Lower eyelid bags or dark circles are two of the most frequent reasons for which people consult our practice. In addition to having excess skin, the ‘bags’ are formed by weakening of the orbital septum. This septum is a fibrous layer within the eyelid and is designed to contain the orbital contents, the eye, the muscles, but also the fat, back in the orbit where it belongs. The weakening of this fibrous layer causes the forward bulging of orbital fat. When skin excision is not necessary you can excise, or sculpt and reposition this fat via an incision in the conjunctiva (the inside of the eyelid) without leaving any visible scar in the skin. Making it a truly minimally invasive procedure with little postoperative down-time. When there is a lot of redundant skin and wrinkles, you might be better off also taking out a small strip of skin. The incision for which is made just below the eyelashes and when healed properly, will be hardly visible.

How long will it take to recover?

New techniques with small incisions, make downtime post-operatively hardly an issue, one should calculate about 1 week of leave of work for nonphysical professions or less active lifestyles. For people that have to do heavy lifting or have otherwise physically strenuous work, this could be up to two weeks. When fat is repositioned it is often held in place with a fine suture that will be visible on the outside (on the skin) of the eyelid. One might also take that into account in deciding when to go back to work. 

What can I do myself before the surgery for an optimal result?

There are number of things you could do at home to prepare yourself optimally for a blepharoplasty procedure. Such as resting sufficiently and eating and drinking healthy.

Patients that smoke will be advised to stop smoking preoperatively for a number of weeks, as studies have shown that smoking has a direct negative effect on wound healing (next to other more serious consequences). Undergoing elective surgery is a great motivator for people to stop smoking and many are happy to have done so afterwards.

Patients on anticoagulant medication will be urged to stop using these a number of days before the intervention if deemed safely. Every drug has its own wash out time, and the advice differs therefore from patient to patient. 

What can I do after the surgery to take the best care of my eyelids? 

Th most important thing you can do yourself at home is take-it-easy. No busy schedule, no heavy lifting or sports and no work in the household for a at least 5-7 days. Since physical effort increases the blood pressure significantly, this should be avoided to prevent unnecessary haemorrhaging and bruising because this can influence the result of the surgery in a negative way. 

Many people also benefit from applying cool packs onto their eyelids for several minutes each hour, for the first two days. This also helps in reducing post operative swelling which can be more pronounced when fat displacement techniques are applied.

An antibiotic ointment is prescribed which should be used two times daily for the first 7 to 10 days after the surgery. Depending on the type of intervention and whether the eyes close easily directly after the surgery, the same ointment can also be used to put onto the eye itself to prevent it from drying out.