Under Eye Bags by Surgery?

I am considering surgery to remove my under eye bags . I was just wondering how many years does the result last ? is it better to remove the fat or reposition the fat? I heard removing the fat causes hollowness and wrinkles but last longer than repositioning the fat? The answer would be appreciated. Thanks

Doctor Answers 6

What Is The Best Technique To Remove Lower Eyelid Bags?

There are many techniques to improve the appearance of your lower eyelids and decrease that awful hungover appearance of excessive fatty protrusion in the lower eyelid.  My personal preference is the technique known as the muscle sling.  In this technique, a portion of the protruding lower eyelid bag is removed, but not very much of it.  Then the lower eyelid obicularis oculi muscle is formed into a dart laterally.  It is pulled under the lateral corner of the eyelid and is anchored to the covering of the upper lateral orbital bone.  This procedure has many salutary effects, one of them being the muscle when pulled taut, replaces the septum orbitale (that piece of tissue that kept the fat back when you were younger). 

In this procedure, you don't get a hollowed eye because only a minimal amount of fat is removed, and yet still, the fat is pushed back where it belongs.  This procedure also eliminates wrinkles on the lower eyelid, puts the cheek fat back where it used to be, and even at times, decreases the prominence of the nasal labial fold.  What a deal!

Eyelid surgery longevity

A lower blepharoplasty usually last for 10-15 years.  The eyes continue to age, so the surgery does not last forever.  Fat removal vs repositioning is controversial and in excellent hands you can get great results for either technique

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Risk and Effectiveness of Lower Eyelid Surgery

Removal of lower eyelid fat bags can be effectively achieved with long term results. I use a lower lid blepharoplasty without fat repositioning. If a patient already has hollowing or develops hollowing of the lower eyelids in the future, injectable fillers work well. Filler treatments also allow greater accuracy in results as opposed to fat repositioning, in my experience.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Under Eye Bags by Surgery?

Removal of undereye bags is a very common procedure. There are multiple techniques and none is a "one size fits all" procedure. To answer your question, you would either need to post photos or, ideally, see a Facial Plastic Surgeon in consultation. The two methods you mention, fat removal vs. fat repositioning, are both very effective when applied to the proper patient. No surgical result is permanent, however. Even after facial rejuvenation surgery we continue to age and suffer the ravages of time. However, blepharoplasty surgery typically provides lifetime improvement. I hope this information is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Under eye surgery and hollowness

Dear nashenas,

  • I believe in fat replacement after removing the excess fat from under the eyes to prevent hollowness
  • This can be done with fat grafting (my preferred method), or fat repositioning
  • When fat is grafted under the eyes, it can last 10 years
  • Overall, fat grafting allows us to smooth the transition from the lower eyelid to the cheek so that you can't tell when the eyelid ends and when the cheek begins

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Treating lower lid fat and bags

As you already know, there are a variety of methods of improving the appearances of your lower lids.  Assuming that your 'bags' are from excess fat, you can have it remove or repositioned with my personal preference for repositioning as it tends to avoid the hollow eye appearance as you age.  If properly done, you bags shouldn't return but your lower lid skin can still become more lax with time and aging.  Your doctor should be able to discuss the pros and cons (and not just 'thats how I do it') so you can make an informed choice as to what would work best for you.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.