What causes eyebags?

• Natural Aging Process: Loss of collagen due to aging causes skin laxity
• Genetic: Family history will make someone prone to have eyebags earlier
• Fatigue or exhaustion: Lack of sleep or overuse of eyes on devices such as computers or mobile phones
• Alcohol and smoking: Drinking of alcohol and smoking contribute to skin laxity
• Allergies: Allergies may lead to repeated rubbing and scratching of eyelid skin
• Medical conditions: Some health conditions such as renal disease and thyroid eye disease can cause eyes to become swollen
• High Salt Diet: Fluid retention, especially upon waking or after a salty meal (usually transient only)

Can I prevent eyebags?

Although we cannot totally prevent the effects of aging, things that may help:

• Change of lifestyle, including
  • get enough good quality sleep
  • reduce screen time
  • quit smoking
  • avoid excusive consumption of alcohol
  • adopt a low salt diet
• UV protection and good skincare can also delay skin laxity

I don’t like my eyebags – what can I do?

Treatment options for eyebags include:

• Energy based therapy such as those using laser and radiofrequency can enhance skin and tissue firmness. This can improve early eyebags and slow down the progression.
• Fillers or collagen stimulators injection to the “valley” under the eyebags may help to make the eyebags look less noticeable.
• Surgery of the lower eyelids (“lower blepharoplasty”) is the best option if your eyebags are moderate to severe, or if you are looking for a longer lasting solution, or more significant improvement.

Eyebag surgery (lower Blepharoplasty)

Overview

Eyebag surgery is a relatively simple surgery and it is usually an outpatient procedure which can be carried out in a clinic or hospital under local anaesthesia. You can have some medicine to help you relax, or if you prefer, an anaesthestist can give you intravenous sedation so that you can sleep during the procedure. An eyebag surgery usually takes about an hour to 90 minutes.

Types of eyebag surgery

The principles of eyebags surgery (lower blepharoplasty) are to remove the excessive fat, to tighten the muscle layer and to excise the excess skin, if needed. There are two options used: Open or Closed approach, depending on the severity of the eyebags and the amount of excess skin. Your surgeon can discuss which is the best option for you basing on your condition.

1. Open Surgery (Transcutaneous)

With a transcutaneous approach, the surgical cut is made on the lower lid a little below the eyelash line. During the procedure a small amount of fat, which is causing the bulge, is removed. Also, the muscle is strengthened and the lax skin is trimmed.

2. Closed Surgery (Transconjunctival)

With a transconjunctival approach, there is no scarring visible after surgery. The cut is made inside the lower eyelid to remove the eyebag fat only. This is a good option where the skin is relatively tight and not much excess skin.

Comparison of the Open and Closed surgery:

Open:

• For moderate and severe eyebags
• Minor skin scar
• Longer recovery time (2-6 weeks)
• More long-lasting result

Closed:

• For mild eyebags, with relatively tight skin
• No visible scar
• No stitches required
• Short recovery time (1-3 weeks)

How much recovery time will I need?

Eyebag surgery is a relatively simple surgery and recover period typically is not long.

Most people go back to work after one to 2 weeks. However, there may still be some swelling at this point which continues to improve for 3 months. Any major swelling or bruising, if any, goes away within 2 weeks in most cases.

After the surgery

As the eyebag surgery is usually an outpatient procedure, you can go home soon after the surgery. You should prepare a pair of sunglasses to protect your eyes and have someone to accompany you home. Driving a car or operating on a machine after the surgery is absolutely not recommended.

You should also:

• Rest at home for one day
• Follow your surgeon’s instructions regarding medication, apply eye ointment /eye drops, and attend follow up sessions
• Use ice pack for 2 days after surgery to minimize swelling and bruising
• No hot shower or bath for the first 2 days after surgery
• Avoid alcohol and spicy food for the first 2 days
• Avoid vigorous exercise for 1 week after surgery
• In case of open surgery, stitches are usually taken off after 7 days and you may use eye cosmetics after that
• Avoid wearing contact lens for 10 days after surgery

Are the results of eyebag surgery permanent?

Although the results of surgery are much longer lasting compared to other treatment options, ongoing changes due to aging means some people may find their eyebags coming back and may opt to repeat the surgery after 5 to 10 years.

Who are not suitable for eyebag surgery?

A person would not be suitable for eyebag surgery when they have:

• Unstable medical conditions such as hypertension, heart diseases, diabetic and thyroid diseases
• Bleeding or clotting disorders, including taking high dose anticoagulants
• Severe dry eye discomfort
• Recent eye surgery such as LASIK or cataract surgery.
• High consumption of cigarettes (heavy smokers)

What are the potential risks for eyebag surgery?

These include: bleeding and bruising, wound infection, persistent swelling, residual eyebag, scarring, eversion of eyelids (ectropion), vision problems (rare), abnormal tearing.

While the eyebag surgery is generally well-tolerated, no cosmetic procedure is without risks—and eyebag surgery is no exception. Following your doctor’s instructions in the recovery period is vital to achieve and maintain your results.

Some skin tips:

• Reduce aging caused by sunlight by using sunscreens on upper and lower eyelids, wear sunglasses when outdoors, and use skincare with antioxidants.
• Salty food will make your body retain water and make eyes look more puffy – avoid high salt food the night before if you want to look good the next day!
• Don’t rub eyes: rubbing can cause skin pigmentation – “dark eye circle”! If your eyes are dry or tired, use artificial tears instead.