Eyebag surgery at age 32 now 78 - they are back, can I have this surgery again?

Question

The eye bags are worse now. My past surgery was amazingly successful. The lower eye was cut directly aligning with my eyelash, healed quickly, the stitching concealed. What peocess is used now, and at what cost? Will my age be a problem?

Dilip D. Madnani, MD, FACS · Answer

Great question and one that we see quite often. The eye bags can recur over time, and in your case, its been over 40 years and they have recurred. Whether you can have surgery or not will depend on the status of your lower eye muscles, if you have any weakness there or if you have any dryness or tearing. There are two common approaches to the lower eye bags- one is transconjunctival, which approaches the bags from the inside of the eyelids and the other is a subciliary approach, which sounds like you had that approach before. I suggest an examination with a facial plastic/plastic/oculoplastic surgeon first to determine whether you are a candidate, and something should be able to be done to improve the appearance. Pricing will vary depending on exactly what procedure is being performed

Cameron Chesnut, MD, FAAD, FACMS · Answer

That is awesome! Good for you. We can turn back the hands of time be we can't stop them from ticking forward. You can absolutely have surgery again. Things are a bit different now - much more minimally invasive techniques and much less general anesthesia. Both are good things!
To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.
Cameron Chesnut
#realself500 Physician

Mehryar (Ray) Taban, MD, FACS · Answer

Revision lower blepharoplasty is possible. Need personal consultation to determine what can be done. See an oculoplastic surgeon.

Thomas S. Taylor, FACS · Answer

Hello!  You can definitely undergo lower eyelid surgery again. It sounds like some of the excess fat has returned to this area. It may need to be removed or repositioned. Also, your skin will need to be addressed and maybe a small amount will need to be excised to tighten the area after the fat is removed.  This surgery can be done through an external lower eyelid incision, an internal eyelid incision or most likely a combination of both which I prefer to do.  Very special attention needs to be paid to maintaining support of your lower eyelids so as to ensure  good eyelid position for an optimal cosmetic outcome and to prevent any dry eye problems post-operatively.  Of course,  in order to formulate a specific plan for your particular situation this will require a consultation and evaluation by one or more experienced plastic surgeons.  I hope you find this information helpful! Thomas Taylor, MD, FACS

Toby Mayer, MD · Answer

Yes this can be done and at your age it is probably done the same way or from the inside of the eyelid if there is minimal excess skin. See a very experienced surgeon for this.

Robert H. Woods, MD · Answer

You can definitely have this done again. You can stick with the same approach you had originally or go with a transconjunctival approach to address the excess fat (bulging) from the inside of the eyelid and then remove or laser any excess skin if this is a problem as well. The advantage of the latter is that the bulging can be treated without a visible incision and the scarring from the previous surgery wont be as much of an issue. If this is all you need you are likely to have no bruising and minimal swelling with no visible incision. About $5000 if you do this in a facility with anesthesia.

Richard O. Gregory, MD · Answer

There is increased risk of complications in secondary eyelid surgery.  However, in selected cases corrective surgery can be done with minimal risk.of complications   it is an excellent idea to seek a surgeon who is experienced in doing secondary surgery and a conservative approach is always advisable.  Risk is also increased (for instance dry eye) as a person ages.

J. Timothy Heffernan, MD · Answer

Thank you for your question. I am glad your first eyelid procedure was successful. If you are in good health then there should not be a problem with doing this procedure again at your age. I would recommend doing this via a transconjunctival approach through the inner eyelid, which will not leave a visible scar. Please consult with an oculoplastic surgeon. Best, Dr. Heffernan

Paul Nazemi, MD · Answer

Thanks for your question.  Lower eyelid bulges or bags can rarely recur after surgery over time.  When indicated, a lower eyelid blepharoplasty can be performed to remove and/or reposition the fat.  This can be performed through a small incision beneath the lash line, or via a transconjunctival approach through the inner eyelid, leaving no possibility of a visible scar.  See a specialist for an examination and best wishes.

Walton Montegut, MD · Answer

Your age is not a problem.  Operations are performed for diagnostic problems.  If the problem is not there, then the patient does not need surgery.  If there is excess skin or fat, this can be removed with an upper or lower eyelid lift.  If a lower lift is indicated, this can be performed via a transconjuntival approach which avoids the incision below the lash line.  Doing this incision a second time can create a problem, especially if there is laxity (looseness) of the lid.  This can be a common problem, therefore, your surgeon would know best.  This is best determined by a consultation in person.  Eyelid surgery is performed under local anesthesia, and the recovery time is minimal.  I like to refer to it like "going to the dentist'.  Patients do very well and heal fast.  Most of the patients in this office rarely bruise.

Eyebag surgery at age 32 now 78 - they are back, can I have this surgery again?

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