Can surgery remedy my tired looking eyes?

Q: Dr. Eppley, I would like information about breast augmentation. I have breastfed two of my children and my breasts sag considerably. I compare them to a much older woman. It is very difficult to buy bras that fit well without padding, and I am not happy with the way I look shirtless. I would like to know about my options.

A: Based on your own description of ‘my breasts sag considerably,’ it sounds like you would need some type of a breast lift if implants were placed. Breast implants have no capability of lifting up a breast and moving the nipple to the center of the breast mound if the starting position of the nipple is below the lower breast fold. Therefore you have to think about the trade-off of scars for fuller and uplifted breasts. You will also have to consider whether you would want saline versus silicone breast implants. I would be happy to look at any pictures that you want to send to give you a more exact recommendation. But for now, I will assume that you need full breast lifts with implants.


Q: Dr. Eppley, I have very thin skin under my eyes and they are puffy. I always look so tired and worn out. Just curious if surgery could correct this?

A: The puffiness under your eyes is a common problem and is due to intraorbital fat that is now sticking out. This is a typical development that occurs as we age. Normally the fat around the eyeball is contained behind the eyelids by certain supportive tissues. As we age these tissues weaken and the fat begins to protrude against the lower eyelid. This creates lower eyelid puffiness or bags. With time, these lower eyelid bags can become quite pronounced. Because fat has a high content of water, these eye bags may be bigger in the morning or after eating foods with high salt contents. While some people have these bags naturally even as early as their teens, most people develop them to varying degrees after the age of 40 or so. This fat removal is a common component of most lower eyelid blepharoplasty procedures. If one does not have any or too much loose skin, the fat can be removed from inside the eyelid. When loose and sagging skin needs to be removed and tightened as well, an external transcutaneous lower blepharoplasty technique is used. Both techniques can result in a significant change that remedies that tired look.