Removing eye bags: cause, technique, scars

How eye bags arise

When the elasticity of the lower lid tissue declines with age, the fat from the eye socket bulges forward and excess skin appears at the lower lid: the so-called eye bags. They can be corrected as a day case at the Kuzbari Centre in the course of a lower eyelid lift; patients lose their exhausted look and regain their youthful presence.

Our eyes, like our hands, often give away our real age fastest. The connective tissue in the lid region, the lid skin and the muscle beneath slacken over time. Through these signs of ageing the fat of the eye socket bulges forward increasingly. So eye bags arise either from the bulging of the orbital fat or from an excess of skin at the lower lid — or from both.

Depending on the degree, the eye bags often look puffy and make us appear exhausted, tired and sad. Unfortunately this impression of tiredness does not disappear even after weeks of holiday, and remarks such as “Didn’t get much sleep?” become part of everyday life.

People often report that the swelling is worse in the morning and eases a little during the day — but sometimes increases again in the afternoon. This daily variation is typical and a sign that fluid is indeed involved. The bulge itself remains nonetheless, because its cause is the fatty tissue.

What eye bags do in daily life

How those around us perceive us can also affect daily life. The eyes in particular reflect our personality for other people. Eye bags and the listless expression they lend can be an obstacle between people. A tired expression has an effect on others too: the way we perceive a stranger’s face is the way we meet the person behind it.

The correction therefore often brings more than a fresher appearance. In a lower eyelid correction the excess of skin and fat is removed or repositioned and the bulge dealt with. That gives the eyes back their alertness; the whole face reads as fresher without looking operated on.

Almost without a scar

In many cases the lower lid correction can be achieved through an approach on the inside of the lid. Then no skin incision is needed at all and no visible scar remains. In other cases a precisely placed incision follows just below the lashes of the lower lid and — depending on how far the slackening extends — a few millimetres beyond the outer canthus. Scars are then often no longer visible at all after a few months, or only on very close inspection.

What decides this is not the wish but the findings: if the protruding fat is the main problem and the skin still has enough tension, the approach from inside is sufficient. If skin also has to be tightened or the lid ligament stabilised, the approach from outside is needed. Sometimes we combine the two with a skin pinch: a very narrow strip of skin under the lashes is removed without opening the muscle.

How we remove your eye bags

Often the correction of eye bags can go through an incision on the inside of the lower lids; then no scars remain at all. Where that is not possible, a precise incision is made directly below the lower lash line. That scar fades quickly and after a few months is often as good as invisible.

The procedure itself is short and causes little pain. During the operation you are sedated: you are conscious but take in little of it and feel no pain. The reason is that an experienced consultant anaesthetist is with you from the start and gives you very strong but short-acting sedative and pain medication before the procedure. You are also given painkillers for the following days when you leave the Kuzbari Centre; most patients need them only on the day of surgery.

The aim is not to remove as much as possible. The importance of experience shows especially in the treatment of the fat in the lower lid: it is either reduced or repositioned so that a harmonious transition arises between the lid and the cheek. Remove too much and the eyes look hollow and tired. Take too little away and the result is barely perceptible. The best possible result is a precise landing.

The time after the procedure

After the lift the eyes are swollen and discoloured — as after an operation. From the third day the swelling starts to recede. Cool packs or frozen peas help; peas mould better and cool pleasantly. In the first days after surgery on the face you can feel low. That is normal, and we are reachable for you during this short phase.

The result of the eyelid lift is a fresh and younger appearance; it appears after about two to three months. With the right surgical technique the natural shape of the eye is preserved. If the operation was well done, all you notice afterwards is the fresher, brighter gaze, because there is no change of type.

The first two weeks, day by day

The most common question after the operation is not whether it hurts but when you will look like yourself again. So here is the course it takes for most patients — as a guide, not a promise.

When we advise against it

Honest advice also says when a procedure does not make sense. We raise these points explicitly at the first consultation — and if one of them applies, you hear it from us before any dates are discussed.

A natural result through competence

Many people have deep and well-founded reservations about facial surgery, because mask-like results exist. The most common causes are skin tightened too far, insufficient tightening of the deep connective tissue, a wrong direction of pull, badly placed scars and failure to correct the age-related loss of volume.

These technical and analytical failings leave the typical marks of a poor lift: an unnatural expression, distorted brows, visible scars and a rejuvenation out of balance. All of that is avoidable with good planning and careful surgical technique. After well-executed eyelid surgery you do not look operated on or tightened but younger and fresher. People notice the change but not its cause.

That is why we ask you to bring photographs of yourself from about the age of 18. Many people believe that raising the brows automatically reads as youthful — that is not always true. With age brows sometimes rise and sometimes fall, and only rarely does the whole brow descend. Your own photographs show us which change has taken place in your case. That makes it possible to rejuvenate without changing.

Results after correction of eye bags

In both slider cases the approach was transconjunctival — through the inside of the lid, without a visible scar — with fat grafting in addition.

Who operates on eyelids at the Kuzbari Centre

Three specialists at the centre operate on eyelids. Whoever advises you also operates on you — and sees you again at every check-up. You choose who you feel most comfortable with.

Frequently asked questions about eye bags

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