Everything You Need to Know About Eye Bag Removal Surgery and Eye Lifts

In the United States, around 100,000 blepharoplasty procedures are performed every year. Also known as an “eye lift” or eye bag removal, blepharoplasty is one of the safest, simplest, and most effective ways to freshen up your look.

When it comes to plastic surgery, blepharoplasty is also an excellent way to get the best bang for your buck. Often, people who think they need a facelift really only need an eye lift. This is because we usually look each other in the eyes- not the mouth or nose.

If your upper eyelids are sagging, you may look old, tired, and not engaging. Removing redundant skin can make a dramatic difference. In this article, you’ll learn what blepharoplasty is and whether you could be a good candidate for eye bag removal surgery.

Ready? Let’s get started.

What is Blepharoplasty?

Blepharoplasty, or eye bag removal, is a type of surgery involving the removal of excess fat, muscle, and skin. As we age, our eyelids stretch, while the muscles that support those eyelids weaken.  This often causes excess fat to gather below and above the eyelids. And this leads to bags, droopy upper lids, and sagging eyebrows.

Not only does this make you look older, but when skin is severely sagging around your eyes it can reduce your peripheral vision (side vision). This means that you notice a deterioration in the outer and upper parts of your field of vision. Blepharoplasty can eliminate or reduce these problems, making your eyes appear both more alert and younger.

Upper Blepharoplasty

For upper blepharoplasty, a surgeon will make an incision in your upper eyelid to remove fat and skin. They will then use a thin stitch to bring the skin back together and create an eyelid crease.

Lower Blepharoplasty

Lower blepharoplasty, or eye bag removal, involves a skin incision on the inside of your eyelid or directly underneath your lash line.  When the incision is made on the inside of your eyelid, this is called a transconjunctival approach which allows your surgeon to access your eyelid without making any visible incisions. This makes it perfect for people who need fat added or removed.

The History of Blepharoplasty

A Roman scientist called Celsus described the removal of excess eyelid skin back in the first century AD.
Surgically fixing the wrinkling and puffiness of lower eyelids and overhanging top eyelids has been completed since the tenth and eleventh centuries.

In 1817, Beer published the first ever medical illustration of an aging eyelid. In 1818, “blepharoplasty” was used for the first time by Von Graefe, describing an eyelid reconstruction after cancer resection. This is the same time period that Europeans began advocating removing upper eyelid skin for the correction of functional problems.
It wasn’t until the early 1900s that surgeons began popularizing the removal of the upper eyelid skin for aesthetic purposes. And in 1907, Conrad Miller (an American surgeon) wrote one of the cosmetic surgery industry’s first books. The diagrams of the incisions used for eye bag removal are remarkably similar to the ones used today.

Why Do You Have Eye Bags?

To understand how eye bag removal works, it’s helpful to know why eye bags begin appearing in the first place.
There are a few different factors that cause you to have bags under your eyes. Often, more than one of those factors will contribute to these eye bags at the same time.

One of the most common causes of sagging skin or under eye bags is when you begin losing fatty tissue in your upper checks- right underneath your eye bags. This fat is present throughout your face and resides just underneath your skin. As you age, this tissue deflates and breaks down in your cheeks much faster than under your eyes.

Because this deflation is uneven, you’re left with protruding or elevated fat bulges underneath your eyes.
Another common cause is when your orbital septum begins to weaken. This membrane is what holds your fat underneath your eye. As you begin to age, your orbital septum begins to weaken. This causes the fat behind the orbital septum to press on the skin and bulge outward. This adds to or causes eye bags.  While some people assume that puffy eyes and under eye bags are due to allergies and fatigue, these are actually often due to lower eyelid fat prolapse. When the fat is removed, sculpted, and/or repositioned, the appearance of bags is greatly improved.

For some people, they’re simply genetically predisposed to a little extra fat under their eyes, which can contribute to eye bags as they age.

Why Do You Have Droopy Upper Lids?

As your upper eyelids begin to droop, they may begin covering your eyes, which can give you a hooded appearance. This makes you look tired and older.  Your eyelids may even droop so much that they begin obstructing your vision. This can mean you’re frequently raising your eyebrows and tilting your head back so you can see. And that can cause headaches, tiredness, and aching around your eyes – particularly later in the day.
Droopy eyelids are known as ptosis, which is generally related to aging. You may also find that you’ve had too much exposure to the sun over the years which has caused your skin to become less elastic with age.

How the Procedure Works

Blepharoplasty is performed on your lower eyelids, upper eyelids, or both within the same procedure. During surgery, your surgeon will make incisions in the natural folds of your eyelid. These incisions are placed just underneath your lashes or behind your lower eyelid, and in the crease of your upper eyelid. For this reason, they’re almost completely unnoticeable once they heal.

Once you’re lying down, your surgeon will make markings to show exactly where the excess fat and skin will be removed. Sometimes, some underlying muscle will also be removed.  The tissue is removed with different surgical instruments, like radio-frequency cutting devices, surgical scissors, and scalpels.

Tissue adhesives or sutures are then applied to specific areas around your eyelids and eyebrows. During the procedure, surgeons decide how much fat, muscle, and skin should be removed based on an evaluation of a number of factors like your bone structure, facial muscle structure, and even the symmetry of your eyebrows.
Some surgeons also use a CO2 laser during surgery, which often results in less swelling. This can also be used to resurface your skin and smooth out any wrinkles remaining in your eyebrow and eyelid area.

Is Eye Bag Removal Right For You?

Before surgery, you’ll need to have a detailed discussion and examination with an experienced surgeon. They’ll let you know all about the benefits and potential risks associated with blepharoplasty and will determine whether you need surgery for eye bag removal or whether the first step could be dermal fillers.

During the consultation, your surgeon should listen to any concerns you have, determine what’s causing your bags, and work out a treatment plan based on your facial anatomy and unique needs.  One way to determine whether you’re a candidate for eye bag removal is to look straight ahead into a mirror. As you look at your eyes, the majority of your iris (the colored part of your eye) should be visible. Your pupil should never be covered by your eyelid.

Ptosis often makes your drooping eyelids narrow the opening of your eye. That can make your eyes appear smaller than they should. It’s not uncommon to lose the crease that usually lies between your eyebrow and upper eyelid.

If you find that your eyelids are constantly limiting your vision, you may be compensating by raising your eyebrows. This can make you look constantly surprised, cause tension headaches, and lead to increased wrinkling along your forehead. You may also notice that you’re tilting your chin up when talking to people and looking down your nose so you can see better out of your eyes.  It’s a good idea to look at some older photographs so you can see if your drooping eyelids have been gradually worsening over the years.

Here are some signs that blepharoplasty could be right for you:

• You have puffy upper eyelids
• Your eyelids are interfering with your vision
• You feel like you look older than you’d like to
• You continually look tired
• You have excess upper eyelid skin
• You tend to avoid eye makeup or your eye makeup disappears when you apply it
• Your confidence or self-esteem is affected by your under eye bags or drooping eyelids
• You have realistic expectations about the outcome of your blepharoplasty procedure
• You’re in good mental and physical health

How Much Does Eye Bag Removal Cost?

Eye bag removal costs approximately $5000 in the United States. The cost will also depend on the skill and experience of your surgeon, along with the complexity and type of procedure performed.

Insurance companies will sometimes cover the cost of blepharoplasty if your visual field is obstructed. If this is the case, you’ll need to have it documented during an exam with photographs and formal visual field testing. Your insurance carrier may require these to be submitted before they’ll approve your blepharoplasty as medically necessary.

Preparing for Blepharoplasty

Before booking your surgery, your surgeon will view your medical history. This allows them to decide whether you’re a good candidate for eye bag removal. You’ll need to make sure your surgeon is aware of any conditions such as bleeding disorders, heart disease or high blood pressure.

These can increase the risks associated with surgery. Previous surgeries like LASIK eye surgery or eyelid surgeries in the past can also impact your risk of complications. You may find that your surgeon asks for medical clearance from your general doctor, depending on your health.

in the weeks before surgery, be sure to eliminate alcohol and smoking. Stop taking vitamin E supplements, ginseng, and any medications containing ibuprofen or aspirin. These can prolong bleeding. If you take any daily or prescriptions medicines, check these with your surgeon.

The day before eye bag removal, make sure you have:

• Clean washcloths
• Ice cubes
• Ice packs
• Sterile gauze pads
• Eye drops
• Enough groceries for a week

Recovering from an Eye Lift

Blepharoplasty is a procedure with a short recovery time. You’ll have significant swelling and bruising on the day after surgery, but this will disappear a little more each day.  Over the first 48 hours, apply ice or cold packs for 10-15 minutes at least once or twice an hour. This will help keep your bruising to a minimum and reduce swelling. After 48 hours, ice is no longer helpful and you should switch to warm compresses. These will promote faster healing.

Your surgeon will let you know which pain medications you should take. Most people won’t need prescription pain relievers and will be fine will over the counter meds.  During the immediate recovery period, you can expect mild discomfort. However, if you find that your vision changes or you experience severe pain, get in touch with your surgeon’s office immediately.

While you’re recovering from your eye bag removal, you can expect to have a red and bruised eye are, and swollen eyes. You may notice that the white part of your eyes (sclera) become bloodshot and red. It will take at least a few weeks for you to completely heal, and you should avoid wearing eye makeup and using contact lenses during this time.

Wrapping up

If you’re tired of looking tired, blepharoplasty may be the answer you’re looking for. The best part? With a skilled surgeon, you’ll simply look like you’re getting much more sleep.  The trick is to choose an experienced surgeon who can guide you through the decision-making process. They’ll answer all your questions so you can know what to expect and decide whether eye bag removal is right for you.

Want to learn more about blepharoplasty? We can help. Get in touch today and let’s talk about your options.

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