Why Do Lower Eyelid Bags Happen?
The eyes are often one of the first features people notice, and the appearance of the eyelids plays a big role in how refreshed or tired we look. As we age, natural changes in the skin, muscles, and fat around the lower eyelids can lead to puffiness or “bags” under the eyes.
These bags are usually caused by fat pushing forward under the skin. Other factors such as aging, sun exposure, allergies, loss of cheek volume, and loose or thinning skin can make them appear more noticeable. This can create a tired, puffy, or older look, even when you feel well-rested.
What Is Lower Eyelid Blepharoplasty?
Lower eyelid blepharoplasty is a surgical procedure that improves the appearance of under-eye bags and dark circles. The goal is to achieve a smoother, more youthful, and rested look.
There are two main approaches to this surgery:
- Transconjunctival Approach: The incision is made inside the eyelid, leaving no visible scar. Fat causing puffiness is removed or repositioned.
- External Approach: A small incision is made just under the eyelashes, allowing removal of excess fat and skin tightening. Laser or chemical resurfacing may also be used to improve skin texture.
In some patients, fat grafting (using fat from another area of the body) may be added to restore volume and smooth the transition between the eyelid and cheek.
Recovery After Surgery
- Cold compresses help reduce swelling and bruising in the first few days.
- Your surgeon may prescribe antibiotic ointment.
- Keep your head elevated and limit activity for several days.
- Most discomfort is mild and can be managed with over-the-counter pain relievers (unless otherwise advised).
Most patients are able to return to normal activities within 1–2 weeks.
Risks and Considerations
Like all surgeries, lower eyelid blepharoplasty carries some risks. These may include:
- Bruising and swelling (common and temporary)
- Bleeding or infection (rare)
- Temporary changes in eyelid shape or position
- Small lumps or cysts that usually resolve on their own
- In some cases, a touch-up procedure may be needed later
Your oculoplastic surgeon will take every step to achieve a natural and balanced appearance, though exact results cannot be guaranteed. Most patients are very satisfied and feel they look more refreshed and youthful after surgery
Summary
Lower eyelid bags are a common concern that can make you look tired even when you are not. Lower eyelid blepharoplasty is a safe and effective procedure to smooth the under-eye area and restore a more rested appearance. Your oculoplastic surgeon will help you choose the right surgical approach for your needs and guide you through a smooth recovery.
Authored by Associate Professor Dr. Pimkwan Jaru-ampornpan, MD
Before & After Lower Eyelid Surgery
