As you grow older, you develop bags under your eyes that can make you look tired and sad. The loss of natural skin elasticity and fat padding below the lower lid makes the eyes look puffy, baggy, and wrinkled. Swelling and discoloration (also called dark circles or tear trough deformity) further aggravate the problem. Because the skin in the area is very thin, it is prone to developing fine lines and wrinkles. All these changes can make you look older than you are. But you don't have to live with these signs of aging. Lower eyelid surgery for eye bag removal can give you a smoother, rejuvenated, more youthful appearance. Continue reading to learn more about eye bag surgery, including what it involves, risks, cost, non-surgical alternatives, and more.
What causes eye bags to form?
An eye bag forms due to the natural aging process. With age, the skin becomes less elastic, loose, and develops lines and creases. The tissues and muscles around the eyes become weak and contribute to the bag formation below the lower eyelids. The weakened tissues allow the natural fat pads in the area to bulge out, creating a bubble-like eye bag appearance. Also, the loss of volume in the malar (cheek) area makes the eye bags appear more prominent. Essentially, these aging changes produce a bulge where you don't need one (below the lower eyelids) and a depression where you want more fullness (in the upper cheeks). That is why the best treatment for eye bags is a combination of removing bulging fat below the lower lids (a surgical procedure called a lower blepharoplasty) and addition of fat to replace lost volume in the upper cheeks.
Do you need surgery to remove eye bags?
Blepharoplasty or eye bag surgery is one of the treatment options to get rid of bags under your eyes. During this cosmetic procedure, the surgeon removes excess fat through an incision inside the lower lid or in the natural skin crease below the lid to tighten loose skin, remove excess fat, and treat wrinkles in the area.
What problems can eye bag surgery treat?
Some of the cosmetic concerns that lower eyelid surgery can address include sagging of the eyelid, a baggy under-eye area, skin wrinkles around the eyes, asymmetry between the left and right lower eyelids, and dark circles under the eyes. You should be honest with your cosmetic surgeon about what bothers you most about your facial appearance. They will show you before/after eye bag surgery photos to help you understand what various procedures can and cannot achieve.
How to prepare for eyelid surgery?
Consultation
During your consultation, be sure to tell your surgeon about all your health conditions and give them a list of your current medications, including dietary supplements and herbal products. This will reduce the risk of drug interactions and reactions to anesthesia medications.
Instructions
Your doctor will give you specific pre-procedure instructions. Follow them carefully to ensure a safe eye bag surgery with expected results. If you are having the procedure under general anesthesia, you will be instructed not to eat or drink anything after midnight on the day before your lower eyelid surgery. Your doctor may also give you some medications, including eye drops, to take or use before surgery. They may ask you to temporarily stop taking some of your medications.
Preparations
You will need someone to drive you home after your blepharoplasty. Before your leave home for your procedure, make sure you have ice packs or cold compresses, sunglasses to protect your eyes from the sun, and all your eye prescriptions to use after surgery.
How is lower eyelid surgery performed?
Lower eyelid surgery involves removing excess skin and fat to give the undereye area a smoother, tighter appearance. The exact surgical approach will depend on your facial anatomy and your aesthetic goals. However, given that the structures in this part of the face are extremely delicate, the surgeon needs a very precise approach for eye bag removal.
Anesthesia
The procedure usually starts with marking the eyelids for the blepharoplasty incisions. This is often done with the patient sitting up so the surgeon can see the eye bags better. Eye bag surgery can be done under general or local anesthesia with IV sedation. If you have general anesthesia, you will be asleep and completely unaware of the procedure. If you get local anesthesia, you will be awake, but the eye area will be numbed so you won't feel anything. If you are having multiple cosmetic procedures, your doctor will likely recommend general anesthesia. Lower eyelid surgery alone can usually be done under local anesthesia. One advantage of local anesthesia is that the surgeon can test eye muscle movements during the procedure.
Incisions
The incisions can vary depending on your facial structure and cosmetic goals. The surgeon will make the incisions inside the lower eyelid or just below the lash line. They will then remove excess skin and fat and tighten up the area to create a smoother, rejuvenated appearance. If you have hollow areas below the eyes, your surgeon may recommend fat grafting to give you a fuller, brighter, more alert look.
What to expect after lower eyelid surgery?
Lower blepharoplasty is typically an outpatient procedure. Unless you're having other procedures performed as well, you should be able to go home the day of your surgery. Your doctor will give you specific post-procedure instructions. This will include applying cold compresses for 24-48 hours to help reduce swelling. Be sure to take all the prescribed medicines and use the ointments and eye drops as advised by your doctor after eye bag removal. Following your doctor's medical advice will help ensure an uneventful recovery.
It is common to have some side effects such as bruising, swelling, dry eyes, and minor discomfort around the eyes in the days after your lower eyelid surgery.
You will need to avoid strenuous exercise for at least 1 week. Your surgeon may ask you to sleep with your head propped up on two pillows for a few days. Be sure to wear good quality sunglasses to protect your eyes while you heal from the surgery and beyond. If your surgeon has placed non-dissolving sutures that don't get absorbed naturally, you will have to get them removed in the office 5-7 days after eye bag surgery. Keep your followup appointments to be reviewed post surgery.
Most patients are comfortable going back to work and out in public 10-14 days after eyelid surgery, when most of the swelling and bruising has disappeared. Call your doctor immediately if you experience symptoms such as bleeding, fever, skin warmth, and worsening pain during the recovery period.
How long do the results last?
While eye bag surgery corrects many of the signs of aging in the under-eye area, it does not put a stop the natural aging process. As you continue to age after your blepharoplasty procedure, changes in your skin may cause the under-eye area to sag and become wrinkled again. The results of eyelid surgery are therefore long lasting but not permanent. How long your lower eyelid surgery results last will depend on your age, the quality of your skin, and how good you are with sun protection and skincare after the procedure.
What are the risks of eye bag surgery?
Besides the expected side effects of bruising and swelling, the potential risks of lower and upper eyelid surgery including bleeding, infection, double vision, vision changes, vision loss, eyelid drooping, adipose tissue necrosis (death of fat tissue), muscle twitches, persistent pain, numbness, skin discoloration, scarring, and wound healing problems.
What other procedures can be combined with blepharoplasty?
You can safely have several other cosmetic procedures at the same time as a lower blepharoplasty, including laser skin resurfacing, dermal fillers, fat grafting, upper eyelid lift, brow lift, forehead lift, facelift, and neck lift.
What are some non-surgical eye bag treatments?
There are different ways to reduce under-eye puffiness and get rid of eye bags. Home treatments can temporarily shrink undereye bags by removing excess fluid that has pooled in the undereye area. However, home remedies and skincare products can only do so much. To permanently do away with prominent under-eye bags, surgery is often necessary.
If the sagging of your eyelid skin is mild to moderate, some non-surgical treatment options may be effective. This includes facial fillers and laser skin resurfacing. Laser skin resurfacing with Erbium YAG or CO2 lasers can tighten the skin. However, these treatments may not be appropriate for people with darker skin tones as the laser can cause discoloration in pigmented skin. Dermal fillers like hyaluronic acid are not approved for use in the under-eye area. However, some cosmetic surgeons do offer hyaluronic acid fillers to give the eyes a fuller, tighter, smoother appearance. This procedure is a temporary solution for eye bag removal because the filler gets absorbed over a period of 6-12 months.
How much does it cost to remove eye bags?
Based on estimates by the American Society of Plastic Surgeons (ASPS), the average cost of eyelid surgery or blepharoplasty in the US is around $3,000. The cost of having bags under your eyes removed can vary greatly depending on where you live, the skill level of your surgeon, and other factors. Because eye bag surgery is usually elective, insurance does not cover the costs. The cost of your surgery will be higher if you're having both lower eyelid and upper eyelid procedures performed.
I am interested! How do I find a surgeon for eye bag removal?
The MeTime app makes it easy to find an experienced cosmetic surgeon for eyelid procedures and related treatments. You can chat with experts, send photos across, set up a video consult, and book your office consultation when you're ready. Download the MeTime app today and get rid of your undereye bags and puffiness without further delay.