Category Archives: eyelids

There are many kinds of growths and bumps that can form on the eyelid as one matures. Little things can pop up causing you to feel less confident about your appearance. Here are some explanations of the different types of eyelid growths and bumps and what can be done about them.

There can be skin tags, cysts, moles, or styes. A skin tag is extra skin that grows in one specific area. It can grow in a 3 dimensional way or sometimes they are more wide than tall. These are likely benign. These can be treated with local anesthetic in the office. The bump is shaved off and it heals in on its own.  

There are several types of cystic lesions. Sometimes these cysts are clear and fluid-filled. These are called hidrocystomas. Sometimes they are filled with white matter. These are called inclusion cysts, also called milia. Sometimes they are filled with sebaceous or oily matter and these are called sebaceous cysts. Most likely these growths are benign or harmless. They can be treated in the office with local anesthesia. These cysts can be drained by making a tiny opening in the bump. Usually, the inner cyst wall needs to be removed to help to prevent a recurrence or regrowth.

Moles are bumps that can be present from childhood or can grow later in adulthood. They can be pigmented or flesh-toned. These should be carefully examined by a physician to make sure they don’t look suspicious. If they look benign, they can be carefully shaved with radiofrequency energy and the edges blended with the surrounding area for optimal aesthetic results. This is called “scarless” mole excision. If there are any suspicious characteristics of the bump, it can be sent for pathology.

Another type of bump is the stye category. These bumps are usually red, tender, and can be a little painful at the beginning. They can be on the inside or outside of the eyelid. The official name is a chalazion. The cause can be from hormones, stress, pollution, ocular rosacea or other unknown reasons. There are oil glands, also called meibomian glands, which sit behind the eyelashes on the eyelid margin/ “water line”. These vertically oriented glands can get blocked by thickened oil. The body creates an inflammatory response as a reaction to the blocked oil. Treatment consists of warm compresses for 10 minutes at a time and perhaps prescription eyedrops, oral medication and infrequently drainage of the stye.

Fortunately, growths on the eyelid are common and most of the time they are benign or not dangerous. They should be evaluated and treated by an Oculoplastic Surgeon or a physician who feels comfortable working close to the eyes. These bumps can be treated in the office with local anesthetic and do not usually require going to the hospital. Recovery can be a few days or a little longer if there is bruising. Treating eyelid growths can increase your self-esteem and take years off of your appearance.

Got bags under your eyes? People may think you are exhausted or sad, even when you are not. This occurs most commonly when someone is in their 40’s or 50’s. Eyelid bags can even affect relationships at home or at work and your self-esteem.

There are many reasons why someone has lower eyelid bags. The first reason is as you mature, the skin and soft tissue thins out revealing the orbital rim. This creates a hollowed appearance under the eyes. Additionally, as one matures, the fat that surrounds and protects the eye is no longer held back by this soft tissue. This creates a hill next to a valley, so this particular anatomic configuration can cause shadows in this space aka dark circles. The under eye area can also get darkened by allergies and other medical conditions.

How do you fix bags and dark circles?

Make sure any allergies to environmental allergens and pollen and sinus problems are adequately treated before starting any aesthetic treatments. Some topical under eye creams can be helpful. Active ingredients such as caffeine, peptides, retinols, hyaluronic acid and growth factors can be added for more effect.

If there is hollowing alone or hollowing accompanied by mild bags, then a hyaluronic acid gel dermal filler with low hydrophilic (low water attracting) properties can be injected under the eyes. Restylane or Belotero are good options. Hyaluronic acid gel can be dissolved with a special enzyme called hyaluronidase if there is an undesired result.

If there is moderate or severe fat prolapse accompanied by hollowing, blepharoplasty surgery may be recommended. The newer trends are to preserve volume. There is a procedure called a fat transposition blepharoplasty where the incision is created on the inside of the eyelid. The excess fat is tucked into the hollowing below it, filling it and making the eyelid contour more even. This can give a well-rested look without looking done, tight or windblown. This newer generation surgery technique permits the incisions to be hidden to avoid telltale signs of surgery.  

The skin around and under the eyes may have lost elasticity over time or there may be fine lines and wrinkles. This skin is delicate and must be treated with meticulous care. Peels, microneedling, laser, radiofrequency and skin pinch/skin flap blepharoplasty can help improve the appearance of extra skin.

Thankfully, bags under the eyes can be improved with creams, hyaluronic acid gel fillers or even surgery so you can feel like your best self. Please consult with an Oculoplastic Surgeon, a surgeon who has done fellowship training around the eyes, to discuss your treatment options.