Eyelid Surgery (Blepharoplasty)

Understanding the Causes of Sagging, Baggy, or Puffy Eyes

Many people feel that their eyes are saggy, droopy, baggy, or puffy. There are a variety of factors that contribute to these conditions, both internal and external.

Aging

Aging is by far the most common cause of sagging, drooping, baggy, and puffy eyes. This is because as you age, your skin loses its elasticity and becomes thinner and more delicate as a result of decreased collagen and elastin production.

Additionally, the muscles and tissues around the eyes weaken with age, which causes the skin to sag and fat pads under the eyes to protrude. The protruding fat pads can result in a baggy or puffy appearance.

Genetics

Some people are more genetically prone than others to developing saggy, droopy, baggy, or puffy eyes. You may have a genetic predisposition to thinner skin, or a weaker membrane designed to hold fat pads in place. You may also have larger-than-average fat pads under your eyes.

These genetic factors can make you more prone to experiencing eye conditions addressed by eyelid surgery at a younger age or with more severity than others.

Sun Damage

If you experience prolonged, unprotected exposure to harmful ultraviolet (UV) rays from the sun, your skin can start to age prematurely.

Sun damage can cause a breakdown of collagen and elastin fibers, which are proteins responsible for keeping your skin strong, structured, and healthy.

Damage to these protein structures can cause the skin to wrinkle and sag.

You can protect the delicate skin around your eyes from sun damage by using sunscreen and wearing sunglasses that have built-in UV protection.

Smoking

Smoking has long been connected to premature aging of the skin and saggy, puffy eyes. Chemicals in smoke, especially nicotine, can damage the collagen and elastin fibers in your skin. Smoking also reduces blood flow to the skin, which in turn hinders the delivery of oxygen and other essential nutrients.

By quitting smoking, you can slow down the aging process and improve the overall appearance of your skin, especially in the eye area.

Sleep Deprivation

If you’re not getting enough sleep at night, you may experience fluid retention and an accumulation of blood in your under-eye vessels, which can cause puffiness and dark circles.

Getting enough sleep at night, usually between seven and nine hours, is critical if you want to maintain your overall health and the youthful appearance of your skin.

Allergies

Allergies cause inflammation, irritation, and itching in the eyes, which can cause your eyes to puff up and swell. If you have chronic allergies, you may constantly rub and scratch at your eyes, causing the skin to stretch and weaken. Stretched, weakened skin can result in saggy or droopy eyelids.

You can treat allergies through over-the-counter or prescription medications. You should also try to avoid allergens in order to alleviate allergy symptoms and prevent further skin damage.

Fluid Retention

If you have a lot of fluid retention, whether from a lack of sleep or adequate hydration, a high sodium diet, or hormonal fluctuations, you may experience swelling and puffiness in your eyelids.

Reducing sodium, drinking enough water, getting enough sleep, and using a cold compress on your eyes can help minimize the amount of fluid retention you experience and alleviate symptoms of puffy, baggy eyes.

Treatment Options for the Eye Area

Blepharoplasty, or eyelid lift surgery, is a popular, effective solution designed to treat droopy, saggy, baggy, and puffy eyes. Blepharoplasty usually involves upper eyelid surgery for eyes that are saggy or droopy, and lower eyelid surgery for eyes that are baggy or puffy.

Many patients choose to undergo surgery on both their upper and lower eyelids simultaneously in order to address their cosmetic eye issues completely in one sitting. Depending on the complexity of the procedure, eyelid lift surgery can take anywhere from 45 minutes to two hours.

The Eyelid Lift Procedure

Blepharoplasty is typically performed as an outpatient procedure with sedation and local anesthesia.

During an upper blepharoplasty, the eyelid surgeon makes a micro-incision along the natural crease of the eyelid so that any residual scars are as small and unnoticeable as possible.

The eyelid surgeon then repositions or removes fat deposits in the eyes while tightening surrounding muscles and tissue. The final step is for the eyelid surgeon to remove excess skin from the eyelid area.

Lower blepharoplasty targets puffiness and bags under the eyes. During lower eyelid surgery, the eyelid surgeon again creates a small incision, this time just below the lash line or inside the lower eyelid. The eyelid surgeon then removes excess skin or fat.

Once the procedures are complete, the incisions are carefully and precisely closed with sutures, and a thin layer of special ointment is applied to the treated areas in order to encourage healing.

Recovering from Blepharoplasty

The recovery process from a blepharoplasty, or eyelid lift, is relatively straightforward, requiring minimal downtime.

During recovery, you’ll use a combination of lubricating eye drops, cold compresses, and ointments to help reduce the potential for side effects and encourage healing.

Most patients return to work within a few days to a week after surgery, though we recommend they avoid exercise and other strenuous activities for a minimum of two weeks.

Stitches are removed after a week on average, with other side effects like swelling subsiding within two weeks.

When recovering from blepharoplasty, you should avoid wearing contact lenses and eye makeup. You should also practice protecting yourself from sun and wind by wearing sunscreen and dark sunglasses outside. Some patients prefer to wear sunglasses around any bright light for two weeks, including indoors.

Any potential scars from blepharoplasty are minor and well-hidden due to where the eyelid surgeon places the incisions during surgery. Scars generally fade with time and eventually become virtually undetectable.

For more information on blepharoplasty and eyelid surgery, you can visit our blog, “Your Blepharoplasty Questions Answered,” where our team covers all your questions related to blepharoplasty.

It’s important to note that your individual results may vary based on your age, skin type, and the extent of your condition prior to surgery. Our skilled and experienced eyelid surgeon can provide you with a personalized assessment to help you set realistic expectations for your surgical outcomes.

What Impacts Blepharoplasty Results

Several factors can impact the results of your blepharoplasty, including:

• Eyelid Surgeon Skill: Only work with a board-certified eyelid surgeon who has extensive experience performing blepharoplasty and achieving high-quality results
• Your Skin Type: If you have thicker or less elastic skin, you may require additional treatments to achieve your desired results compared to someone with more elasticity
• Your Overall Health: Your health in general can impact your healing process and the final results of your surgery — if you have medical conditions that affect your healing speed, you may require more downtime to recover

Before your blepharoplasty, we will discuss any potential risk factors during your consultation, as well as the best ways for you to take care of your skin after surgery.

Longevity

The results of blepharoplasty are quite long-lasting. While your eyelids will still age as you do, the aging process around the eyes is significantly delayed due to blepharoplasty.

Blepharoplasty is designed to provide long-lasting results, but it’s important to incorporate practices to help support your blepharoplasty. Some steps include taking care of your overall health through a balanced diet, regular exercise, and sufficient sleep.

You should also protect your eye area from sun damage by using sunscreen and appropriate sunglasses. Avoid smoking as much as possible, since it accelerates the aging process and damages your skin.

Finally, consider non-surgical treatments to help maintain and complement your results, such as laser skin resurfacing or injectable fillers.

Less Invasive Alternatives to Upper and Lower Lid Blepharoplasty

There are less invasive alternatives to surgical blepharoplasty available.

Botox is one option, as it can help lift and tighten the skin around the eyes. By injecting Botox into strategic areas of the eyebrow, an eyelid surgeon essentially performs a chemical brow lift, which offers a subtle lifting effect. This treatment can help alleviate the appearance of sagging or droopy upper eyelids, but the results are temporary.

Ultherapy is another option for non-invasive treatment, as it uses targeted ultrasound energy to lift and tighten skin. Ultherapy on the brow area can provide a more significant lift than Botox can on its own. It can also stimulate the production of collagen, which helps maintain results for a longer period of time.

Injectable fillers can help treat hollow areas around the eyes to conceal puffiness in your lower eyelids. Injecting filler around the eyes can create a smoother and more youthful appearance.

Some other less invasive procedure options include lasers, microneedling, and chemical peels, which are designed to improve your skin’s tone and texture. These procedures can help stimulate the production of new collagen and tighten delicate areas of the skin.