JOE EVIATAR, MD: Well, that's different. Some people really have eye bags and they have them all the time. And that's a different story because that's not really fluid. That's more related to fat pockets that are around the eyes. Normally the eyes are surrounded by fat. As you get older, and some people genetically, they just have more bags and more of the fat is forward. And that looks like puffy eyes, but that's really not puffing. Lots of patients say to me, "Oh, can't you just suck the fluid out from under my eyes?" but it's not fluid, it's actually fat pockets.
MARY FISCHER, MD, PT: What can people do about that?
JOE EVIATAR, MD: Well, the treatment for that is surgery. We do surgery even from underneath the lid, so you don't have to have a scar on the outside. And we use a laser very often and we remove the fat pockets.
MARY FISCHER, MD, PT: How about dark circles under the eyes?
JOE EVIATAR, MD: Dark circles can be more problematic because unlike fat pockets that can be removed, dark circles are in the skin itself. Now some people get some dark circles from vascularity in the skin, if they haven't slept enough, and so-forth. And those patients, just covering it with make-up or some ice may be helpful. But some people really get pigmentation in the skin and around their eyes and nobody really knows why. In those patients, there are some physician-type products that are lightening agents, like Hydroquenone, that help with pigment, if it's truly pigment in the skin.
MARY FISHER, MD, PT: Is that something an opthamologist can prescribe?
JOE EVIATAR, MD: Yes, particularly eye plastic surgeons, people like that can prescribe it.
MARY FISHER, MD, PT: Great. I feel better already. Those are great tips. I'll try them out-and you all should try them out, too. Thanks for coming on the show.
JOE EVIATAR, MD: Thanks for having me.
MARY FISHER, MD, PT: And thank you for joining us for Working Well.