after eye bag surgery my eyelids pulled down what can I do surgery for under eye
bags is a very popular procedure contributing to this popularity is that
eye bags are associated with genetics and can be seen at almost any age a wide
range of doctors from general plastic surgeons to other medical specialists
are willing to perform eye bag removal surgery as a specialist I can state
without reservation that the under eye area is deceptively complex and
achieving natural-looking results and avoiding complications is not always so
straightforward the eyelid support structures and muscles need to be well
understood by the surgeon the delicate balance of the anatomic relationships as
needed to avoid complications cannot be overstated the fact that eyelid
surgeries performed so close to the eye also adds a unique element of risk when
compared to other cosmetic procedures I'll discuss common complications that
can happen after under eye bags surgery how they can be addressed and how these
potential issues can be anticipated to lower the risk of these complications
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 Manhattan and Long Island for over 20 years I was first trained in
eye surgery before I specialized in cosmetic and reconstructive surgery of
the eyelids patients come to our practice from around the world with a
range of issues after eyelid surgery in particular lower eyelid retraction eye
back surgery can be done via two approaches the transcutaneous approach
and the transconjunctival approach in the transconjunctival approach which
is my preferred technique herniated fat that causes under eye puffiness is
sculpted with the intended outcome of you looking like it appears like you
never had I bags no skin is removed no external incision is made i find this
approach to be effective at preserving the complex and delicate support
structures of the lower eyelid which by keeping them intact results in my hands
in avoiding common complications associated with lower eyelid surgery the
transcutaneous approach on the other hand involves making an incision right
below the eyelashes to remove and sculpt the fat it is a more traditional
approach to lower eyelid surgery commonly taught to general plastic
surgeons with this approach eyelid skin is often removed in an effort to tighten
the skin wrinkled under-eye skin is often seen by surgeons to be in excess
or redundant skin in my experience wrinkled skin is more due to poor skin
quality not excessive skin quantity this is often where problems start because
skin removal can lead to complications as stated earlier the lower eyelid
structure can be deceptively complex the lower eyelids in many ways are like a
suspension bridge so there are critical elements that keep that bridge up the
lateral canthal tendon that holds the eyelid to the bone an area called the
posterior and middle lamella of the eyelid which acts like pillars to
support the lower eyelid and the anterior lamellar which is the skin in
front of the eyelid the muscle in front of the island is the orbicularis oculi
muscle which acts like a hammock or sling to keep the eyelid in place very
often when lower eyelid blepharoplasty is performed through the transcutaneous
approach this delicate balance can be compromised for example when the
supporting muscle is traumatized and skin is removed in the effort to reduce
and improve wrinkles the subsequent scarring that leads to complications
such as eyelid retraction where the eyelids are pulled down or ectropion
where the lower eyelids Evert outward as a specialist with a background in
ophthalmology I can state that it is critically important that the lower
eyelid be in proper position because it's not just about the aesthetics but
it's also about the health of the eyes proper eye function requires the
continuous lubrication of the surface of the eye with tears when the eyelid is
everted or retracted the natural distribution of tears and the proper
protection of the eye is compromised when I see a patient who has experienced
a complication after eyelid surgery I explained that the strategy of surgery
is to restore anatomy the questions that need to be addressed are is there enough
skin at the front of the eyelid is there enough support for the lower eyelid
usually in eyelid retraction these issues are the foundation of the
reconstructive procedure you need support from the inside that typically
requires some type of grafting procedure a shortage of skin very often also
requires skin grafting the appearance of the skin graft
during the early healing process and after healing is completed is of major
concern for patients during consultation I explained that I strive to achieve
optimal blending of the skin graft with meticulous suture technique and the use
of wound healing technology such as PRP or platelet-rich plasma and
extracellular matrix at the time of surgery improvement of the skin graft
appearance after healing may involve the use of different lasers an important
aspect of anatomical restoration is a structure called the lateral canthal
tendon which connects the eyelid to the bone structure I surgically repair and
reconstruct the lateral canthal and routinely as part of the procedure
in our practice we do our procedures in our own certified facilities we have
dedicated staff that the patient gets to know very well from the time of their
appointment to the time of their surgery and afterwards we do this procedure
under local anesthesia with Lite IV or intravenous sedation so that the
recovery is more comfortable and is quick healing depends on your health and
lifestyle for example if smoking compromises oxygen supply and causes
inflammation this all negatively impacts the healing process depending on the
extent of the surgery our patients typically are able to return to work in
one or two weeks swelling continues to improve over several weeks to months
full surgical healing like any other surgery is complete in about one year
many people have come to us from around the world because they were upset about
losing the character of the shape of their eyes after lower eyelid surgery
restoring their characteristic shape with revisional eyelid surgery has made
a significant impact on their self-confidence and sense of feeling
attractive if you've had lower eyelid blepharoplasty and you feel that your
lower eyelids are lower than they should be you may have lower eyelid retraction
I would advise you to address your concerns with your surgeon and see if
the recommendations being made are to your satisfaction
if you feel that revisional surgery is needed meet with a highly experienced
cosmetic oculofacial plastic surgeon to learn about your options I hope you
found this information helpful thank you for your question
you