At the Virginia Institute of Plastic Surgery, board-certified plastic surgeons Dr. Burton Sundin and Dr. Reps Sundin bring more than 30 years of combined experience to facial rejuvenation. Serving Richmond and the surrounding region, our practice is known for precise technique, thoughtful surgical planning, and naturalistic results that enhance rather than alter your features. Puffy morning eyes are common, but when fullness becomes persistent and structural, eyelid surgery is often the most effective and lasting solution.
When under-eye bags or upper lid heaviness are caused by protruding fat pads, excess skin, or tissue laxity instead of temporary fluid retention, blepharoplasty directly corrects the underlying anatomy. Below, we outline how to determine whether surgery is appropriate and what a customized treatment plan may involve.
Why Puffy Eyes Persist
Mild swelling after sleep is typically related to fluid shifts and often improves within hours. Chronic puffiness, however, usually reflects anatomical changes that topical products and lifestyle adjustments cannot correct.
Contributing factors often include:
- Fat prolapse: Weakening of the orbital septum allows fat pads to shift forward, creating visible fullness.
- Skin laxity: Collagen loss from aging and sun exposure leads to loose, redundant eyelid skin.
- Structural relaxation: The supportive tissues around the eyes gradually lose firmness over time.
- Genetic influence: Some individuals develop prominent upper or lower lid fullness early in adulthood.
When these deeper structures are responsible, meaningful improvement requires structural correction.
Determining Whether Surgery Is Appropriate
A thorough consultation is essential. Dr. Burton or Dr. Reps Sundin evaluates skin quality, fat distribution, eyelid position, brow support, and overall facial balance before recommending treatment. The goal is not simply to remove tissue, but to restore proportion and function while maintaining natural expression.
You may be a strong candidate if you wish to:
- Reduce upper eyelid heaviness: Excess skin that creates a hooded or fatigued appearance.
- Improve visual obstruction: Redundant tissue that interferes with your field of vision.
- Smooth persistent under-eye bags: Fullness that remains consistent throughout the day.
- Refine lower lid contour: Laxity or separation between the lower eyelid and cheek.
If puffiness is primarily fluid-related or minimal, non-surgical options may be discussed. Our recommendation is always guided by long-term results rather than short-term fixes.
Your Eyelid Surgery Options
Blepharoplasty is highly individualized. Surgical technique is selected based on your anatomy, aesthetic goals, and whether concerns involve the upper eyelids, lower eyelids, or both.
An upper eyelid lift removes or repositions excess skin and, when necessary, a small amount of underlying tissue through an incision concealed within the natural crease. In many cases, the procedure can be performed under local anesthesia, allowing for a controlled experience and efficient recovery.
A lower eyelid lift focuses on fat repositioning, conservative removal when appropriate, and skin tightening. Incisions are typically placed just beneath the lash line or inside the lower lid using a transconjunctival approach, which avoids an external scar. When indicated, eyelid surgery may be combined with brow or facial rejuvenation procedures to ensure balanced results.
A Thoughtful, Expert Approach To Puffy Eyes
Persistent puffy morning eyes caused by excess skin or fat rarely resolve on their own. At the Virginia Institute of Plastic Surgery, Drs. Sundin apply board-certified expertise, advanced fellowship training, and decades of surgical experience to determine whether eyelid surgery is the right answer for you. If you are seeking a lasting solution delivered with precision and a commitment to natural results, schedule your personalized consultation with our Richmond team today.
