Eyebag Surgery

Eyebag is a common sign of facial aging. However, eyebag may also appear in younger people due to hereditary and environmental factors. Eyebag is caused by herniation of fat and laxity of skin in the lower eyelid. Eyebag is often associated with dark eye circle and ‘tear trough’, a condition where a groove appears at the junction between the lower eyelid and the cheek. Eyebag gives impressions of aging and tiredness.

Eyebag surgery (lower blepharoplasty) is effective in treating the eyebag problem. There are two types of eyebag surgery: The transcutaneous technique and the transconjunctival technique. To select which technique to use depend on the type and severity of the eyebag problem. As the lower eyelid is continuous with the cheek, lower blepharoplasty can be combined with other procedures to rejuvenate the cheek and mid-face, such as fat graft and facelift.

Preparation

1.    Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

2.    Stop smoking at least one week before surgery. Smoking negatively affects wound healing and increases risks of other post-operation complications.

3.    Stop the following one week before surgery:

a.    All supplements that contain vitamin E, ginseng, ginkgo, garlic, fish oil and other ingredients that increase bleeding during surgery.

b.    Medicine that increases bleeding during surgery such as aspirin, NSAIDs and warfarin. However you may need to consult your physician who prescribed the medicine before you stop them.

4.    On the day of surgery, wear simple and comfortable clothing. Do not wear any jewelry and metal objects on the face and body.

5.    Bring a pair of sunglasses on the day of surgery for use after surgery

6.    Don’t wear contact lens on the day of surgery

Surgery

Duration: 2 hours

Anaesthesia: Local anaesthesia

Hospitalization: Not required.

Recovery*: Back to work in 3-7 days, light exercise after 1-2 weeks, heavy exercise after 3-4 weeks.

*The speed of recovery and duration of rest may vary from person to person and also depends on the physical burden of the work and exercise the patient is going to resume.

Surgery Technique :

1.    Transcutaneous Method: an incision is made near the margin of the lower eyelid. Depends on the condition some herniated fat may be removed and the remaining fat is repositioned to smoothen the contour at the lower eyelid-midface junction. Excess skin is removed. A limited midface lift can also be performed at the same time. Scar is located very close to the eyelid margin and usually not noticeable after full healing.

2.    Transconjunctival Method: a small opening is made on the inside surface (conjunctival surface) of the lower eyelid. Fat is removed or repositioned through the opening. No resection of skin is done and there is no external scar. This technique can be used to remove excess fat and reposition fat in the lower eyelid but is not able to remove excess skin.

Post-operative Care**

1.    What to expect: Swelling usually peaks on the second to third day after surgery and then gradually subsides. Post-operative pain is usually minimal.

2.    General care:

a.    Apply cold pack during the first 3 days and warm pack thereafter. Elevate the head during sleep to reduce swelling.

b.    Avoid smoking for at least one month. Smoking increases the risk of wound complications.

c.    Use sunglasses for protection when going outdoors.

d.    Get a good rest and enough sleep to speed up recovery.

e.    Be relaxed and calm. Contact the clinic if there are any queries.

f.     Don’t use contact lens for at least 1-2 weeks.

3.    Medicine: Finish the oral antibiotics as prescribed. Take the painkiller when necessary.

4.    Wound care: Clean the wound with a clean cotton tip soaked with sterile water/saline. After that apply antibiotic ointment. No dressings are required.

5.    Physical activity: Avoid heavy physical activities and exercises for at least one month.

6.    Follow-up: Come back one week after surgery for suture removal and review.

7.    Emergency: If there is heavy bleeding, rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

**The instructions in this section are not meant to be exhaustive and are only for general references. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for specific advice.