Bags under the eyes, dark circles or fat bulges in the lower eyelids can cause a tired appearance. In fact, this phenomenon, which results from fat bulges, sagging of the central face and dark color in the cheek area, is one of the most common reasons for seeing an eye plastic surgeon (oculoplastics). Today, the range of treatments is wide, and includes surgical and non-surgical solutions such as filler injections , Botox and facial rejuvenation treatments. Treating this phenomenon gives the face a fresher and less tired appearance.
A normal facial structure, in which the transition between the lower eyelids and the cheek/face is emphasized, is a structure that is easily maintained up to a certain point, and over the years, due to internal and external factors, a change in the structure occurs. In many cases, the change is minimal, and in many other cases, a significant, substantial, and significant change occurs.
Over the years, and the natural process of puberty, there is a relative sagging of the cheek, and alveolar fat (normal eyelid fat) protrudes above the sagging. The resulting appearance is of depressions under the eyes that give a tired appearance or of dark circles under the eyes. In older ages, the condition may be accompanied by real weakness of the eyelid / expression muscles.
Fortunately, there is not just one solution to the question of what to do about bags under the eyes, but several solutions, each of which is suitable for the different sources of the phenomenon’s formation, as well as for the preferences and personal profile of the patients.
Fortunately, there is not just one solution to the question of what to do about bags under the eyes, but several solutions, each of which is suitable for the different sources of the phenomenon’s formation, as well as for the preferences and personal profile of the patients.
When the protruding fat or depressions under the eyes are aesthetically disturbing, or give a tired appearance that does not match the patient’s feelings, and when there is no other suitable solution, lower eyelid surgery or surgery to correct bags under the eyes may be considered.
Lower eyelid surgery is suitable for men and women over the age of 30 who suffer from protruding fat, bags or dark circles under the eyes, wrinkles and excess skin, and when no other aesthetic treatment can be offered to improve appearance. In some cases, the surgery can also be performed at younger ages.
Lower eyelid surgery is usually performed under local anesthesia with intravenous sedation or general anesthesia, depending on the patient’s wishes. Therefore, you must come fasting for 8 hours from food. You may drink water up to 3 hours before the surgery (if you have diabetes, you will be required to fast for only 6 hours and consult your doctor about how to take your diabetes medications). When taking blood thinning/anticoagulant medications, you must stop taking them a few days before the surgery, as recommended by the surgeon and with the approval of the doctor. You must come with a companion for the surgery, since you cannot drive or return alone by public transportation due to the anesthesia and due to the local swelling after the surgery.
Surgery to remove or reshape the eyelid fat by partially removing it or repositioning it in the depression area. If necessary, the eyelid skin and the expression muscle are stretched in a controlled manner.
The surgery is suitable for cases where the severity of the condition is moderate or higher. The surgery is performed under local anesthesia with sedation or under general anesthesia.
To continue reading about eyelid surgery in a variety of different situations, please click on the link here.
Injecting fillers to blur the transition between the cheek/central face and the lower eyelids. The treatment is effective in mild cases where there is no significant protrusion of eyelid fat and does not provide a permanent solution.
The fillers last between one and two years and sometimes even longer, and it is not necessary to continue the treatment for life, depending on the patient’s wishes and the aesthetic result.
To continue reading about fillers, please click on the link here .
In some cases, a combined treatment can be performed that includes a surgical procedure along with a filler, thus obtaining a full effect. Prof. Guy Ben Simon will tailor the best treatment for you.
Watch the interview in which Prof. Caruso interviews Prof. Guy Ben Simon, explaining in detail the phenomenon, the solutions and also illustrating with examples. In this information, you can find a partial answer to the eyelid problem and its conventional treatment. By contacting Prof. Guy Ben Simon and coming to the clinic, you will be able to receive an accurate and personalized response specific to your individual situation and accordingly adjust the best treatment according to the patient’s preference. Prof. Guy Ben Simon, an eye surgery specialist, in an interview on Prof. Caruso’s program:
The equivalent of a younger, fresher, more alert appearance for the eyes and face in general, and a reduction or elimination of the vision problems you have experienced.
The surgeon marks the prominent bags and depressions with a fine marker. The incision is usually made on the inside of the eyelid (conjunctiva); in these cases, there is no external scar. When the bags are accompanied by excess skin in the lower eyelid, the skin is removed through an eyelid crease incision or a subciliary incision, where the scar is delicate and almost invisible after surgery. After anesthesia, an incision is made in the conjunctiva through which the prominent fat is shaped, and if necessary, the excess skin is removed, and the incision is sutured with a fine, long suture. In some cases, and depending on the aesthetic disorder, prominent fat in the eyelids is removed or repositioned – fat repositioning – and the height of the eyelid is corrected when there is weakness in the angle of the eye. In cases where there is a lack of fat in the eyelids or face (sunken eyes), an injection of autologous fat can be considered to give a fuller, more youthful appearance. The fat is extracted from the abdomen or thigh.
In the first week after surgery, there is slight swelling of the eyelids, with subcutaneous hemorrhages. Vision is usually normal and there is no impediment to performing routine activities except for strenuous physical activity or swimming in a pool. It is common to apply antibiotic ointment to the surgical wound for a week, take eye drops, and apply cold compresses for the first two days after surgery, in order to reduce swelling. If a skin incision was made and there are stitches, they are removed 7-14 days after surgery. The final result of the surgery is observed about one to three months after surgery.
It is important to choose an ophthalmologist with a specialization in eyelid surgery – oculoplastics, a unique field that focuses on upper eyelid surgery, lower eyelid surgery (sags under the eyes), forehead and eyebrow lifting, and eye socket and tear duct surgery. As well as having experience in lower eyelid surgery, who will be able to diagnose and adjust the surgery or treatment required for you. It is recommended to see before and after photos of other patients in order to adjust expectations, and sometimes it is even possible to consult with patients in order to understand the experience of the treatment and recovery.
During the meeting, an initial introduction is made, the patient’s wishes are understood, and expectations are adjusted to the possible outcome. Prof. Ben Simon performs a comprehensive examination of the eye to assess diseases and associated conditions that will require adjustment of the surgery to eye health. A comprehensive examination of the eyelids is also performed, including all aesthetic and functional disorders that can be improved. After a discussion with the patients, an optimal treatment plan is implemented. In most cases, the solution is surgical, but in other cases there are non-surgical treatments such as Botox injections, peeling, or fillers .
After the examination, patients go to the clinic manager to complete tests and receive the technical details of the surgery, including scheduling an appointment.
The clinic team includes Miri Sapir, who receives the patient, completes some of the preliminary tests, and serves as an aesthetic consultant, and Anna Kasner, the clinic manager, who coordinates the surgeries and obtains full details about the nature of the process.
Surgical treatment will be done depending on the problem –
If there is a relatively smooth transition between the lower eyelid and the central face, a little fat can be removed in a controlled manner to prevent that hill that creates shadowing (and bags).
Of course, it is preferable for the surgery to be performed through an incision in the conjunctiva (the inner part of the eyelid) in order to prevent scarring of the skin in this sensitive area.
If, on the other hand, the excess fat is small, and there is a depression under the fat sac, then volume must be restored to the tissue.
This procedure is performed by injecting natural fillers (hyaluronic acid) or fat (from the chin area or another area of the body).
In fact, the fat that is falling is natural fat and the real situation is not excess fat but a change in its normal location.
In other cases (usually at older ages) there is excess real skin (a process called festooning).
In this case, skin must be removed in a controlled manner but the subcutaneous muscle must be preserved (and even strengthened). There are cases where there is excess subcutaneous muscle – here a low-dose Botox can be injected. In conclusion, a comprehensive examination of the eyes, eyelids, muscle and eye position, central facial position, muscle strength and the degree of skin tension is necessary.
After this examination, the treatment (which does not have to be surgical) can be adjusted.
Regarding upper eyelids – you must remember that you are the one who decides which surgery to undergo. If they don’t bother you, there is no reason to perform surgery even if the doctor recommends it.
When choosing cosmetic surgery, you must be comfortable with the decision, examine the available treatment options, and accordingly choose the type of surgery/treatment desired (not treating or not performing surgery is also a reasonable option).
The cost of the surgery is determined depending on the type of surgery (and as you understand, there are a large number of surgeries or treatments available), so without a comprehensive examination, it is not possible to determine the cost of the surgery.
To schedule an appointment for diagnosis and treatment, call 050-2971663 or email clinicgbs@gmail.com and we will be happy to serve you.
MEDICA Medical Center, HaBarzel 28, 1st floor, Ramat HaHayal, Tel Aviv
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