How effective is cosmetic lower eyelid blepharoplasty, either the transconjunctival or infraciliary approach, in permanently removing eye bags? (photo)

Doctor's Answers 1

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Dr Jonathan Lee

Aesthetic, Hand Surgeon

Very effective.

A transconjunctival blepharoplasty typically means that the removal of, or reduction of the three pockets of fat under the eyelid through an incision, a hidden incision that is inside the eyelid. So you see when I turn down the islet, you can see the red mucosa. We go in through there. It's scarless—leaving no visible scars.

And we can help to remove the fat. It's good in that sense, but it cannot shrink the skin. If you’ve got a big eyebag and you’re going to remove the fat, then the skin is loose. It cannot address loose skin on its own. And usually, you will need to do a pinch blepharoplasty.

Some doctors remove the fat in a pinch blepharoplasty, or they have other kinds of energy-based devices to tighten the skin. You can do a CO2 fractional or Fraxel or a carbon dioxide resurfacing for the outer skin to tighten the skin.

A subsidiary blepharoplasty is where we make the incision underneath the eyelash line. With this incision there, you can pinch some skin and trim it off if it's too loose. You can also remove the fat from the front, or do other more complicated things like fat repositioning.

The scar is very subtle and it will disappear. We can hide the scar in the eyelash line. It's not very obvious. So it's a good cosmetic approach. Both of them are very effective, but my opinion is that the subsidiary approach is better because we can just pinch and remove excess skin.

The Agnes procedure is a radiofrequency needle, which we can introduce through the skin to shrink the eye bag and the surface skin. For wrinkle reduction and skin tightening too, but it does this in a much more conservative way, so we sometimes might have to do two or three treatments to get the results we want. For more severe cases we might need to do multiple treatments. But it's very conservative. The improvements are usually incremental and there's no incisions required, obviously, so minimizing the risks of surgery.

Similar Questions

What are effective treatments to remove fat under the chin? (photo)

Thank you for your question and sharing your photo. There are many options for removing fat and sculpting the chin. They include facial massage, injections to dissolve fat, cryolipolysis, and liposuction. Some methods are effective whilst others may not be. Cryolipolysis is a method of fat removal by freezing of the fat cells using the application of a handpiece to cool the tissue to sub-zero temperatures (between -11 to +5 °C). This is a non-invasive technique that allows localised reduction of fat deposits. One or more sessions may be required to get the desired outcomes.

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Answered By

Dr Terence Goh

Plastic Surgeon

How can I get rid of surgical scars after blepharoplasty and epicanthoplasty?

Thank you for question. The scars appear to be lighter than your skin tone because the skin along the scar is unable to produce pigments after recovery. Although it is not possible to get rid of it totally, the appearance of the scar can be improved. The white scars can be camouflaged by using epidermal cell transplantation of melanocytes. This will bring pigmentation to the white scars. However, it may require a few sessions to get a satisfactory outcome. As for the raised profile of the scar, some steroid injection may help to level it with the skin surrounding it. I hope my reply helps.

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