Under Eye Bag Returned Months After Blepharoplasty

Question

i had blepharoplasty in Nov and now the under eye bag is back under one eye? My doc said he has to wait to touch me up until Aug?? I have one bag!!! It looks so bad!What could have caused this? And is there anything I can do until the revision?

Carlos L. Wolf, MD · Answer

You probably have fat that was never removed. While it is better to have to remove more fat than to have to fill an area that was over resected, it is unfortunate that you may require another surgery.  There is probably no eye surgeon out there that ihas not had this problem. The key is to have it happen infrequently. 
You probably have the bag on the lateral part of your lower eye lid or the medial part of the upper eye lid. These are the most common areas. In order to avoid this problem I frequently remove the lateral fat pad first. As long as your doctor is willing to treat you I would continue to see him.  You can sometimne reduce the size of the fullnes with a small steroid injection.  Your surgeon is correct in waiting as you may have some swelling that will go away. Patience may be rewarded. Good luck.

Andrew P. Trussler, MD · Answer

Thank you for the question. Lower eyelid bags are common complaints that can usually be addressed with a lower eylid blepharoplasty and mid face lift. All can be approached through the lower eyelid, and these can be complex surgeries to many physicians. If your lower eyelid was approached with a standard simple blepharoplasty it may actually worsen the result. For eyelid bags I would consider removing lower eyelid skin with a fat repositioning (septal reset) and orbicularis (muscle) suspension, combined with a lateral canthopexy and cheek lift. Without these maneouvers, elimination of your bags would be difficult.
I hope this helps and let me know if you have any further questions.
Dr. Trussler

Tanveer Janjua, MD · Answer

The fat pockets can sometimes appear months after surgery. Usually it is because of the scar pushing and pulling on the fat pockets as it is maturing. A small fat pad can be easily removed as early as six weeks after surgery. However, it is ideal to wait for six months as the healing process has not completed.
While waiting for surgery, you can get a filler like Juvederm or Restylane to fill out the depressed areas around the fat pocket and it will minimize the bulge.
Regards

Michael A. Persky, MD · Answer

Hi Belay,
Sorry to hear about your unsatisfactory result with your blepharoplasty.
Sometimes a fat compartment is either missed, or insufficiently removed, or more fat may herniate (very rare).  You are now 4 months post surgery.  An experienced eye surgeon should be able to remove the fat without waiting until August.
I hope that all goes very well.
Good luck and be well.

William Portuese, MD · Answer

It sounds as though one of the fat pads on the lower lids was not adequately addressed by removal of the under eye fat pads. This can simply be done by a transconjunctival approach to go in and remove the fat pad. It is important to wait at least three to four months after the original surgery before embarking on a touchup procedure.

Under Eye Bag Returned Months After Blepharoplasty

Answers (5)

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