Eyelid surgery or eyebags surgery is one of the most commonly performed cosmetic procedures nowadays. With aging, facial skin becomes loose and thin, and fat under the skin atrophies (gets absorbed). This results in fine lines, wrinkles, and loose skin, especially around the eyelids.
The skin of the eyelids is naturally thin, and with aging, the septum (a layer that keeps the fat under the eyes in place) becomes loose and thin. As a result, fat under the eyes becomes visible, leading to the development of eyebags, giving the eyes a puffy and aged look. Similarly, the upper eyelid skin can become loose and hang over the eyes, contributing to an older appearance.
These problems increase with age, leading individuals to feel socially and psychologically concerned. Since the face, particularly the eyes, is a prominent feature even when wearing masks, people seek solutions to these issues by consulting doctors for advice on treatment options.
Consultation and Assessment
Patients visiting the clinic are consulted by Dr. Abdul Malik, who takes a detailed history, including:
- Any co-morbid conditions such as diabetes, hypertension, heart problems, or hepatitis B/C.
- Smoking habits and medications.
Dr. Abdul Malik then performs a thorough assessment, focusing on:
- Eyebrow and eyelid position.
- Loose skin in the upper and lower eyelids.
- Presence of eyebags, sunken eyes, scleral show, and canthal position.
After the examination, he discusses treatment options, their pros and cons, recovery, and possible complications. Baseline tests are advised, and in some cases, fitness evaluations are required from the patient’s treating physician.
Preparation and Procedure
After obtaining fitness clearance, the procedure is performed under local anesthesia.
Upper Eyelid Surgery
- Marking is done in a sitting position.
- The area is prepared under sterile conditions.
- Loose skin is removed, and fat compartments are evaluated.
- Excess fat is conservatively removed or redistributed for a uniform appearance.
- Hemostasis is secured, and the wound is closed.
Lower Eyelid Surgery
- Marking and preparation are done similarly.
- Incisions are made, and dissection is carried out to the cheekbone.
- The septum is opened, and fat from all three compartments is conservatively removed or redistributed.
- The orbicularis muscle is stitched to the periosteum of the zygomatic bone for a long-lasting effect.
- Extra skin is removed, and the wound is closed.
Postoperative Care and Recovery
- Patients are discharged after 1-2 hours in the recovery room.
- Oral medications are prescribed for 5-7 days.
- Patients are advised to sleep with their head elevated.
- Dressing is changed after 48-72 hours, and stitches are removed in 5-7 days.
- Swelling and bruising may last 7-10 days.
- Patients can return to work after a week.
- Good results are visible after 2 months, once internal tissue edema settles.
Benefits of Eyelid Surgery
- Elimination of loose eyelid skin.
- Removal of eyebags.
- Achieving a youthful and attractive facial appearance.
- Symmetry of both eyelids.
- Increased confidence to reintegrate into society.
- Long-lasting results (8-10 years).
Potential Side Effects
Although rare and minimal with an experienced plastic surgeon, the following side effects may occur:
- Swelling and bruising.
- Hematoma (less common).
- Redness in the eyes.
- Asymmetry.
- Malposition of eyelids.
- Recurrence of the problem.
- Ectropion (if excessive skin is removed).
- Visible scars or scar hypertrophy.
Cost of Surgery
The cost varies and may include other procedures such as facelift surgery, eyebrow lifts, Botox, or filler injections:
- Upper eyelid surgery: PKR 70,000–85,000.
- Lower eyelid surgery: PKR 90,000–120,000.