Everything you need to know about eye bags surgery

What causes eye bags?

Fat surrounds the eyeballs, which cushion and protect the eyes. A layer of tissue called the septum holds the fat inside the eye socket. With age, the septum weakens and the fat bulges out causing eyebags and the appearance of dark circles under the eyes.

ageing facial anatomy

Can I remove eyebags without surgery?

If the fat bulges out, do we just remove it or push it back in? It is not as simple as that. Other considerations may affect the methods used.

These are some the methods of removing eyebags we have heard of:

Tightening the septum

asian woman with eye bags

Some companies sell radio frequency machines that can tighten the septum, similar to how it tightens the face. However, excessive heating can cause excessive scarring and damage the eyelid, which pulls it down and results in ectropion.

Remove the fat with laser

Lasers that melt fat for liposuction can also melt the fat of our eyebags. However, this method is not very popular. After all, shooting lasers next to the eyeball is not exactly the safest thing to do.

If you don’t do enough lasering, you won’t achieve anything. If you do too much, you put the eyeball at risk. Additionally, the laser equipments are expensive and the results aren’t as ideal as traditional methods.

Removal of the fat and the “Scarless” Eye Bag Removal

This concept sells very well because there are no external cuts. You approach the fat by cutting inside the lower lid. Most people find the promise of no external cuts attractive, but they often end up disappointed with the results. Besides, scarring because of complications can still occur.

Removing fat alone can worsen wrinkles and make dark circles under the eyes more noticeable. If your lower eyelid skin is loose, a surgeon must remove it with external cuts. There is no way to avoid this.

Performing the surgery is harder because the access becomes smaller, which occurs through a small cut in the eyelid. There are some faces where this access may not be adequate to do a proper job.

scarless eye bag removal

Why do some eyes still look old after eye bag surgery?

We have seen people who have had their eyebags removed and still look old because of their tear-trough deformity. The tear trough deformity is simply the visible bony socket of the eye.

As people get older, their cheeks start sagging, exposing the bony eye socket. People commonly refer to this sagging as the tear trough.

When the cheek sags, the lower part of the cheek and the nasolabial folds will also look more prominent. Removing eye bags without correcting the tear trough deformity will give a result something like this.

tear trough asian woman

Eye bag Surgery

Remove the fat via a sub-ciliary incision

Making a cut 2mm below the eyelash margin leaves an invisible scar when it has healed. It removes wrinkles, lifts the cheek, and gets rid of eye bag fat. Patients experience less fear during surgery because surgeons do not perform any procedures inside the eye while the patients are awake.

Pull the fat downwards into the cheek

Instead of lifting the sagging cheek back up to cover the socket of the eye, the fat of the eye bag can be pulled down to fill up the tear trough. Surgeons typically perform this through a transconjunctival approach.

There are many videos on YouTube advertising for this but there are few videos that frankly discuss the disadvantages. This is one such video that tells the other side of the story:

You need to pull the fat downwards (transpose) and stitch it onto the cheek. Sometimes, the shape of the face and the narrow cut inside the eyelid prevent us from doing that. What the surgeon will probably do if this happens is to excise the fat and inject a filler instead. But this only has a lifespan of about 9 – 12 months.

Some surgeons will not attempt to transpose the fat and routinely inject with fillers or fat.

There are two important considerations with this approach: the cheek and the nasolabial folds

Also, pulling the fat downwards fills the trough and makes the cheek look puffy, with noticeable nasolabial folds (red arrow)

puffy cheeks

Lifting the cheek gives a tight, lifted and youthful appearance.

Local Anaesthesia for eye bag removal

Plastic surgeons usually perform eyebag surgery under local anesthesia. A local anaesthetic and nerve blocks easily anaesthetise the operated area. However, patients typically experience anxiety during a surgery, so we usually add a sedative to help them remain calm. This is more so in the case of patients undergoing “scarless” eye bag surgery via an incision inside the eyelid.

Eye bag removal Singapore

Our team at SIM ENT & Facial Surgery is skilled and dedicated to performing eye bag removal surgery. We ensure your safety and comfort while delivering outstanding results.

We invite you for a consultation to tailor a treatment plan that achieves your goals.

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