Thank you for your question.
You submitted your question with a photo.
And you’re asking about the appearance of what you recognize as possibly under eye bags
or hollowness which is the basis of your question and that you’ve been having this at the
age of 29 for only the past 7 weeks.
And you go on to describe some of the situations with your sinuses but currently, you cannot
take a decongestant because you are breastfeeding.
I can certainly share with you my perspective for a situation like yours which comes into
my office pretty constantly every day, not so much in exactly the same way but basically
the question is whether a person has under eye bags versus hollows.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Helping people with the appearance around their eyes whether it’s with under eye bags
or whether it’s with hollows as well as upper eyelid surgery and wrinkles etc. is
a core speciality in my practice.
As I said, I’ve been doing this for over 20 years.
So to begin with, I think it’s important to recognize first what is the issue and how
it is being expressed currently.
You submitted a photo actually looking upwards and that’s actually very helpful.
When you look upwards and this bulge appears, well that is pretty consistent with something
called lower eyelid fat prolapse.
Lower eyelid fat prolapse means that the fat that is normally around your eyes pushes forward
and creates this bulge.
Now patients often, just people in general not just patients, people often look at themselves
and see these bulges but rather than focusing on the bulge, they look at the area adjacent
to the area below it and that area is perceived as under eye hollow.
Now that being said, when you are noticing something like this for only seven weeks,
certainly I have observed over the years that for some people, fluctuations in allergies
and sinus issues can cause these bulges to look more prominent.
And when people have this type of situation, I basically ask them is it constant, is it
where it doesn't matter how much sleep you get or whether you are already managing sinus
problems, allergies etc.
Is it still fairly constant?
And a lot of times patients will say that there are days where they look good and there
are days where they don't look so good.
So I say that essentially you do something when there are more not so good days as there
are good days.
And when you have a modest amount of fat prolapse, although surgery is probably going to be the
ultimate definitive procedure, in our practice we have certainly embraced a strategy especially
for busy people to also use ways to camouflage this fat prolapse.
And again, this is fat that has pushed forward and essentially it’s a hernia that’s why
it’s referred to as herniated fat.
But up to a certain level, you can actually place a filler and a filler such as in the
hyaluronic acid family such as Restylane and Juvederm and you place it in this area right
below the fat that’s called the tear trough.
Now this procedure is done with a little bit of local anesthetic and it is done with techniques
so that there’s a minimum chance of bruising.
And basically within a few minutes, you can actually blend the space between the bone
and the fat and that helps to make this area look a lot better.
And patients who are having this just minimal problem are very pleased and very satisfied
with this strategy.
If the fat becomes more prominent to the point where you can’t blend it so well, well that’s
probably a good time to consider surgery.
A lot of times, people don't want to spend the time and the cost of doing injectable
fillers and they’ll just want to go for the surgery from the beginning.
So it’s a matter of personal choice and lifestyle, etc.
I think that you can maybe allow yourself a little bit more time since it’s now been
only 7 weeks to establish whether this is being constant for months rather than a few
weeks.
And if such is the case and you mention that you are breastfeeding, so depending how far
along you are away from the time you delivered, hormonal levels and fluid can also have some
degree of impact.
And it’s just a matter of observation.
So before you move forward with any procedure, you can meet with an experienced, qualified
specialist and discuss these variables and see what transpires in terms of a physical
examination.
And when you look from the perspective of not only the front view with your eyes looking
up but as I do in my practice, I take a lot of pictures and then I review these pictures
with my patients and I’ll take a front view and a three quarters view, a side view and
of course a physical examination to get a sense of volume and what would be the strategy
that is optimal for the individual patient.
So again, meet with an experienced, qualified specialist.
Make some observations on your own as to how this is appearing.
And if it’s constant, then again, the strategy can be filler instead of surgery for a while
or just surgery but it doesn't negate the possibility of still needing fillers if that
area still looks a little bit hollow but that’s a conversation you discuss with your doctor.
So I hope that was helpful, I wish you the best of luck and thank you for your question.