Patients come from around the world to Prasad Cosmetic Surgery seeking under eye bag surgery to improve the appearance of tired looking under eye bags. Eye bag surgery or lower blepharoplasty is performed to address under eye bags or puffy eyes.
Dr. Amiya Prasad, a leading oculofacial plastic surgeon, has performed eyelid surgery for more than 25 years, and is considered one of the best in his field. People often seek lower blepharoplasty because their friends and family tell them they look tired because they have puffy eyes, or sagging lower eyelids.
Puffy eyes/under eye bags are often misinterpreted as being caused by fatigue or allergies. The bags that are seen under the eyes that remain unrelated to sleep, or allergies, excessive salt intake, and sinus issues are due to lower eyelid fat prolapse. The fat padding that prolapses is referred to as orbital fat. This is based on the fact that the eye sits in a space called the orbit, and this space has fat in compartments to support and cushion the eyeball. Orbital fat can herniate forward, causing puffy under eye bags that are always visible. To improve the appearance of the bags under the eyes, the excess fat may be sculpted, and removed.
Loose Skin – Many people are concerned that after the under eye bags are removed from under the eyes, there will be loose skin. Depending on the support of the lower eyelid, loose skin can be addressed at the same time. Often, the skin that accommodates the eye bags/fat pockets is tightened after surgery by the orbicularis oculi muscle. The orbicularis oculi muscle contracts like a belt, and tightens loose skin.
Wrinkled Skin – Wrinkled or crepey lower eyelid skin is generally due to diminished skin quality, not excess skin quantity. It is common for surgeons to believe that wrinkled lower eyelid skin is due to excess skin quantity, which is often the case of upper eyelids, so they take the same approach by excising skin with surgery. This often leads to a skin shortage, which can cause lower eyelid retraction, ectropion (lower eyelid skin everting outward), entropion (eyelid skin everting inward), and the inability to fully close the eyes during sleep, or to distribute tear film to clean the eyes. Dr. Prasad avoids these complications by improving eyelid skin quality non-surgically with treatments like lasers to tighten, tone, and resurface lower skin; as well as injectables like platelet-rich plasma (PRP) or platelet rich fibrin (PRF) to improve skin quality, texture, and thickness.
You may be a candidate for under eye bag surgery if:
Dr. Prasad spends a lot of time with every patient in consultation. During your consultation at Prasad Cosmetic Surgery, a special blepharoplasty examination will be conducted. The goal is to properly classify your unique features based on gender, age, ethnic background, and skin condition. This will allow Dr Prasad to select the best approach for treating the under eye bags, and improving the skin of the lower eyelids.
To address the under eye bags, lower eyelid surgery, also known as lower blepharoplasty, is performed.
There are different surgical techniques a surgeon can use to treat puffiness in the lower eyelids, but the overall approach usually involves sculpting and removing prolapsed orbital fat. Depending on the technique used, surgery time varies.
– external incision in the lower eyelid to access the fat pockets
Most surgeons make an external incision just below the eyelashes when performing lower blepharoplasty, which is known as the transcutaneous incision, which means “through the skin”. A well placed incision can be virtually invisible when fully healed. Patients with darker skin may experience darker pigmentation (hyperpigmentation) along the incision line.
This approach often involves making incisions and flaps of the orbicularis oculi muscle. The delicate orbicularis oculi muscle is very important as it supports the lower eyelid like a hammock. If the integrity of the muscle is compromised, the shape of the eye can be altered.
This approach commonly used by general plastic surgeons who don’t specialize or have enough experience in eyelid surgery, often results in rounding of the lower eyelids, changing the natural shape of the eyes; scleral show where too much of the white of the eyes (the sclera) becomes visible; or pulling down of the lower eyelids called lower eyelid retraction. This type of surgery should be performed with an understanding of other eyelid procedures to preserve the natural shape of the eye.
– Incision is made in the Inside of the eyelid, behind the eyelid skin, in an anatomic feature called the conjunctiva to access the fat pockets
The transconjunctival approach to lower blepharoplasty requires knowledge of the delicate structures close to the eye, so it is mostly performed by cosmetic eyelid surgery specialists like Dr. Prasad. He uses the internal incision in the conjunctiva from inside the eyelid when he performs lower eyelid blepharoplasty. This approach has several benefits:
Many people who consider lower eyelid surgery also choose to have upper eyelid surgery.
Oculoplastic surgeon Dr. Amiya Prasad developed his own approach to IV sedation combined with local anesthesia called LITE™ anesthesia. General anesthesia where a patient is paralyzed, and a tube is placed in the throat connected to a respirator is avoided. Local anesthesia allows patients to recover faster from all types of cosmetic surgery (with the exception of complex rhinoplasties/nose jobs) and go back to normal life quickly. Dr. Prasad’s patients have benefited with a comfortable and quick recovery with his unique anesthesia method.
After eye bag surgery, minimal swelling and some bruising are typical, which diminishes anywhere from within a week to ten days. Most patients return to work about one week after surgery. You will receive specific instructions for your recovery, and typically have a follow up with Dr. Prasad in about one week. Read lower blepharoplasty recovery process
The cost of eyelid surgery is based on surgeon’s fee, anesthesia, facility fees, and extensiveness of the surgery. Dr. Prasad performs his surgeries at his state-of-the-art surgical facilities to provide the highest level of safety for his patients. Financing options are available for qualified candidates.
To schedule a consultation with the Board-certified Oculoplastic surgeon Dr. Prasad, contact us at our Manhattan office at (212) 265-8877 or Garden City Long Island office at (516) 742-4636. Patient financing options are available for qualified candidates.