Dr. Joseph M. Perlman Advanced Plastic Surgery Centre

I just returned from a restful vacation. Not only was I stress-free but I was also allergy free. It did not take long to return to the typical Houston weather and my allergies flared back up. It was back to the over-the-counter antihistamines and decongestants. It still left me with puffiness of the lower eyelids. This is a common symptom of “hayfever”, although most allergies are due to other air contaminants including pollution, mold, cedar, and pollen.

In my practice, I see many patients who desire to have treatment for excess eyelid skin and puffiness. In many older patients, the problem is due to the laxity of the membrane that keeps the fat around the eyeball in its proper place. The eyeball only occupies about half the space of the eye socket. The rest is filled with fat which serves as a shock absorber as well as the muscles that move the eyelids and eyeball. As we get older, the membrane that holds the fat pads in place weakens and the fat “pooches forward”. A surgery called blepharoplasty removes some of the herniated fat and repositions the remainder. Over the course of the last 20 years, the philosophy in regard to eyelids surgery has changed. When I was a resident over 25 years ago, the common practice was to remove the fat that was herniated, but this tended to leave a more sunken look to the eyelids, particularly the lower eyelid. Nowadays, we have learned to conserve and reposition fat rather than remove as much as we used to.

For patients whose puffiness is due to allergies, over-the-counter antihistamines, and decongestants will help. There are also creams available that contained penta peptides. These are proteins made of essential amino acids, that I discussed in a previous broadcast. These penta peptides strengthen the capillaries in the eyelids to prevent fluid from leaking out. They also help promote the removal of the fluid from the eyelid tissue. This also corrects the discoloration that many people have that causes dark circles of the lower eyelids.