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Aesthetic Procedures: Eyelids

Aesthetic Procedures: Eyelids

Aesthetic Procedures: Eyelids

Lower Eyelid Surgery (Lower Blepharoplasty)

Lower Eyelid Surgery
The lower eyelids are an important part of the appearance of the eye as well as the cheek and midface. An aesthetically pleasing lower eyelid adds greatly to a harmonious facial appearance.

The lower eyelid is made up of skin, muscle, fascia, fat, and ligaments binding these together. When there is laxity in the lower eyelid due to skin or ligament loosening and/or fatty excess from the fat surrounding the eye, this leads to prominent eyebags. Quite often as well, and due to ageing, the cheek bone becomes retruded and loses fatty volume, contributing to the tired appearance and irregularities of the aged lower eyelid.

When mild, these deformities may be amenable to non-surgical treatment. However, surgical correction leads to more precise and powerful results. Additionally, the lower eyelid blends with the midface and nasolabial folds, and there are procedures that can address the lower eyelid and lift the nasolabial folds simultaneously (see midface lift).

What to expect during lower eyelid surgery

Lower eyelid surgery is commonly performed under local anaesthesia with sedation, or general anaesthesia. Depending on the complexity of surgery, lower eyelid procedures usually range from 60 to 90 minutes. At the end of the procedure, you will be monitored for a few hours before being discharged. This is to help with any pain control and monitor for any immediate post-operative complications. Your comfort, safety, and satisfying outcomes throughout are our priority. Vision will not be obstructed by the procedure, though we would advise that a responsible individual accompany you after you are discharged.

After your lower eyelid surgery

After the procedure, there is mild swelling and bruising of the lower eyelids which is maximal at 2 days and the majority of which settles at 2 to 3 weeks. For the first few days, you will be given antibiotics, painkillers, and anti-swelling medication as well as eyedrops. Cold compress for a few days is also advised. These post-surgery steps can help to reduce swelling and lower the risk of complications. You will be followed-up with at routine intervals to monitor your recovery progress.

Potential risks and complications

Potential post-procedural complications include infection and bleeding. These are extremely rare and usually very treatable. Uncontrolled bleeding after the procedure can compromise your vision, hence patients will be monitored for a period post-procedure before you can be discharged. Dry eyes can occur after the procedure but is treatable with moisturizing eye drops and is usually resolved.

FAQs

Can I remove my eyebags without surgery?

Non-surgical eyebag removal includes methods such as radiofrequency or laser treatments that either help to tighten the lax skin and fascia, or ‘melt’ the underlying fat. While these methods may work for some, especially those with very minor eyebags, consistency and longevity with these procedures is difficult to achieve and may lead to worsened pigmentation or bumpiness in the lower eyelids. Another way of ‘removing’ eyebags is to camouflage the contour irregularities of the lower eyelid through filler and/or fat grafting in and around the lower eyelid. Again, this may be suitable for some, but seldom achieve a lasting or complete result.


 
References
1. Wong C-H, Mendelson B. Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution. Plastic and Reconstructive Surgery [Internet]. 2017 Aug;140(2):273–82.

2. Pascali M, Botti C, Cervelli V, Botti G. Midface Rejuvenation. Plastic and Reconstructive Surgery [Internet]. 2015 May;135(5):1305–16.

3. Hidalgo DA. An Integrated Approach to Lower Blepharoplasty. Plastic and Reconstructive Surgery [Internet]. 2011 Jan;127(1):386–95.

4. Kim EM, Bucky LP. Power of the Pinch. Annals of plastic surgery [Internet]. 2008 May;60(5):532–7.

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