Fatty hernias under the eyes

Ocular herniation, also known as fatty eyelid herniation, is a condition where orbital fat moves out of its original place in the orbital septum. As a result of the weakening of this structure, the fat pads become visible under the skin, resulting in characteristic bulges in the lower eyelid area.

This process is related to the body's natural ageing, during which the elastin fibres degenerate and the circular muscle of the eye weakens. Fatty hernias can occur in both the lower and upper eyelids, although those under the eyes are more noticeable and more likely to be the subject of aesthetic interventions.

What is an eye hernia?

Ocular herniation, also known as fatty eyelid herniation, is a condition where orbital fat moves out of its original place in the orbital septum. As a result of the weakening of this structure, the fat pads become visible under the skin, resulting in characteristic bulges in the lower eyelid area.

This process is related to the body's natural ageing, during which the elastin fibres degenerate and the circular muscle of the eye weakens. Fatty hernias can occur in both the lower and upper eyelids, although those under the eyes are more noticeable and more likely to be the subject of aesthetic interventions.

Causes of fatty hernias under the eyes

Fatty hernias under the eyes result from the displacement of orbital fat beyond the orbital septum, which loses its elasticity and strength with age. The weakened orbital septum is unable to hold the fat pads in place, leading to their prominence in the lower eyelid area.

Main causes of fatty hernias:

1. Ageing of the body: The ageing process causes degeneration of the elastin fibres in the skin and a weakening of the oculomotor muscle, which promotes the movement of fatty tissue.
2. Genetic factors: A predisposition to fatty hernias can be inherited. In some cases, early visualisation of fat pads is observed at an early age.
3. Lifestyle: Smoking, chronic stress, lack of sleep or an unhealthy diet accelerate the ageing process and reduce the elasticity of the skin.
4. Hormonal factors: Hormonal changes affecting water retention can exacerbate the visibility of fatty hernias.
5. Mechanical damage: Injuries around the eye can weaken the structure of the orbital septum, leading to the prominence of fat pads.

Although fatty hernias are most often associated with the ageing process, their formation can be accelerated by poor skin care and lack of UV protection.

How to get rid of a fatty hernia under the eyes?

Treatment of fatty hernias under the eyes depends on the severity of the hernia and the patient's preference. Options include non-invasive methods, aesthetic medicine procedures and surgical removal of fatty hernias.

Non-invasive methods:

• Cool compresses: They help to reduce puffiness and improve the appearance of the skin around the eyes, although the effect is temporary.
• Lymphatic massage: It improves circulation in the lower eyelid area and reduces the appearance of swelling.
• Lifting cosmetics: Creams containing caffeine or vitamin C can tighten the skin, but will not remove fat pads.

Aesthetic medicine treatments:

• Laser therapy: Used to firm the skin and reduce wrinkles around the eyes, which can improve the overall appearance of the lower eyelids.
• Mesotherapy: Introduction of active substances that improve skin tone and support regenerative processes.

Surgical removal

The most effective way to permanently remove fatty hernias is through a lower eyelid correction, also known as a lower eyelid blepharoplasty. During the procedure, the surgeon removes excess fat and, in some cases, skin, which restores the smooth contour of the lower eyelid. Blepharoplasty can be performed traditionally or with a laser, which minimises the risk of scarring.¹

Does fatty hernia repair carry side effects?

The removal of fatty hernias under the eyes, especially by surgical methods, is an effective way to improve the aesthetics of the lower eyelids. However, like any medical procedure, it carries some risk of side effects, which depend on the method chosen and the individual reaction of the patient.²

Potential side effects of surgical procedures

1. Swelling and bruising: Following lower eyelid blepharoplasty, temporary swelling and bruising may occur in the operated area.
2. Sensory disturbances: For a few weeks after surgery, patients may experience slight numbness or altered sensitivity of the skin around the eyes.
3. Asymmetry: In rare cases, there may be a slight asymmetry between the eyelids, requiring correction.
4. Scars: Although modern methods minimise their visibility, there is a risk of minor scarring at the incision site.
5. Complications rare: Very rare but possible complications include infection or bleeding in the eyelids.

Risks in non-invasive methods

• Laser or mesotherapy treatments are generally safe, but may cause temporary redness or irritation of the skin.
• Improper execution can result in an uneven aesthetic effect.

Risk minimisation

Choosing an experienced specialist and following recovery recommendations significantly reduces the risk of complications. It is also important to discuss any contraindications and individual predispositions with the doctor in advance.

How to distinguish between fatty hernia under the eyes and lymphatic stasis?

Fatty hernias under the eyes and lymphatic stasis in the lower eyelids can look similar, but differ in both cause and treatment. Here are some key differences to recognise them.

Fatty hernia under the eyes:

• Cause: It is the result of a weakening of the orbital septum, which leads to the displacement of the fat pads beyond their original location.
• Appearance: It is characterised by permanent, prominent bulges under the eyes that do not diminish after resting.
• Duration: Fatty hernias are permanent and do not change their appearance depending on the time of day.
• Treatment: It requires the intervention of aesthetic medicine or surgical removal of fat pads, such as through blepharoplasty.

Lymphatic stasis

• Cause: Caused by fluid retention, often due to insufficient lymphatic drainage, fatigue, high salt intake, alcohol or sleep deprivation.
• Appearance: Puffiness under the eyes is observed and can be variable - increasing in the morning and decreasing during the day.
• Duration: The swelling is temporary and subsides with the application of cool compresses, lymphatic massage or the elimination of the triggering factors.
• Treatment: Includes home remedies such as lymphatic massage, limiting salt in the diet and getting regular sleep.

Key differences

• Mobility and structure: A fatty hernia has a more compact structure, while lymphatic stasis is soft and can change shape under pressure.
• Response to lifestyle changes: Lymphoedema can subside with proper care and changes in habits, while fatty hernia requires specialised treatment.

If the problem is difficult to diagnose, it is advisable to consult a specialist who will assess, by means of a clinical or imaging examination, whether fatty hernias or lymphatic stasis are the cause of the problem.

Ważne pytania i odpowiedzi

• Does fatty hernia of the eyelids only affect the lower eyelids?

  Fatty eyelid herniation most commonly occurs in the lower eyelids, but the upper eyelids can also be affected. The upper eyelid contains fatty tissues that, if the orbital septum is weakened, can move and cause a visible protrusion.

• What is the procedure for removing fatty hernias under the eyes?

  With the eyes, the removal of fatty hernias is usually performed through blepharoplasty. The procedure involves the removal of excess skin and the displacement or reduction of the fat pads, which restores the natural contour of the lower eyelids. The procedure can be performed traditionally or with a laser.

• Does a fatty hernia of the upper eyelids require different treatment than of the lower eyelids?

  Fatty herniation of the upper eyelids often requires a similar approach to the lower eyelids. Depending on the severity of the lesion, removal of excess skin and fat correction can be performed to improve the aesthetics and function of the eyelids.

• What influences the weakening of the orbital septum?

  The orbital septum weakens with age due to ageing processes such as loss of skin elasticity, degeneration of elastin fibres and muscle weakness. Factors such as lifestyle, chronic stress and smoking can accelerate this process.

• Can massages help reduce fatty hernias?

  Massages, such as lymphatic drainage, can improve circulation in the eye area and reduce swelling, but will not remove permanent changes caused by displaced fat pads. Successful treatment of fatty hernias usually requires medical intervention.