What can I do for bags under my eyes?

This can be a difficult area to treat. The first step to finding what you need, is to look at the lower eyelids area. Is the problem excess skin? Fatty deposits under the eyes? Or is loss of tissue caused by bone loss or fat descent of the cheek fat pads. Look at the corner of the eye, is the tissue here too lax, needing tightening of the tissues or a canthopexy. There are a number of options to treat this area.

Lower eyelid lift (lower blepharoplasty)

This procedure is best to treat excess skin or excess fat deposits. It is the most powerful manoeuvre.  It can be combined with one or more of the above treatments. It involves redraping or removing excess fat and reducing excess skin. This allows sculpting of the tissues around the eyes while adding definition. The lower blepharoplasty usually involves a lateral canthopexy or canthoplasty to anchor the corner of the eye and gives the procedure longevity.

Filler

This can be an easy way to treat lower eyelid hollowing or tear trough. A small amount can be injected along the. This can fill the concavity, allowing the light to retract, and improves the appearance of dark circles under the eyes. At the swan clinic, we always use a TSK cannula with very light pressure to ensure your safety during this procedure. We also use a very soft filler of the best quality in this location to prevent fluid absorption by the filler which can paradoxically increase the heaviness in this area.

Fat grafting

If you have cheek bone loss or fat pad descent, then you might benefit from fat grafting along the orbital rim and along the cheek bones. This can improve the fine lines around the eye and improve the hollowing along the lower eyelid. The advantage of fat grafting is that 50-80% lasts forever and it uses your own tissues.

Anti wrinkle injections

If wrinkling on the outside of the lower eyelid is the problem, then you might benefit from anti wrinkle injections. It helps weaken the muscle that can contract excessively and cause these lines. The dose and location can be tailored to your needs.

Medical grade creams and peels.

Prevention is the key to successful treatment. Medical grade topical treatments are best for treating fine lines. Creams that hydrate the skin and include retinol and c-esta can do a lot to reverse thin crepey lower eyelid skin. This can be combined with a peel after proper skin preparation.

Where is this surgery performed?
Lower blepharoplasty is an operation which is done in a major accredited hospital under general anaesthetic. A specialist anaesthetist will look after you during the procedure. It is performed as day surgery and usually takes two hours. The ligaments are restored to their rightful places with treatment of the lower eyelid fat pads. The skin is minimally tightened to restore the youthful eye appearance.
How can I prepare for surgery?
You will need to see Dr Hadi twice. The first consult takes you through the operation as well as expected results. The second consult is at no extra cost to you and runs through things again. All risks and benefits will be discussed with you and treatment will be tailored to your needs and your body shape. When you decide to proceed, there are a few things you can do to prepare.

  1. Eat healthily by avoid excessively fatty foods and foods high in sugar.
  2.  Stop smoking as this significantly increases complications rates. You cannot smoke for 6 weeks prior and 6 weeks after surgery.
  3. Stop all blood thinners unless previously discussed with Dr Hadi. Please stop any over the counter medications that might thin the blood. A comprehensive list will be provided during your consultation.
  4. Shower the night before or the morning of surgery with a medicated soap. These reduce the bacteria living on the skin and there is evidence it reduces chance of infection.
  5. Fast (do not eat anything) at least 6 hours prior to surgery. You will be given this time from Kareena Hospital.
Best practices in Lower Blepharoplasty
The recognition that the relationship between the inner and outer parts of the eyelid are important. With time, the outer aspect of the eyelid becomes lax and droops down as it becomes stretched. This gives us a sad look. Part of the surgery is to restore the outer corner of the eyelid upwards by suturing the outer corner of the eye. This is a canthopexy or canthoplasty procedure. The junction between the lower eyelid and the cheek is also important. This operation is tailored to the patient. In some circumstances, the bulging fat pads are minimally resected, while in other circumstances they are redraped across the lower orbit bony margin. This allows the tear trough to be treated.
Plastic surgery before and after photos
Due to the respect and privacy of our patients, we do not publish before and after photos on our website. However, many of our patients have graciously allowed their photos to be viewed by new patients considering the procedure. These photos are available to be viewed during the detailed consultation with Dr Hadi.
How long will the procedure take?
The procedure takes around 2-3 hours depending on what you need. You will need to be fasted for 6 hours before the procedure. Pre-operatively the skin is carefully marked. Local anaesthetic is then injected into the area. The excess tissue is removed and the blood vessels carefully cauterized. Sutures are then carefully placed and then tape is applied. You will then be given pain killers.
How long will I stay in hospital?
The surgery is usually performed as day surgery so you can go home the same day as long you are well enough to go home. However, you can stay overnight if you wish. You will be given antibiotic tablets and pain relief tablets to take home so that you can be comfortable. You will be given Dr Hadi’s number to contact her if you have any concerns or questions post operatively.
Are the sutures dissolvable?
Your wound is closed with dissolvable sutures.
When can I shower?
You can shower from the next dry. The dressings can get wet, please blow dry them if needed after showering.
When can I drive?
You can drive as soon as your vision is uninterrupted. This generally takes a week.
When can I exercise?
Gentle walking is encouraged from the next day. Two weeks for light exercise, four weeks for heavy exercise.
When can I go back to work?
Depending on the work you do and how physically demanding it is, you will need 1-2 weeks off before return to work.
Best Plastic Surgical outcomes?
Your part in the operation is essential. You can help achieve the best possible outcome by:

  • Immediately after the procedure, apply the gauze squares we give you dipped into iced water. Change these regularly. You can apply these that night and continue the next day. Cool compresses are beneficial for up to 24 hours.
  • Sleep on two pillows at night
  • Avoid heavy exercise and lifting for at least 2 weeks.
  • Avoid pain killers which contain antiplatelet. Please check with us prior to taking medication not prescribed by us.
  • Take the antibiotics we prescribe for you. These will last five days and help prevent infection.
  • If you notice your eyes feel dry or are tearing excessively, you can benefit from artificial tears. These are over the counter and available from pharmacies.
  • Come back for regular review as detailed in the next section to ensure your healing is progressing at each stage.
What about post-operative follow-ups?
As a minimum, you will be seen by Dr Hadi after surgery, at one week, at six weeks and twelve months after surgery. This is so that you can have the best possible outcome. Please call the Swan Clinic on 9526-6885 following your surgery to ensure we have booked all your follow up appointments. As our patient at the Swan Clinic, you will be well looked after and can always count on our honesty as we always have your wellbeing in mind. Please feel free to contact us if you have further questions.