skin is aesthetic (cosmetic) eyelid surgery, also called blepharoplasty. This procedure also is performed to remove the excess fat and drooping skin of the upper eyelids that can result in a "tired-looking" appearance, due to heredity and aging. The best candidates for eyelid surgery are individuals who are physically healthy and realistic in their expectations.
An outpatient procedure, eyelid surgery is usually performed under local anesthesia. When eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.
If you are having both top and bottom eyelids done, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.
If you have a pocket of fat beneath your lower eyelids but do not need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.