Tuesday, 15 June 2010 00:23

Bags under the Eyes (Lower Blepharoplasty)

Bags under the Eyes (Lower Blepharoplasty)


Getting older is a fact of life that few of us like to admit to. Consequently, visual signs of aging are particularly unwanted and can be the cause of considerable loss of self-esteem.  As some people age they are particularly prone to a build-up of excessive pouches of fat and loose skin beneath the eyes, often detracting from their once-youthful and attractive eyes and making the individual look tired and dispirited, whether that is so or not.

The skin under the eyes is quite delicate. This is the reason why it is prone to sagging, discoloration and wrinkling. If you do not take good care of the skin surrounding this area, you will look older and more mature than you really are. So, when you look in the mirror and your reflection looks as if you are in a chronic state of stress and the weight of the whole world is on your shoulders, a lower blepharoplasty, or lower eyelid surgery, might be the procedure to help you get rid of problems concerning the skin around your eyes, particularly eye bags.

What Causes Eye Bags?

Eye bags tend to run in families so, if your parents appeared to suffer from this problem as they aged there is every possibility that you will too. Other causes of eye bags tend to be:

  • Habitual fatigue and stress
  • Being deprived of sleep
  • Smoking
  • Allergies
  • Thyroid not functioning properly

Another cause of eye bags developing also include too much exercise or over-exerting yourself according to clinical studies.  A poor diet has also been attributed to bags developing beneath your eyes, especially individuals whose diets consist of too much salty food and insufficient water. Furthermore, people whose diet consists of processed food that is also high in sugar are also considered susceptible to the development of bags beneath their eyes. This has been attributed to additional free radicals circulating through the body, causing levels of oxidative stress that is too high. This is the cause of sagging skin and puffiness around the eyes, resulting in premature aging according to the May 2008 edition of the European Journal of Clinical Investigation.

What Exactly are Bags under the Eyes?

People susceptible to puffiness underneath the eyes often begin to show signs during their 30s. Apart from the skin losing its elasticity and sagging in response to the effects of gravity on loose skin, the fat layer in the peri-orbital area of the eyes, on which your eyeball balances, sags along with the loose skin and over-stretched muscle causing the unsightly eye-bags. Statistics reveal that men aren’t immune to wanting to look younger and, nowadays, more and more are booking cosmetic procedures. The latest figures reveal that surgery to remove bags from underneath the eyes accounts for up to 21% of all cosmetic procedures that are requested by men, with up to 60% of these being for the over 50 age group.

Surgery to Remove Eye-bags

Surgery to remove these bags under the eyes is not an inexpensive option but it can be very effective and create an incredible boost to an individual’s self-esteem. Surgery that is carried out to remove this excess fat, including the loose skin and sagging muscle beneath the eyes, in the periorbital area, is known as Blepharoplasty.  Altogether, including the immediate pre-surgical tests and consultations, the surgery to remove bags under the eyes will take around 14 days.

Are You Suitable for Blepharoplasty?

If you are considering cosmetic surgery of any kind you need to ensure that you consult a reputable surgeon. Furthermore, any reputable clinic will make sure you have a full pre-surgical consultation during which detailed information about your health will be taken, you will be given a thorough physical check-up and the surgeon you are consulting will establish whether you are suitable for this kind of surgery. In other words, the surgeon will establish why you have decided to have this kind of surgery and what you are most concerned about. Your surgeon will also take a detailed medical history, including information about your family.

Before agreeing to operate on your eyes the surgeon will want to establish exactly what your expectations are with respect to surgery to remove bags from under your eyes. This is important because you are not going to stop the aging process.  Instead, you will appear more rested and refreshed which can contribute to a more youthful attitude and appearance.  No matter what kind of surgery you have, no surgeon is going to be able to provide you with the face of the dewy-eyed 18 year old you once were. You will also be advised that, no matter how well the surgery goes, the kind of result achieved will depend on the kind of skin you have – and that, in part, is determined by your genes.

Finally, your surgeon will make you aware that it could take up to a year before the full effects of your operation to remove the bags from under your eyes is achieved.  After you have had your stitches removed, you will notice some improvement and, after that, month by month, the improvement continues. However, you will need to be patient and realize it could be a full 12 months before the best effects will be clear.

How is the Surgery Carried Out?

Laser surgery has revolutionized many cosmetic surgery techniques and surgery to remove bags under the eyes is no exception. The surgeon usually makes an incision along the natural folds of the eyelids, although some surgeons will operate by making an internal incision. This latter procedure leaves no scars visible from the outside which, of course, is a preference in any elective cosmetic surgery. However, Blepharoplasty is not always carried out for cosmetic reasons. It is sometimes performed to improve an individual’s peripheral vision.

After being admitted to the outpatient clinic or day surgery unit the surgeon will arrive to have a chat and get you ready for surgery. You may be surprised to see him arrive with a marker pen or ‘Sharpie’ which he will use to draw on your skin so that he operates in the correct place. Once you have signed the consent form the surgeon will answer any questions you might have and will do everything possible to put your mind at rest. After this last consultation you will be ready for surgery to go ahead. Once you get down to the operating room the total time you can expect for your operation is between one and three hours. Lower blepharoplasty can carried out under local or general anesthetic, usually in a day surgery unit or outpatient clinic with surgical facilities.

Once the incision has been made your surgeon will separate the subcutaneous layers of skin from the top layer of skin and trim away any excess fat, as well as repairing any loose muscle or skin that is sagging.  Once the surgeon has finished the actual surgery the incision will be carefully closed using very fine sutures or surgical glue. For Blepharoplasty on the lower eyelids the surgeon will extend the incision 1cm out to the edge of your eyes, into the crows’ feet area and then lift the skin up and outwards. The skin is carefully teased away to separate out the layers, enabling the surgeon to once again remove any excess tissue from the area before finally closing the incision in a way that prevents any scarring from showing.

Immediately Post-Surgery

The first thing you will probably notice is swelling and bruising around the eye area. These can take ten to fourteen days to heal properly, although you will find that the healing process can actually take a few months. Along the line of your eyelashes you will notice some pink scars which, once healed, fade out very quickly. Immediately after surgery you will have icepacks over your eyes to help reduce swelling and bruising as much as possible. You will also be given adequate pain relief to help you cope during the immediate post-op period, as well as eye ointment that you will need to keep applying. The swelling and bruising is at its most severe in the first two or three post-operative days, usually subsiding slowly after that. Make sure you protect your eyes from UV light during the healing process: a pair of dark glasses will protect your eyes as well as hide the bruising from immediate view. You will also be advised not to rub your eyes or rub your eyelids with a towel.

Once you have had your surgery, before being discharged home, you will be advised about follow-up treatment and be allocated a nurse counselor to provide you with any support you may need or to provide you with answers to any questions that you may have. A post-operative appointment will be made for you to see your surgeon. It is essential that you attend this appointment to ensure that everything is healing properly and there is no post-operative infection developing at the incision site.

What to Expect Following Surgery

Once the bruising and swelling have subsided and you have had your stitches removed you will notice that you no longer look drawn and tired all the time. No amount of surgery is going to remove the mark of years from your skin, but men especially who have undergone surgery to remove bags from under the eyes notice that they look around 10 years younger than prior to the operation. You will look more refreshed and, probably due to an increase in self-esteem and self-confidence, you will appear more positive and energized, with a more ‘opened’ look to your eyes.

Risks Associated with Surgery

Since this operation can be carried out under local anesthetic the risks usually associated with the administration of anesthesia are considerably reduced. Generally, the risks associated with this kind of surgery to remove bags under the eyes tend to be:

  • Vision that might be blurred or impaired slightly. This only temporary, however.
  • Dry Eyes
  • Difficult to close eyes
  • Your lower eyelid may pull down. Again, this is only temporary.
  • Alterations to skin sensation or numbness in the area around the eyes
  • Eyelid ptosis. This is an abnormal positioning of the eyelids
  • Persistent pain
  • Ectropion. This involves the area around your lower eyelid being more lax than normal, causing your eyelids to roll outwards. This can also be associated with sagging brow and forehead.
  • Poor wound healing, infection, bleeding, blood clots – all of which are associated with normal surgical complications. Also included could be the risk of DVT, and complications involving your heart or lungs.
  • Fluid accumulation
  • Spontaneous surfacing of sutures, poking through the skin and causing discomfort and irritation
  • Loss of eyesight
  • Possibility of revisional surgery

Additional Information

The cost of surgery to remove bags from beneath your eyes will not be covered by health insurance since it is considered to be a cosmetic procedure. The costs vary from clinic to clinic and from country to country. However, in the USA the costs average from $2,000 to as much as $6,000 depending on the intricacy of the operation. In the UK the cost is approximately $3,900 USD. These costs include the pre-surgical consultation, the anesthetists, the cost of the surgeon and the cost of the operating room facilities.

Cosmetic surgery is not an inexpensive option and prevention is obviously better, and cheaper, than a surgical cure. Obviously, you can do nothing about the genes you have inherited. However, you can pay attention to your lifestyle, including your diet and whether or not you smoke, how much you exercise, and how much alcohol you consume. Ensure you eat plenty of fruit and vegetables as they contain polyphenols that help to mop up free radicals caused by the oxidation process that occurs during cell metabolism. You also need to ensure you get sufficient sleep. Paying attention to these details will help reduce the impact of aging on your skin and, possibly, prevent bags under the eyes from developing to the extent that surgery is needed.

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