What is under-eye bag surgery (lower blepharoplasty)?
Under-eye bag surgery, known in medicine as lower blepharoplasty, is an aesthetic procedure that corrects the appearance of the lower eyelids. It removes or repositions the fat deposits that create bags, as well as excess sagging skin below the eyes, refreshing the eye region.
With age, the skin below the eyes becomes thinner and more lax, and the fat that normally supports the eyeball pushes forward, creating puffiness and bags. Darker circles and fine lines join in, so the face looks tired and older than it is, even when the person is well rested.
The goal of lower blepharoplasty is not to change the gaze or the features of the face, but to restore a rested, alert look to the eyes. The result is natural — the person looks like a fresher, more rested version of themselves, not as if something has been radically changed.
At Medical Time, before the procedure it is carefully assessed what the cause of the problem is — excess skin, fat bags or both — as the choice of technique depends on this. The plan is made individually, with an honest conversation about what can be achieved for each patient.
Who is under-eye bag surgery for — indications
The surgery is recommended when puffiness, bags or excess skin below the eyes give the face a permanently tired look that does not improve with rest, sleep or creams. This is a change in the structure of the eyelid, not a passing swelling.
Lower blepharoplasty is considered in the following situations:
- pronounced bags and puffiness below the eyes that create a tired look
- excess sagging skin on the lower eyelids and fine lines
- a permanently tired facial expression despite sufficient sleep and rest
- asymmetry of the lower eyelids or slight drooping of the lid margin
- a wish to refresh the gaze and rejuvenate the eye region
- dissatisfaction with under-eye bags that emphasise facial ageing
How under-eye bag surgery is performed — technique
The technique is chosen according to what the main problem is. When fat bags are foremost and the skin is still elastic, an approach through the inside of the lower eyelid (the transconjunctival technique) is often used, so there is no incision or scar on the outside at all. Through this approach the surgeon removes or repositions the excess fat.
When there is also excess sagging skin along with the bags, the incision is made just below the lash line, where it is practically imperceptible after healing. Through it the surgeon removes or repositions the fat deposits and removes excess skin, gently tightening the supporting structures of the lid if needed.
The procedure is precise and conservative — the aim is to remove exactly as much as is needed, because excessive tissue removal can change the shape of the eye. That is why the surgeon's experience in this delicate area is especially important.
Lower blepharoplasty is often combined with upper eyelid surgery, when the whole eye region needs refreshing. At Medical Time, the technique and extent of the procedure are agreed with the patient after examination and assessment.
Preparing for under-eye bag surgery
Preparation begins with an examination and assessment of the skin, the fat bags and the tone of the lower eyelids. The surgeon agrees on the technique with the patient and explains the expected result. The procedure is often performed under local anaesthesia, with the option of mild sedation, so preparation is simpler than for operations under general anaesthesia.
The following is usually requested before the procedure, with the exact scope tailored to your condition:
Honest disclosure of health details, especially eye problems and dry eye, affects safety and the result.
- laboratory blood tests, including clotting parameters
- information about eye problems, dry eye and previous examinations by an ophthalmologist
- a list of medications you take, especially blood thinners
- stopping smoking before and after the procedure, as it slows healing
- avoiding eye make-up on the day of the procedure
- information about chronic conditions and drug allergies
- arranged escort for the return home after the procedure
The procedure, anaesthesia and duration
Under-eye bag surgery is most often performed under local anaesthesia, with mild sedation if needed, so the patient is awake and relaxed but the eye region is completely numb. For more extensive or combined procedures general anaesthesia is also possible, at the team's discretion.
Once the anaesthesia takes effect the surgeon makes the incision according to the chosen technique — through the inside of the lid or just below the lashes — and removes or repositions the fat bags, removing excess skin as well if needed. The incisions are carefully sutured with very fine thread that leaves an imperceptible trace.
The procedure usually takes about an hour, and somewhat longer when combined with the upper eyelids. Because it is often done under local anaesthesia, the patient most often goes home the same day, with an escort and clear care instructions.
During the procedure the patient's condition is monitored, and the eye region is cooled and tended so that swelling is as small as possible. The patient's comfort and safety come first throughout the whole procedure.
Recovery after under-eye bag surgery — realistic, phase by phase
Recovery is most often short and comfortable. In the first days swelling and bruising around the eyes, mild tightness and tenderness are expected, and sometimes a passing feeling of dryness or stinging in the eyes. Pain is usually mild and easily tolerated.
Cooling the eye region in the first days reduces swelling and bruising. Sutures, if used on the skin, are removed after a few days, after which the trace below the lashes becomes increasingly hard to notice. Bruising most often fades during the first to second week.
Many patients return to social settings after roughly seven to ten days, once the bruising has faded and can be covered with light make-up. Fine swelling subsides gradually, and the final, refreshed appearance is seen after several weeks to a couple of months.
In the first days, straining, bending over, rubbing the eyes and wearing contact lenses are avoided, as instructed by the surgeon. At Medical Time, follow-up appointments monitor healing and provide recommendations for caring for the delicate skin around the eyes.
- first days: swelling, bruising and mild tenderness around the eyes
- cooling the eye region to reduce swelling
- removal of sutures after a few days when used on the skin
- returning to social settings most often after seven to ten days
- final refreshed appearance over several weeks to a couple of months
Risks and possible side effects
Lower blepharoplasty is a precise but routine procedure with a high level of safety when performed by an experienced surgeon. Still, the area around the eyes is delicate, so it is important to know about the possible side effects before deciding.
Possible side effects and risks include:
A precise technique, conservative tissue removal and following the instructions reduce the risks. Everything is discussed openly before the procedure, with a realistic assessment.
- swelling, bruising and temporary tenderness around the eyes
- passing dryness, stinging or increased tearing of the eyes
- temporarily blurred or sensitive vision in the first days
- asymmetry or a slight change in the position of the lower lid margin
- very rarely, downward pulling of the lid with excessive tissue removal
- a visible incision trace in those whose skin tends to scar
- general risks associated with anaesthesia, which are assessed before the procedure
Why have your under-eye bag surgery at Medical Time
The area around the eyes is delicate and requires precision and a sense of measure. At the Medical Time hospital in Belgrade, under-eye bag surgery is performed by an experienced team, with a conservative technique and the goal of a natural result — a rested gaze, not a changed facial expression.
The procedure is often performed under local anaesthesia, with a short recovery and a return home the same day. From the consultation, through the assessment, to check-ups, everything is available in one place, with clear information and realistic expectations.
- an experienced team and a precise technique in the delicate area around the eyes
- the option of a procedure under local anaesthesia, with a short recovery
- conservative tissue removal for a natural, rested appearance
- the possibility of combining with upper eyelid surgery
- modern equipment and high standards of safety
- follow-up appointments and support during recovery
Cost — under-eye bag surgery
The cost of under-eye bag surgery depends on the technique (through the inside of the lid or with removal of excess skin), the extent of the procedure and on whether it is combined with upper eyelid surgery. You receive the exact price and plan after a consultation and examination.
For an individual assessment and all information, get in touch — we will gladly answer any question.
- Under-eye bag surgery (lower blepharoplasty)
- Lower blepharoplasty through the inside of the lid
- Combined upper and lower eyelid surgery
For an individual assessment and an appointment, call 062-399-888.
Frequently asked questions about under-eye bag surgery
The procedure is most often performed under local anaesthesia, so the eye region is completely numb and you feel no pain during the surgery. Afterwards mild tenderness and tightness appear, which are easily tolerated.
When done through the inside of the lower eyelid, there is no incision or scar on the outside at all. When excess skin also needs to be removed, the incision is made just below the lashes, where it becomes practically imperceptible after healing.
Recovery is most often short. Bruising fades during the first to second week, so many patients return to social settings after seven to ten days. Fine swelling subsides gradually, and the final appearance is seen after several weeks to a couple of months.
The aim of the procedure is to refresh the eye region and restore a rested look, not to change the gaze or facial features. That is why tissue is removed conservatively, so the result looks natural.
Dark under-eye circles and mild puffiness are sometimes eased with non-surgical treatments, but pronounced fat bags and excess skin are resolved permanently only with surgery. What the right solution is for you is assessed at the examination.
In the first days contact lenses and eye make-up are avoided until the wounds heal. Once the bruising fades, light make-up can be used for cover, as recommended by the surgeon.
The result is long-lasting, as the removed fat bags generally do not return. Over time, with natural ageing, the skin around the eyes may slightly relax again, but the refreshed appearance lasts for years.
The price depends on the technique, the extent of the procedure and on whether it is combined with the upper eyelids, so it is set after a consultation and examination. For an individual assessment and an appointment, call 062-399-888.