What is it?

The eye is the mirror of the soul. It projects happiness, ecstasy, sorrow, dejection, fear, in fact all forms of emotion.

If the eyes are marred by hooded upper or puffy lower lids, an expression of constant tiredness is given to the face and the sparkle of youth is gone.

It is one of the least invasive cosmetic procedures. A relatively simple, safe and long lasting technique to reduce eye bags (fat deposits) under the eyes or over the eyelids, excessive wrinkles and loose skin.

How and why do we develop bags under the eyes?

As we age, our skin becomes even thinner and looser under the eyes, however the primary reason is due to fat descending leaving a hollow. This can be corrected either by lifting and redistributing the fat surgically, or by temporary camouflage with fillers or permanent camouflage fat transfer or a combination of both. The problem with fat transfer in this region is lack of predictability with regard to ‘fat take’ or increase in transferred fat volume with weight gain.

Veins underneath the skin can become more visible when the skin thins, and this can often create a darker appearance underneath the eye. Another reason that fluid can collect beneath the eyes is our sleep position; if we lie horizontal this tends to happen as well as the dilation of veins under our eyes. These veins travel and drain into the nose; allergies and nasal congestion can also cause the veins to dilate – giving a darker appearance of the skin.

Dark circles and puffy eyes are very common with allergies. Sometimes we can just be unfortunate with genetics; dark circles and bags underneath the eyes are often inherited. It’s always sensible not to dismiss any possible factors for eye bags though, as puffy eyes can be the first sign of fluid retention due to a medical problem such as kidney or liver disease; make sure you consult your doctor if you have swelling underneath the eyes that does not seem to improve.

What are the options to remove bags underneath the eyes?

There are two options for the removal of bags underneath the eyes; blepharoplasty (eye bag removal surgery) or dermal fillers. The problem with being treated at a  dermatology led clinic rather than a plastic surgery led clinic is there is a tendency to imagine that non surgical options are better. They are certainly easier for the physician, and sometimes for the patient, but are often temporary, in the long term more expensive, and do not address the underlying pathology.

Fillers are the non-surgical eye bag (tear trough) treatment that we offer at The Warwick Clinic; this procedure is extremely popular and we see all of our patients benefit from this treatment immensely. Not only does it have a high satisfaction rate and an enormous ‘wow factor’, the procedure also only takes about 10 minutes long and can last up to 12 months.

Eye bag (tear trough) removal surgery, otherwise known as blepharoplasty, is a straight-forward day-case procedure at The Warwick Clinic, but is often performed with general anaesthetic.

Eye bag removal surgery is a permanent way of removing those nasty tear troughs, and achieving an overall fresher and more youthful appearance. This surgery also removes excess skin and fatty tissue from above the eye, but does not smooth out crow’s feet (the little wrinkles that appear at the side of our eyes as we age) which requires laser or peel treatment. Blepharoplasty has been known to not only improve the appearance of the eye aesthetically, but also improve vision in some cases.

Before and after

What are the alternatives?

Chemical peel or laser resurfacing of the lower lids can help and enhance eyelid surgery. Ultherapy can sometimes reduce eyebags.

What happens?

There are essentially two methods of blepharoplasty that are carried out by our Surgeons.

Traditional Blepharoplasty

Lower Lid
 – An incision is made very close to and just under the lash line, sagging skin and loose muscle is excised along with any excess fat. The surgeon then tightens, reshapes and sutures the skin. The resulting “hairline incision” heals very quickly and tends to fade within weeks.

Upper Lid – 
A very similar procedure to the lower lid, however, the incision follows the natural contour of the eyelid and is made in the natural fold of the lid, the resulting “hairline incision” becomes the eyelid’s new skin crease.

Transconjunctival Blepharoplasty

A state of the art technique which is becoming increasingly popular. Used to treat the lower eye bags on patients with good skin elasticity, the incision is made through the conjunctiva (inside the lining of the lower lid) therefore leaving no visible scar with little chance of the “pulling down” of the lower lid and without changing the natural shape and contour of the eyes.

How long should it last?

The procedure can ‘turn back the clock’ but it cannot ‘stop it ticking’. Your natural ageing process will continue normally, however, the more alert and youthful look should last for years.

Will I be asleep?

Yes, twilight sleep. You will be sedated heavily with medication throughout the procedure. Your Consultant Anaesthetist is present throughout surgery to ensure that you are comfortable and pain free. You will probably have no recollection of the procedure. General anaesthesia can also sometimes be used, preferences will be discussed during your consultation with your Consultant Cosmetic Surgeon.

Is there any discomfort?

Some swelling, tenderness and discomfort may be experienced for a few days which will be controlled with medication if necessary.

How long does it take?

The procedure takes between one to two hours and you can usually return home on the day after treatment, returning approximately one week later for your first post-operative appointment.

Can I drive myself home?

No – because of the medications used during surgery, you cannot drive for 24 hours.

What will I look like immediately? When will I look good?

Normal healing takes approximately one week and any further discoloration or swelling subsides very quickly so that within two to four weeks you should be completely back to your new self.

When can I wear make-up?

A week after the procedure, when most of the swelling has subsided, you may apply eye make-up. Of course, you may wear lipstick right away. Contact lenses can be worn after two weeks. After eyelid surgery, a number of our female patients decide on a “make-over” and a new hairstyle to enhance their change in looks.

How much will it cost?

Your best investment is an individual consultation with a surgeon you trust. Cosmetic Surgery is usually a life-time investment. Our patients are treated as individuals, and costs do vary from person to person dependant on their individual needs. However, the total cost of your procedure will be quoted at the consultation, fully inclusive with no hidden extras.

I have negotiated some remarkable prices in UK hospitals for those patients who are able to travel, and who are flexible about dates.

Should I have eyelid surgery?

Only you can answer that question. Be sure you are doing it for the right reasons: your own sense of self confidence and self esteem. No matter what anyone else thinks, if you are happy with your appearance there is no reason to have it changed. So before making that decision, attend a consultation, get the facts. Be realistic in your expectations and make an educated decision that is right for you.