I have swelling under my right eye only.
One doctor suggested fillers while another one blepharoplasty.
Any suggestions?
What could be the reason of swelling under one eye only?
Which treatment is better for under eye treatment.
Fillers or blepharoplasty?
Thank you for your question!
You submitted a single photo and you described a swelling that you feel is only under your
right eye and that you’re a little confused because one doctor recommended blepharoplasty,
another one recommended filler.
So what you’re describing is a situation that is confusing patients more and more these
days because of the many options available and the conflicting interests of the people
offering those options.
So let’s begin by first identifying the swelling.
If you refer to this large swelling that’s below your eyelid margin that’s fairly prominent
when you’re looking up, well that area of swelling is called lower eyelid fat prolapse.
Now in your left eye, it appears that you also have lower eyelid fat prolapse.
So then the question is: what’s better?
Blepharoplasty or injection?
Well, this question comes up in our practice every day.
As a cosmetic oculofacial plastic surgeon, I am continuously being seeing patients who
have had fillers done who have very significant fat pockets under their eyes.
So I do have a little bit of a bias because most of these people who come for revision
or some kind of correction ultimately require that inject them with a material called hyaluronidase
to dissolve their filler.
Because when they had this filler, this puffy bag became even puffier and the whole area
looks swollen.
There’s a place for filler and when someone has a small amount of fat prolapse and when
they come to our practice, we offer them that option of being able to camouflage a little
bit of that fat prolapse with a filler before they are ready for a blepharoplasty.
So from my perspective, looking at your photo, it’s pretty clear to me that if you were
some to come to my practice, I would recommend blepharoplasty and I would say that fillers
are not just going to be beneficial to you.
Now that doesn’t mean that fillers in other areas can’t be helpful.
A lot of times when someone has a situation like yours, they also have volume loss in
the cheek area.
So we may add volume in the cheek area to kind of off-set the balance or the imbalance
between the lower eyelid fat prolapse and the hollowing of the cheek.
But ultimately, for herniated fat, for fat that’s pushed forward, lower eyelid blepharoplasty,
in my opinion, is the best solution.
So with that being said, I think that you need to first evaluate who the doctors you
saw were.
Were they both surgeons?
And if they were surgeons, understand why one surgeon leaned towards fillers and I would
also say that it might be worthwhile to say what if you don’t like the fillers, what
are your options?
Because certainly people who have these fillers done who have puffy under eye bags are often
pretty angry and would have preferred not to have it done rather than to have something
done where they look fairly swollen.
So it’s all about selection and making intelligent decision.
If you’re afraid of surgery, you may be better off doing nothing than getting an injectable.
But I think that in your situation, surgery would be beneficial.
We alleviate the fear or surgery in our patients because in our practice, our facilities are
within our office and we have Joint Commission approved facilities so we kind of try to make
the surgery as less scary for the patients having a more family type of environment where
they know everybody and they’re comfortable as opposed to going to a hospital or surgery
center where there’s a de-personalization.
And the procedures we do for lower eyelid blepharoplasty are done under local anesthesia
with LITE IV sedation which means that there’s often very quick recovery.
And many times, I’ve even suggested to our patients that if you look at our patients
for lower eyelid blepharoplasty and I’ve been doing this for over 20 years, the amount
of swelling and bruising is often less than people if they have injectable fillers.
We’ve seen patients come to our office who have tremendous bruising and a lot of swelling
from having injectables.
So it’s not like they were avoiding the undesirable effects of having surgery.
With surgery, we have lot of control over that and so our patients don’t look very
swollen or very bruised after a week and they don’t have the bags anymore.
So that’s something for you to learn and hopefully this was helpful to you.
So I wish you the best of luck and thank you for your question!