As people enter middle age, the relaxation of skin and orbital septum causes fat within the septum to protrude outward. Many individuals develop a lump-like bulge beneath the lower eyelids, appearing as a pouch hanging under the eyes—hence termed "eye bags." These eye bags contribute to an aged appearance.Eyelid bag removal surgery involves removing the protruding fat deposits through a conjunctival incision, leaving no visible scars on the skin. If the lower eyelid skin is lax, an incision can be made 1-2 millimeters below the lash line. This allows simultaneous removal of both the eyelid bags and excess skin, achieving a wrinkle-reducing effect.
Surgical Methods:
1. Transconjunctival Approach (commonly known as non-incisional fat removal):
Suitable for middle-aged and young adults with pronounced eye bag protrusion but no significant lower eyelid skin laxity or wrinkles.Access is gained through the conjunctiva via a 4-5 mm incision. The protruding orbital fat is excised. This procedure is simple, minimally invasive, causes minimal swelling, does not induce eyelid ectropion, and allows for rapid recovery (approximately 2-5 days). The absence of visible skin incision scars makes it highly popular among middle-aged and young patients.
2. External Incision Method:
Suitable for middle-aged and elderly individuals with pronounced eye bags, lax lower eyelid skin, and visible wrinkles. The incision is typically designed 1-2 mm below the lash line. After healing, the incision is highly concealed and difficult to detect. While removing herniated orbital fat, it also excises lax skin, reducing local wrinkles.
This technique demands high technical proficiency. During excision of excess skin and fat, precise assessment and calculation of lower eyelid laxity and fat protrusion are essential. Skin removal along the eyelid margin should be minimal to prevent ectropion.while more skin may be removed beyond the lateral canthus to eliminate crow's feet wrinkles. Excessive removal of orbital fat should be avoided to prevent orbital depression. The incision is closed with subcutaneous sutures using American Micro-Q absorbable sutures, leaving no visible stitches and requiring no removal. Recovery typically takes three to five days.
Precautions:
(1) Surgical incision design. This directly impacts the outcome. Incision placement depends on patient expectations and the surgeon's aesthetic judgment. Thorough preoperative discussion with the plastic surgeon is essential to avoid post-operative disagreements over results. (2) Patients with keloid-prone skin should not undergo this procedure, as it may cause excessive scar tissue formation that compromises cosmetic results.
(3) If facial skin conditions such as folliculitis or acne are present, these should be fully treated before considering facial cosmetic surgery.
(4) Patients with bilateral conjunctivitis should first treat the eye condition before undergoing lower eyelid surgery.