High Cholesterol Leaves Woman With 'Most Severe' Eye Bags Surgeon Has Seen

Abby Rivera is no ordinary beauty influencer. The single mom and widow has attracted hundreds of thousands of followers by sharing honest reviews and sincere conversations about navigating life and beauty techniques with a rare skin condition.

Rivera, 42, first noticed the spots under her eyes back in 2010. "I was unaware of what they were at first until a friend who was a dermatologist told me," Rivera told Newsweek.

Rivera, who lives in the northern suburbs of New York City with her son, suffers from familial hypercholesterolemia. This is genetically high cholesterol that can build up in little pockets underneath the eyes. These deposits are called xanthelasmas.

"When they were smaller, it did not affect me as much, but when they started to grow, it then bothered me," Rivera said.

In 2022, she went to see an oculoplastic surgeon, a surgeon who specializes in plastic and reconstructive surgery around the eyes. "When seeing him, I was told I had the most severe case of xanthelasmas he has ever seen," Rivera said. "Because of the shape and wideness of them, it's making it very hard for him to go and do the surgery that he normally does."

Even after getting the xanthelasmas removed, there is a chance that they will come back. Rivera knows this firsthand: "The last time I had them removed was April 2018, but they have since come back and are larger since then," she said. "Now, they are at the largest they have been."

Dr. Jessica Lattman, an oculoplastic surgeon in New York City, told Newsweek that there is a great deal of false information surrounding xanthelasmas and their treatment: "One of the biggest misconceptions about xanthelasmas is that they can be treated with a laser or some kind of topical treatment. This is absolutely false. That may not be what you want to hear, but if you take the 'easy way' with just the laser, you may end up with scarring and more problems than you had in the first place."

Lattman explained that these surface treatments do not work because the xanthelasma goes through all levels of the skin. "The only way to remove them is to surgically excise them, and that really has to be done by somebody who really understands the eyelid," she said. "The eye is a tricky area [...] On the lower lid, it's really important to be able to assess how much skin you can take without causing the lower lid to get pulled down or distorted."

Although Lattman sees patients with xanthelasmas on a weekly basis, the condition is still quite rare, occurring in roughly 1.1 percent of women in the U.S. and 0.3 percent of men. Although you can reduce your risk of recurrence after surgery by lowering your cholesterol, there is always a chance that the xanthelasmas can come back.

Rivera said that she is still on the fence about getting the surgery. "At the current moment, I am waiting to get a second opinion and have a consultation scheduled for April 27. The cost of the surgery is concerning, and I am also worried about spending all this money and then having the potential of them coming back.

"Many of my followers have suggested I go to a foreign country for surgery as it would be cheaper, but this is something I will NOT entertain," Rivera added. "There is always a chance that something goes wrong, and I do not want to take that risk. My case is quite complex, and multiple doctors have told me my case is the worst they have ever seen."

In the meantime, Rivera is documenting her journey and experiences on social media under the handle @abbythebadassmom. She shares makeup and skincare tips that help with her condition.

"I first downloaded TikTok during the pandemic when I was bored at home," Rivera said. "I always held back from sharing about makeup and skincare because of my eye condition. But, in November 2021, I finally started to make some videos with makeup. The first video got 2 million views, and it was me just sharing my mom makeup routine. Many people loved how realistic I was. They kept asking more questions and wanting more videos. So, finally, I had the confidence to share more, and haven't stopped since.

"People love my honesty and realistic makeup routines. Also, giving advice on makeup and skincare that works for more mature skin," Rivera added.

In just over a year, Rivera has gained over 166,000 followers and millions of likes and views. However, although she has received positive feedback from many of her followers, social media has definitely been a double-edged sword. "You do have to have a thick skin for TikTok, especially in the beauty space, and for me, because of my eye condition, it is even worse," she said. "There have been many hateful comments from trolls criticizing how hideous my eyes are. In the past, I might have clapped back, but now I just delete, block and move on."

For the most part, Rivera's condition has not affected her makeup routine, but there are some things that she cannot do. "Many people powder under their eyes to set their concealer, but if I add too much powder, it will be an awful sight. I also have to make sure to pick concealers which are hydrating, so they do not fall into my lines and xanthelasmas. Anything matte or long wear under the eyes is a no for me," she said.

Lastly, we asked Rivera what her No. 1 makeup item would be if she could have only one: "That's a hard one, but probably concealer, due to my eye condition. Top five right now are Givenchy Prisme Libre, Kulfi, Charlotte Tilbury, Kosas and Winky Lux."