I Had Lower Bleph Surgery One Year Ago but Still Have Bags - Suggestions? (photo)

I had upper and lower bleph - top worked great but bottom still have bags. Any suggestions to eliminate bags?

Doctor Answers 7

Hollow lower eyelid and midface improved by a midface lift

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Lower eyelid blepharoplasty generally improves bulging fat and excess skin, but usually does not improve hollowing of the lower eyelid or the junction between the eyelid and cheek. I think that you would be improved by a transcutaneous lower blepharoplasty with midface lift.

I Had Lower Bleph Surgery One Year Ago but Still Have Bags - Suggestions? (photo)

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You have a few things going on as others have desribed.  You should seek a consultation to best discuss your different options.  Revisional surgery is definitely more complex.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Residual eyelid bags after blepharoplasty

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Your posted photos show outer eye corners lower than inner eye corners with loose hanging lower eyelid edges, worse on the left than the right. I do not know what your surgeon did but it looks like you had scleral show before surgery and slightly more scleral show after surgery. Your eyelid skin is like a shower curtain hanging from a rod and in your case the rod is loose and curves downward in the middle rather than being straight horizontal. You need the lower eyelid edge (the curtain rod) raised and made more horizontal. That will not happen if you just remove more skin or fat (the curtain). Just from the photos alone it is impossible to say what surgery would work best. If the lower eyelid mobility is restricted and you cannot push it up over the pupil you will need more extensive surgery than just a canthopexy/plasty (raising of the outer corner).

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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Residual eyelid bags post surgery

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It is likely that your results can be improved with revision surgery and/or filler injections. Seek a second opinion with a facial or ophthalmic plastic surgeon.

Revision blepharoplasty for recurrent eyelid bags.

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Revision blepharoplasty for recurrent eyelid bags along with lid support and tightening for your lower lid sagging as well is what you need. I do not think a laser will adequately treat your problem.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Persistent lower eye bags

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I agree that you have persistent lower eyelid fullness likely due to excess peri-orbital fat. The concern in your case is that you appear to have decreased lower lid tone and some festooning. A more aggressive skin excision or correction may cause ectropion or lower lid being pulled down and away from your globe. You may consider some non-surgical options first, such as Ultherapy for improving skin tone and Fractional CO2 resurfacing to improve texture and provide for micro tightening. If these approaches don't satisfy you, your surgeon may perform a conservative transconjunctival periorbital fat reduction with a conservative skin pinch; otherwise you may require a subcilliary incision with fat reduction and cathopexy/canthoplasty to reduce the risk of ectropion.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon

I Had Lower Bleph Surgery One Year Ago but Still Have Bags - Suggestions?

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Based upon your posted photos I agree that your result is not optimal. Best to seek other opinions. I might redo with a lateral cantalpiexy. 

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.