What causes eyelid eversion?
Eyelid bags result from multiple contributing factors. Decreased tension in the orbital septum allows orbital fat to protrude, creating a "pouch-like" appearance. Simultaneously, laxity of the orbicularis oculi muscle forms a "crescent moon" effect, while skin laxity leads to wrinkles. Therefore, correcting eyelid bags requires addressing these multifaceted causes.First, reinforce the orbital septum and tighten the orbicularis oculi muscle. Finally, remove excess skin. However, some patients and surgeons mistakenly view correction solely as skin tightening, neglecting septal reinforcement and orbicularis muscle tightening. If skin is removed appropriately but the septum and orbicularis muscle remain untreated, bags will quickly recur.Excessive skin removal may cause lower eyelid ectropion. In recent years, many scholars have agreed that in eyelid bag correction surgery, reinforcing the orbital septum and tightening the orbicularis oculi muscle are more crucial than skin removal.
Following lower eyelid surgery, mild lower eyelid eversion caused by edema or bruising typically resolves spontaneously within 2–3 months without special intervention. However, severe eversion is challenging to correct, and effective corrective methods often conflict with aesthetic goals.Partial removal of the lower tarsal plate may narrow the lower eyelid, altering the eye shape. Skin grafts or flap transplants, meanwhile, leave noticeable and unsightly scars. Thus, preventing lower eyelid eversion post-surgery is paramount.
Beyond lower eyelid ectropion, complications from eye bag correction include: lower eyelid hollows caused by excessive orbital fat removal; a stiff appearance and subcutaneous nodules resulting from hematoma organization or subcutaneous scar contracture; eyelash loss; and hypertrophic scarring at the incision site.Bilateral asymmetry. While some complications stem from individual physiology, most arise from the surgeon's fundamental skills, professional expertise, and aesthetic judgment. Therefore, careful selection of a surgeon is essential for eye bag removal.