Eyebag removal (Lower Blepharoplasty) 

1) via External Cut (Transcutaneous technique)

Some patients need lower eyelid surgery to improve the appearance of tired looking under eye bags. Eye lift surgery or Blepharoplasty  of the lower eyelid is performed to address under eye bags, loose skin and sagging tissue supporting the lower eye area.

What causes bags under eyes?

Puffy eyes – under eye bags are often misinterpreted as being caused by fatigue or allergies. The bags that are seen under the eyes that remain unrelated to sleep or allergies are due to lower eyelid fat prolapse. The fat that prolapses is referred to as orbital fat. This is based on the fact that the eye sits in a space called the orbit and this space has fat in compartments. To improve the appearance of the bags under the eyes, the fat may be removed, repositioned and sculpted.

Loose Skin – Many people are concerned that after the under eye bags are removed from under the eyes, there will be loose skin. Depending on the support of the lower eyelid, loose skin can be addressed at the same time. Often, the skin that accommodated the eye bags/fat pockets is tightened after surgery by the orbicularis oculi muscle. The orbicularis oculi muscle contracts like a belt and tightens loose skin.

Eyelid Support – Properly restoring lower eyelid support requires several different specialized techniques. In addition, the support structures of the eyelid can be shaped in a way that can create a brighter appearance to the eyes.

The benefits of having “eye bags” surgery

Having lower eyelid blepharoplasty to treat eye bags, loose skin and tissues under the eyes can have a dramatic effect on the overall aesthetic of your face. You will appear less tired with a fresh look, by addressing the eye bags (fat pockets). With the sagging eyelids being toned and eye bags removed, your eyes can look many years younger.

What is a lower eyelid surgery?

To address the under eye bags, loose skin and sagginess of the lower eyelid, lower eyelid surgery also known as blepharoplasty is performed.

There are different surgical techniques a surgeon can use to rejuvenate the lower eyelids, but the overall approach usually involves removing fat (or sculpting and redistributing the fat or septum) as well as removing excess skin and sagging muscle. Depending on the technique used, surgery time varies.

The two most common eyelid surgery approaches

Transcutaneous Approach

– external incision in lower eyelid

Many surgeons commonly make an external incision just below the eyelashes when performing lower blepharoplasty known as the transcutaneous incision which means “through the skin”.  This approach can be advantageous if there is sagging of the skin and the orbicularis oculi muscle (the muscle which supports the eyelid). A well placed incision can be virtually invisible when fully healed. Patients with darker skin mayexperience darker pigmentation (hyperpigmentation) along the incision line.

This approach often involves making incisions and flaps of the orbicularis oculi muscle. The delicate orbicularis oculi muscle is very important as it supports the lower eyelid like a hammock.  If the integrity of the muscle is compromised, the shape of the eye can be altered.

This approach commonly used by general plastic surgeons who don’t specialize or have enough experience in eyelid surgery often results in “rounding”, “scleral show”, or pulling down of the lower eyelids called lower eyelid retraction. This type of surgery should be performed with an understanding of other eyelid procedures to preserve the natural shape of the eye.

Transconjunctival Approach

– Incision in the Inside of the eyelid

This approach has several benefits:

No external incision so signs of surgery are unnoticeable. Even a close up eye exam will not reveal signs of surgery.
The shape of the eye is typically better preserved as the orbicularis oculi muscle integrity is preserved.
Minimal trauma to the fragile support network of the eyelid structure.

Eyebag Removal Surgery from inside lower eyelids (Transconjunctival technique)