Question: 10 years ago, I had lower blepharoplasty and the fat pads removed under my eyes. Now there are fluid sacs under both eyes. I just turned 50. Can this fluid be drained or will it just come back? What causes it and what are my options to get rid of the tired looking sacs?

Dr. A’s Answer: What you have are called festoons. It is unlikely that this is related to your previous surgery. Allergy can make them worse or cause them to show up on people who are genetically pre-disposed. Sometimes removal of the allergen will fix them, but often times once they set in, they don’t go away. I would avoid having any injections around them, either temporary (like Restylane/Juvederm) or permanent (fat). This is more likely to make them worse rather than better. Surgery is rarely an answer, but in severe cases it is and involves excising the entire fold of skin. The only treatment that I believe is reasonable to consider in your case is laser resurfacing. Laser resurfacing has a chance at improvement and is very unlikely to make them worse. Laser resurfacing has other benefits with regard to wrinkle improvement. I speak here of real laser resurfacing, either dual mode erbium or CO2. A low-level laser will not work. Be aware, that this level of resurfacing involves some healing time.

Best Regards,

Dr. A