Bags under the eyes not only affect older patients but can be quite common in young people. Fortunately, these bags can be treated with a surgical procedure that leaves no scars. The name of this procedure is transconjunctival lower eyelid blepharoplasty with fat transposition.
The surgery consists of making an incision on the inside of the lower eyelid to find the fat pockets that create the bags. Because this incision is not made through the skin but through the eyelid mucosa, there is zero risk of leaving a scar.
The steps of the operation are as follows. Once the fat pockets responsible for creating the bags have been identified, the fat is transposed onto the bone of the anterior cheek region. This maneuver allows the surgeon to eliminate the bag and improve cheek volume with the same procedure.
The space between the maxillary bone and the cheek fat pad is perfect to contain the fat of the lower eyelid. The fat is transposed onto the bone with a suture, which is passed through the skin in the area adjacent to the nose. Next, the suture is passed through the individual fat pockets in order to create a single pedicle of fat.
Finally, the suture exits through the skin in the same area where it was introduced.
Tying of the suture over a cotton bolster will transpose the eyelid fat onto the anterior cheek.
Lower blepharoplasty with fat transposition is an outpatient operation that takes about an hour. It is generally performed under intravenous sedation. The surgery requires a sterile environment so it must be done in an accredited surgical facility.
Regarding the recovery process, patients should expect mild bruising and some swelling around the eyes for about a week. It is common to feel some discomfort for the first few days, but the recovery is not painful in the least. The sutures are removed 10 days after surgery in the doctor’s office.
Clinical results are evident about a week after surgery. However, patients are encouraged to wait 3 to 4 weeks to judge the final result. Postop. pictures are taken one month after the operation.
Blending of the eyelid-cheek junction is one of the hallmarks of youth. Blepharoplasty with fat transposition achieves this goal in a safe and reproducible manner. Nevertheless, it is a delicate and intricate operation that should only be performed by highly experienced and formally trained oculoplastic surgeons.
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