Q. I am a woman of color. For the past several years I have been noticing that I look tired and have bags under my eyes. Do you think it would be safe for me to have facial surgery or am I more likely to scar because of my skin tone?

A. The literature speaks to both sides of this question, so I will tell you my personal experience. I trained in New Orleans, where a substantial number of my patients were African Americans and Latins. I have practiced in Miami for more than 20 years, and needless to say, I have many patients who fit that description, too. I do warn my patients that there is a possibility they may scar poorly or with keloids, but thus far that has not occurred.

Scars can result from a patient's propensity to form them but they can also form from poor surgical technique such as undue tension in an incision site or poor placement of incisions.

Speaking of incision placement, you may be a candidate for a transconjunctival lower lid blepharoplasty (removing your lower lid bags by making an incision inside the eye). If so, there would be no incision outside your eye and therefore no scarring.

I recommend your have consultations with several facial plastic or plastic surgeons before making a decision. Do not hesitate to ask questions, and make sure you are comfortable with the doctor.

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