Eye Bag Surgery: Everything You Need to Know

Lower eyelid blepharoplasty is a common cosmetic procedure

Many seeking to permanently get rid of bags under their eyes turn to the aesthetic procedure known as lower-lid blepharoplasty (or, among friends, as eye bag removal). Under-eye bags are often the first aging-related complaint of those seeking to improve their appearance. These can make anyone look chronically tired and beleaguered.

For anyone considering this surgery on the lower eyelid, here’s everything you need to successfully navigate this sought-after procedure.

A woman with undereye bags

John Renston / The Image Bank / Getty Images

What Is Eye Bag Surgery?

For those who have begun to notice pouches forming on what used to be a completely smooth mid-face contour, or saggy skin, eye bag surgery may offer a solution. This works by tightening muscles, removing excess skin and potentially elevating suborbital fat to offer a more refreshed appearance.


With the transcutaneous approach the incision is made on the lower lid a little below the lash-line. As part of this approach excess muscle and skin are trimmed while area fat, which may be causing a bulge, is elevated.


With this approach to removing bags under eyes, there is no scarring after surgery, with the incision made inside the lower eyelid. This is a good option in cases where the skin is relatively tight but the fat needs to be repositioned somewhat.


While many adults may consider undergoing eye bag surgery, this procedure is not for everyone. First, you must be evaluated to ensure you are a suitable candidate. Some chronic conditions that may conflict here include:

  • Hypertension
  • Diabetes
  • Heart trouble
  • Bleeding or clotting disorders
  • Thyroid abnormalities
  • Severe or unstable medical conditions

Other factors that won’t necessarily stop the surgery but may instead delay this include:

  • Presence of dry eye irregularities
  • Prior LASIK (laser epithelial keratomileusis) or PRK (photorefractive keratectomy)
  • Smoking, which predisposes you to ocular surface disease and tear film problems
  • Use of supplements such as niacin, echinacea, and kava, which can predispose you to ocular surface disease.

Potential Risks

While this is generally well tolerated, no cosmetic procedure is without risks and eye bag surgery is no exception. Some early risks to consider include:

Likewise, some complications to be aware of that can occur a bit later include:

  • Abnormal positioning of the eyelid
  • Crossed eyes
  • Muscle injury
  • Exposure of the clear part of the eye
  • Scarring
  • Abnormal tearing

Fortunately, such occurrences tend to be rare.

Purpose of Eye Bag Surgery

This is the type of procedure that many contemplate as their skin begins to show signs of aging. The potential to present a rejuvenated appearance can be a real confidence booster for some.

How to Prepare

Before undergoing eye bag surgery it’s important to follow your doctor’s directions. This may mean first giving up smoking, or at least refraining from doing so for a couple of weeks before surgery, since this can interfere with the ocular surface and cause dry eye.

Prior to the procedure, it’s important to talk to your doctor about any supplements you may be taking or medication, prescription or otherwise, that may put you at risk for excessive bleeding or predispose you to ocular surface disease.

Also, tell your doctor what your goals are for the eye bag surgery and ask to see before and after pictures of similar cases. This will help you to ensure that you have realistic expectations of the results of the procedures.

What to Expect the Day of Surgery

Surgery to remove eye bags is typically performed in an outpatient surgical center or office-based suite. Although, at times this may be done in a hospital setting. In cases where you need to be admitted, you can expect to stay around one or two nights.

If this is strictly surgery to remove eye bags it should only take about 45 minutes to 1 hour. The surgery can take several hours if the upper eyelids are done as well.

Before the Surgery

You can expect the doctor to mark your lids with a surgical pen while you are in a seated position.

To make you comfortable you will likely be given local anesthesia in the lid area, as well as topical drops on the eye so that you are numb to any sensations. Or, you may possibly be given general anesthesia, which will up you to sleep for the procedure. You can discuss with your doctor which may be better for your situation.

During the Surgery

Your incision will be hidden along the lower lash-line. The surgeon will then remove any excess skin, muscle or fat, or reposition this. After the procedure, the incision will be closed with fine sutures.

After the Surgery

You will likely be able to go home after just a few hours with some pain medication to keep you comfortable for the first few days after surgery. You likely won’t even need to wear any bandages.

Additional Procedures

While eye bag surgery alone may be enough to rejuvenate your appearance, some may also wish to augment the approach with other cosmetic procedures such as:

  • Use of fillers such as hyaluronic acid to increase under-eye volume in certain areas
  • Skin resurfacing with an erbium YAG laser or with chemical peels for further lid tightening
  • Simultaneous brow or midface lift

Together with the eye bag surgery, this should hopefully remove remaining wrinkles and help you to attain the smooth contours you are after.


Under eye bag removal is generally well tolerated. You should begin to see signs of recovery soon after the procedure.


While your recovery should be pretty rapid, expect to take a few days off work and stay home. During the immediate recovery period, cold packs may help with any swelling or bruising you may have. Keeping your head elevated can also help minimize swelling.

After only a few days much of the swelling and discoloration should begin to disappear. Although, for up to one month or so you may still see some signs.

For the first few days you may experience some sensitivity to light, some dry eye and even some blurred vision from lubricating ointments for your lids. Expect to have any stitches removed within the first three or four days after the procedure.

Long-Term Care

Make sure to avoid any strenuous activity for the first couple of weeks. Also, during this two-week period avoid using your contact lenses, as well as wearing any makeup.

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Article Sources
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