[Music] [Music] Are the results of eye bag surgery permanent?
Under eye bags which are present all the time is caused by fat pockets located under the eyes
pushing forward like a hernia this puffy appearance is often seen
running in families as a genetic trait bags under the eyes are also associated
with aging sinus problems and allergies during the course of a consultation for
under eye bags patients will often ask me is the surgery for eye bags that they’re
planning to have going to be permanent I’ll discuss how I
address concerns about the longevity of results
you can expect after having surgery for under eye bags
I’m Dr Amiya Prasad I’m a board-certified cosmetic surgeon and
fellowship-trained oculofacial plastic
and reconstructive surgeon I’ve been in practice in New York City
and Long Island for over 25 years I specialize in cosmetic eyelid surgery
as well as revision eyelid surgery for complications referred
by other doctors one of the most popular procedures i perform for under
eye bags is called transconjunctival blepharoplasty
in conventional plastic surgery under eye bags are approached by the surgeon
making an incision through the skin this approach is called a transcutaneous
blepharoplasty in this conventional approach an incision is made
just below the eyelashes so the skin and underlying muscle can be
elevated in order to gain access to the fat pockets in my practice
my preference is to access the under eye fat pockets
through a transconjunctival approach this means that I’m able to treat the
fat pockets responsible for your under eye bags
from the inside of the eyelids thereby leaving
the outside skin and supporting muscles intact and undisturbed
this technique is considered technically advanced and can be
challenging for a surgeon in comparison to a transcutaneous approach i prefer
the transconjunctival approach because it allows me to preserve the
shape and character of your eyes much more predictably
than with a transcutaneous approach I see a lot of patients for
complications from transcutaneous blepharoplasty these complications include problems
such as lower eyelid retraction and ectropion a common complaint I hear

from patients who have undergone transcutaneous blepharoplasty
from the outside is that they feel that they’ve lost the
shape that was characteristic of their eyes they complained that their eyes ended up
looking rounded and that they don’t look like themselves
in addition I often see patients complaining of having dry
eyes after this approach dry eyes can be caused by excess eye
exposure or from a too low position of the lower
eyelid after surgery this limits the tear film distribution
many of my colleagues justify performing transcutaneous blepharoplasty
because they want to do something about under eye
wrinkles by removing the skin in order to make the skin appear to be
tighter I respectfully disagree with this assertion on the basis that
under eye wrinkles are caused by a loss in skin
quality related typically to aging as well as other contributing factors such
as excess sun exposure smoking and environmental stressors to the skin
although it may look like there is extra skin
under the eyes for most people there’s actually no
excess skin essentially we’re not dealing with a skin
quantity problem but rather a skin quality problem this means that when a
transcutaneous blepharoplasty is performed you can end up with a skin shortage
resulting in problems such as as I mentioned before eyelid
retraction and ectropion since the main issue with the under eye
skin is skin quality we can improve the skin quality with
issues such as wrinkles and skin discolorations through
procedures such as fractional co2 laser resurfacing
the objective in using fractional co2 laser is to refresh the epidermis
and to strengthen the dermis the dermis is the foundation of your skin
and precise heat application to the dermis stimulates new collagen production
thereby improving the appearance of wrinkles I further enhance
skin healing and collagen production with prp
or platelet-rich plasma prp or platelet-rich plasma is a concentration
of the part of your blood responsible for wound healing
two key aspects of wound healing is the creation of
new blood vessels and the production of new collagen both of which are needed
for healthy looking skin as mentioned earlier i sculpt the prolapsed fat
responsible for under eye bags by performing transconjunctival
blepharoplasty generally speaking after i perform
transconjunctival blepharoplasty your eyes retain their natural shape
since the skin muscle and other support structures
are not violated and are left intact some of the art in performing
transconjunctival blepharoplasty is dynamically judging the effect
of fat sculpting on your appearance as I’m performing the surgery
my target is to create the appearance as if you never had under eye bags
oftentimes people with under eye bags also have deficiencies in their
cheekbone structure additionally in your 40s and
older there is a diminishing in bone volume
as well as loss of soft tissue skin thickness and
fat volume this is why i often combine surgery with the placement of
long lasting cheekbone filler at the bone level
using a technique called structural volumizing
the fat pockets responsible for under eye bags
exist in specific anatomic compartments when fat is sculpted from these
compartments it’s unlikely that new fat will occupy
these same compartments in the future however since there is
still fat located further behind the fat that was
sculpted as aging and bone volume loss progresses
there is the possibility that additional fat
may shift forward later in life this means that the longevity of results
is going to be different for someone who’s having their procedure in their
20s in comparison to someone who’s having it in their 60s speaking
from experience it’s not unusual for patients to
enjoy the results of their lower eyelid surgery
for 10 to 20 years and even longer as stated earlier other aging changes
can be addressed with volume enhancement laser and other
surgical options in my practice i perform transconjunctival lower eyelid
blepharoplasty using local anesthesia with light iv
or intravenous sedation my patients appreciate the advantages of this
approach in comparison to the risks and recovery
associated with general anesthesia usually i have my patients returned to
work in about a week with minimal evidence of bruising or
swelling if you’re considering surgery for under eye bags
you can be optimistic about the long-term benefits of this procedure
since the human body is not permanent future aging changes around the eyes and
cheeks can be addressed as needed i hope you found this information
helpful thank you for your question
[Music] [Music]