Eye Bag Removal Surgery In Singapore – Lower Blepharoplasty

Eyebag

Eye Bag Removal & Treatment Methods in Singapore

Lower blepharoplasty, otherwise known as eye bag removal in Singapore, can address both eye bag and lower lid skin excess and laxity.

There are 2 main eye bag removal surgery methods:

1. Subciliary Lower Blepharoplasty (External Method)

• This method is suitable for patients with excess lower eyelid skin and fat pockets. Removal of fat alone would result in gathering of excessive loose skin.
• A fine cut is made just below the lower lid eyelashes. A small strip of excess skin and fat is then removed.
• Those patient with severe laxity of the lower lid may need additional tightening procedure to prevent drooping of the lower eyelid post surgery (lateral canthopexy or lateral canthoplasty).
• The scar below the eyelashes often becomes imperceptible after about 3 months.

2. Transconjunctival Lower Blepharoplasty (Scarless Method)

• This method is suitable for young patients with no skin laxity/excess. The fat pocket is removed via a small cut in the back of the lower lid, leaving no scar on the exterior.

COMPARISON OF SUBCILIARY VS TRANSCONJUCTIVAL LOWER BLEPHAROPLASTY

	Subciliary Lower Blepharoplasty (External Method)	Transconjunctival Lower Blepharoplasty (Scarless)
Photo	Lower Blepharoplasty – Eyebag Removal	Lower blepharoplasty – Transconjunctival – Scarless Eyebag Removal Side profile of the lower lid showing the cut on the inner (conjunctival) surface.
Scar	Faint scar – below eyelash	Scarless (incision hidden on the inner surface of the lower eyelid)
What is done	Removal of eyebag Removal of lower lid skin excess. Lateral canthopexy to tighten lower lid laxity (optional) Fat redistribution to smoothen the contour of the lower eyelid (optional) Laser resurfacing of wrinkled lower lid skin (optional)	Removal of eyebag Fat injection to smoothen the contour of the lower eyelid (optional) Laser resurfacing of wrinkled lower lid skin (optional)
Suitable patient	All patients with eyebag.	Younger patient with eyebag, and no lower lid skin excess or laxity.
Suture Removal	1 week	None

PROCEDURES DONE TOGETHER WITH EYE BAG REMOVAL SURGERY:

The following procedures are commonly combined with eye bag removal surgery:

• Double eyelid surgery – Incisional blepharoplasty
• Facelift
• Fat grafting to face
• Conventional or Profractional Laser Skin Resurfacing to the face for rejuvenation (removal of wrinkles and to improve texture and elasticity)

METHODS OF EVALUATION FOR LOWER LID SKIN LAXITY

• It is common to remove excess lower lid skin after the removal of the eyebags. If there is a pre-existing laxity of the lower lid, removal of skin excess can cause the lower lid to droop and turn outwards away from the eyeball (ectropion).
• There are two ways to assess lower lid laxity :
  • Pinch test (snap-back)
    • The lower lid skin is pulled downwards forwards and allowed to snap backwards. This checks the laxity of the lower lid (tarsal laxity).
  • Distraction Test
    • Pull the lower lid skin away from the white of the eye (sclera). A gap of more than 8 mm denotes laxity (tarsoligamentous).

Lateral Canthopexy

• It is a procedure done to tighten the lower lid to prevent ectropion. A non-absorbable suture is placed over the lateral corner of the lower lid (lateral canthus) and tied to the sidewall of the bony socket of the eye (lateral orbital rim).

DESCRIPTION OF EYE BAG REMOVAL PROCEDURE

Transconjunctival lower blepharoplasty (scarless method)

• The lower lid is pulled downwards and a small cut is made on the inner (conjunctival surface).
• Resection of the excess medial, central and lateral fat pad.
• Wound closure with absorbable sutures.
• Adjunctive procedure :
  • Fat transfer to lower lids
  • Laser skin resurfacing treatment to lower eyelid/ face
• Surgical duration: 1 hour
• Day Surgery (home on the same day)

Subciliary Lower Blepharoplasty

• Pre-operative marking to determine the amount of lower lid skin to be removed.
• A cut is made just below the eyelash margin.
• Dissection to expose and remove the excess lower lid fat pads (eye bags).
• Excess lower lid skin is trimmed.
• Wound closure with very fine non-absorbable suture.
• Adjunctive procedure :
  • Lateral canthopexy to tighten the lower lid and prevent ectropion.
  • Fat transfer to lower lids
  • Laser treatment to lower eyelid/ face
• Surgical duration: 1-2 hours
• Day Surgery (home on the same day)

ANAESTHESIA

• A combination of local anaesthesia with IV sedation for maximal patient comfort.

POST OPERATIVE CARE

• Mild discomfort to be expected includes:
  • Swelling usually resolved in 1 week.
    • In rare instances, swelling may take several weeks to resolve.
    • Avoid exertion and raise the head up by 30 degrees to hasten the resolution of swelling.
  • Bruising is usually resolved in 2 weeks.
  • Tearing
• Post-operative medications:
  • Antibiotic ointment to be applied regularly 3-5 times a day
  • Antibiotic eye drops 3 times a day
  • Oral antibiotics
  • Analgesics (pain relief) and anti-swelling medications
• Removal of suture at 1 week.
• Resumption of light exercise after 3-4 weeks.
• Refrain from wearing contact lenses up to 4 weeks post-surgery.

RISK AND COMPLICATION OF EYE BAG REMOVAL SURGERY

• Bleeding/ Haematoma (blood clot accumulation)
  • Avoid exertion post-operative.
• Infection
  • Very rare
  • Avoided by clean (sterile) technique during the surgery.
• Ectropion/ Scleral show
  • This is prevented by performing lateral canthopexy.

COST OF EYE BAG REMOVAL SURGERY

• Lower blepharoplasty for the removal of eye bags is considered as cosmetic surgery. The correction of ectropion is a medical procedure.

During your consultation, Dr Ng will discuss popular eye bag removal surgery methods in both Singapore and Korea. Our plastic surgeon will tailor the eye bag removal methods to best suit your needs.