Lower eyelid bags or baggy eyelids: They occur as you get older. Mainly they run through the family, so if your parents have had lower eyelid bags you got a very good chance of getting them as well. They are little fatty protrusions of the normal fat of the orbit. But at the layers of the lid get a big weaker as you get older, they forwardly prolapse over the edge of the bone and they look like eyelid bags.
And so they have to be assessed and then hopefully we can remove them through a transconjunctival approach meaning from the inside of the eyelid for the approach it doesn’t require any stitches or sutures at all.
Surgery for lower eyelid bags is done under local anaesthetic, it is done as a day case, you would have your surgery done here at Clinica London.
However during the assessment, because every patient is slightly different, with the lower lids, I also have to make sure, that there is no skin that has to be taken out as well. So I assess the skin laxity and I also assess the lower eyelid laxity, to see whether I need to put some special sutures at the corner, to hold up the lid during the surgery and for the first weeks afterwards.
And I make sure that you don’t have a dry eye, because if you have; I have to take special precautions, perhaps putting in a punctal plug or giving you extra eye drops afterwards. So lower eyelid bags could certainly be dealt with surgically usually from the age of about 50-55 upwards.
If you have just small eye bags before that, we can very often correct them by very careful and delicate use of hyaluronic acid (HA) gel. By using the TearFill, it would just be a cannula administration of the gel, something like Restylane or Juvéderm, to the upper cheek and tear trough. That can hide the eye bag.
But as you get to being more the age of 45 to 55 it is at the borderline of whether you will be alright to get filler, hyaluronic acid gel or whether you are going to need surgery for it. So it is very important that you have your assessment done by a properly trained oculoplastic surgeon who is used to examining and assessing around the eyelids, including the health of the eye for the dry eye and who can deal with any complications that could occur with any treatment of lower eyelid bags.
Ms Jane Olver is the founder of Clinica London and a Consultant Ophthalmologist and Oculoplastic Surgeon. Her special expertise is in oculoplastic and cosmetic eye surgery including eyelids and lacrimal surgery. She is specialised in endoscopic lacrimal surgery for watering eyes in adults and children. She has over 20 years’ experience in treating people with eye problems just like you, and has published extensively in scientific journals about Ophthalmology and Lacrimal Surgery and is the author of the books “Ophthalmology at a Glance” and “Colour Atlas of Lacrimal Surgery”. At Clinica London, she is responsible for the Aesthetic Medicine and Surgery part, as well as patients with eye, eyelid and tear duct problems, and acute eye problems.