Suggestion on eye bag treatments and risk level if surgery is needed?
I've had under eye bags since 10 years ago. It becomes worse in this couple of years due
to my allergy to pollen and my bad sleeping position (lay on my belly). I have not tried
any eye bag reduction treatments except some eye cream, and it is not helpful. Can someone
give me some suggestions on what procedure I should do based on my current situation
and what the risk level is if I need a surgery?
Thank you for your question!
You submitted two photos where you’re smiling but you described in your history that you’ve
had under eye bags for about 10 years that the bags became considerably worse because
of allergies and in your opinion, sleeping on your face and so you’re asking about
surgery and of course relative risk. So certainly I can help you understand what’s going on
with your under eye bags and give you some guidance about how to minimize the risk of
any solution.
To give you a little background, I’m a cosmetic oculofacial plastic surgeon that means I specialize
first in eye surgery before I had very selective training in specialty called oculofacial or
ophthalmic plastic and reconstructive surgery. It’s a very narrow specialty after eye surgery
training and it’s surgery dedicated dealing of diseases and conditions of the eyelids,
the orbit or the bone around the eyes, the lacrimal system, the tear gland, the tear
ducts. So eyelid surgery is something I’ve been doing a lot for over 20 years in practice
in Manhattan and Long Island.
So when it comes to under eye bags in a relatively young person, we have to first let you understand
what they are. They are fat pockets. The fat pockets are due to prolapse of the fat that’s
around the eyes and it’s called lower eyelid fat prolapse. And this is why the under eye
creams that you didn’t mention in your question don’t work because the fat is deep and it’s
a volume therefore topical creams are not going to do anything.
Now over 20 years ago when I went into practice, I made it a personal mission to minimize risk
with any kind of cosmetic surgery. I always felt that an elective surgical procedure is
something that, if there are risks you can avoid, then let’s figure out a way to avoid
it. I’m also board certified in general cosmetic surgery that includes facelifts,
breast surgery, liposuction, tummy tucks etc. So what I did over this time is evolve a system
and a process of doing these procedures with the principles derived from what I did first
which was making eyelid surgery a safer and lower risk procedure.
Now there are two types of risks that you have to be concerned about: one is the risk
of the type of anesthesia. When you look at where the risks of plastic surgery occur,
a significant percentage are related to anesthesia-related issues. Now of course, when you talk about
anesthesia, it’s not the anesthetics specifically or the gas necessarily but it’s a systemic
impact of being under general anesthesia compounded by the type of surgery that’s being done.
This doesn’t necessarily apply to eyelid surgery but there are procedures like liposuction
or tummy tucks where there are risks of physical and medical complications which are compounded
by general anesthesia.
What we do is we do these procedures under local anesthesia. That’s like the local
anesthetic you get if you to the dentist and we also give a little sedation, that reduces
the anxiety. The key is to minimize pain, minimize, minimize anxiety. So we found in
our practice with all the things we do, whether it’s facelift, breast augmentation, liposuction,
we are able to accomplish these procedures with minimal physical risk.
The second risk which is also very important is the surgical associated risk. Now this
is a controversial topic but frankly coming from the perspective of a super specialist,
I always come from a perspective as a person as to how doctors select doctors people from
the family. When a physician has a family member who needs medical care, they always
find the best in terms of the most specialized, with the most experience with a focus in a
particular area. So I’m going to advise you in the same way. As an oculofacial plastic
surgeon, I can say that the anatomy and the complexities of the eye area in terms of just
the training in oculofacial plastic surgery far exceeds in volume and complexity in comparison
to general plastic surgery and facial plastic surgery. The numbers speak for themselves
when you look at logs of surgical cases.
Now it also goes to what type of practice you have. And again, I would say in minimizing
risk, going to an oculoplastic surgeon is somebody who understands eyes and understands
in a very complex level, eyelid surgery, the risks are diminished. It doesn’t mean we’re
immune to complications. No surgeon is ever immune to complications. But managing those
complications is something that, when it comes to the hierarchy of surgery, for example in
my practice, patients come from around the world for me to fix complications of eyelid
surgery. This is over 20-year period of doing this and people knowing that I’m known for
doing revision surgery.
So I would say that the balance to help you make the right decision would be find the
experience doctor who does a lot of eyelid surgery, comes from a specialty background
and do it under local anesthesia with LITE™ sedation. I think that is my opinion and is
how I do my surgery in my practice and we do our surgeries in our own facilities in
both our offices which are certified by the Joint Commission which is the same body that
certifies hospitals and surgery centers. So safety is of course of the highest value and
is critical for the successful outcome for any procedure. So talking about risks, this
is my advice to you and of course meeting with doctors and feeling comfortable with
who you are having performed the procedure for you.
So I hope that was helpful, I wish you the best of luck and thank you for your question!