What is the best method for eye bag removal in Singapore?

Doctor's Answers 6

Firstly, it is most important to establish that we are dealing with a true eyebag and not what is commonly referred to as a pseudo eyebags. In this case the bulge is due to a hypertrophied lower eyelid muscle which can be improved by the simple administration of a toxin to relax the muscle.

So assuming that we are dealing with a real eyebag , there are a few considerations worth mentioning.

1. The severity of the eyebags which takes into account the fat bulge , the laxity of the eyebag skin and the associated tear trough depression. In addition any hollowing of the midface cheeks will aggravate the appearance of the eyebag.

2. Is the patient looking for a surgical correction or a non surgical option . This is where the preference of the patient comes into play although we all know that surgical lower blepharoplasty gives a better and more permanent result.

I will therefore limit my short discussion to what I would normally offer my patients if they are seeking a non surgical alternative.

1, For mild to early moderate eyebags if the patient does not want a procedure with any downtime I would recommend a filler correction to “ hide “ the eyebag . The correction can usually be improved by doing some skin tightening treatment of the lower eyelid region either with a momopolar RF device like Exlilis ot a HIFU device like Ultraformer III which has a dedicated 2mm hand piece especially suited for this area. This treatment is usually done before the filler . In some cases the addition of a filler to the mid Cheek is required to improve the outcome,

2 For moderately severe eyebags where filler injection plus skin tightening is inadequate to hide the eyebags , I would recommend the NILER procedure ( Non incisional Laser eyebag Rejuvenation ) . This procedure was named by me in 2009 when I first started using the Accusculpt laser with a 600 micron 1444nm wavelength fibre optic handpiece. This wavelength of light is primed to induce a lipolysis effect thus eliminating the fat bulge . It also has a skin tightening effect on the area treated . However there is usually swelling after the procedure which can last from 3-7 days. In cases whereby there is a significant undereye hollowing as well a filler would be required at 8 weeks post laser to improve the appearance. Because there is removal of the fat bulge the results do last longer than with fillers alone.

Whatever treatment option you decide upon it is important to discuss with your doctor the aesthetic outcome you are hoping to achieve before making a decision .

Hope this helps.

Hi Janice. My honest advice will be for you to consult a doctor for a consultation and confirm that it is indeed an eye bag. Having been in medical aesthetic practice for over 10 years, I have had many instances when seemingly ‘eye bag appointments’ have turned out to be something else.

I have had a few patients with prominent lower eyelid muscles which were solved with just a simple shot of BOTOX ™. No surgery or other procedure was required. These patients are often pleasantly surprised.

In some other situations, there was significant volume deficiency of the mid-face just below the lower eyelid. The difference in forward projections and the angle of projections made the patient feel he or she had an ‘eye bag’. But in actual fact, correction of this volume deficiency with basic fillers or a referral to the Plastic surgeon for a fat transfer procedure solved the issue.

In some other cases, significant tissue/skin laxity in the under eye area, also gives the patient the presentation of eye bags. Non-surgical skin firming with devices like a simple RF/HIFU device or a surgical referral for a lower pinch blepharoplasty can solve the issue if there is very little enlargement or protrusion of the fat pad.

Now, coming to the ‘juicy’ part with no pun intended. If indeed, there is significant enlargement of the lower fat pads resulting in the presentation of eye bags without the above factors to complicate the situation, then a volume reduction of the offending fat pads in the area may be warranted. Traditional surgery is expedient. Surface contact-only aesthetic devices may be disappointing as energy delivery to the fat pads may be insufficient to contract or stimulate enough lysis of the fat pads.

But if all else fails, short of undergoing surgery, a technique that originated from a Japanese Dermatologist, Dr Toshio Kobayashi and later brought to commercial use by his Korean collaborator, Dr Ahn Gun Young, founder of the Gowoonsaseng Dermatology chain of clinics in Changdam, Seoul is now available.

Dr Ahn has managed to create a microfilament so delicate, it is almost as fine as an acupuncture needle. This microfilament can be attached to his patented device that generates an energy pattern designed to melt the fat bulging out around the eyebag areas safely and at the same time firm the skin.

The microfilament is coated with an ultrafine layer of silicon, also specially patented by Dr Ahn, so there is no risk of heat injury to the skin. Previous techniques such as Laser Eyebag removal such as NILER can possibly induce skin burns according to Dr Ahn.

EYE REVO provides a safe and effective solution for mild to moderate eyebags for patients who prefer a non-surgical option.

I hope the information helps in your quest to solve your ‘Eye Bag’ issues.

Photo of Dr Samuel Ho
Dr Samuel Ho

Plastic Surgeon

Eyebags are present not because of just excess fat, but also because the membrane (orbital septum) covering the fat is lax, allowing it to bulge out like a hernia. It also causes the surrounding areas to look depressed, giving rise to a surrounding sunken look and deep creasing.

Treatment of the eyebags are a complex subject, as it not only involves removing the eyebag fat, but also tightening the membrane, as well as filling the depressed areas and removing excess skin if required.

Non-surgical methods basically involve only 1 or perhaps 2 of the aspects mentioned - they merely serve to camouflage the eyebag. What this often means is that the treatment is not permanent and the eyebag recurs very quickly after less than a year. Also, the eyebag may still be visible during certain periods of the day or during animation of the face.

Surgical treatment is the only method to permanently remove the eyebags. This is a multistep procedure. The first involves using a 1cm hole in the inner part of the lower eyelid to access and remove the eyebag fat - a scarless procedure. At the same time, the membrane is tightened and a SOOF lift is performed.

For many of my patients, this is all that is required - a scarless blepharoplasty. For others, other steps are required - filling of the depressed portions with fat graft and removal of excess skin (a pinch blepharoplasty).

Once eyebags are properly treated surgically, they never recur.

Costs for surgical eyebag removal range from $3500 to $7000 incl GST depending on what is required.

Thanks and best regards,

Dr Samuel Ho

for eye bag treatments, there are non-surgical and surgical options.

There are gradings for the severity of eye bags and in cases where it is not that severe, non-surgical options would be the preferred choice and vice versa for surgical options.

Non-surgical options:

Sometimes the appearance of eye bags are accentuated and made to look worse than it really is when there is loss of volume in the upper cheek / tear trough region.

Replacement of volume in these areas with fillers can improve the appearance of the eye bags without the need for surgery whilst at the same time making you look more refreshed and less tired.

Other non-surgical options include lasers and radiofrequency machines.

Surgical options:

In severe cases, surgery is usually recommended to remove the adipose (fat) tissue from the region.

It is thus important to have a discussion with your doctor so that he/she can examine you and recommend the most appropriate plan.

Hope that helps. All the best!

Dr Ho Rui Ming

The treatment of eyebags varies greatly amongst doctors. In the past, doctors would literally remove the excess fat thereby 'removing' the eyebags.

As our understanding of anatomy and the ageing process has increased, doctors have realised that as we age, we lose fat in our face and when that happens we look old. An eyebag is really just a bulge in the tissues beneath our eyes and it is obvious because of the groove under it. I prefer not to 'remove' the eyebag. I redistribute the fat to restore the youthful contour of your lower eyelid by camouflaging the groove under the bag. This way, when my patients get older, as we all do, their eyes will not look as hollow as someone who has had their fat removed.

This procedure can be done without scars.

The cost for lower blepharoplasty starts from $4000.

Firstly, it is most important to establish that we are dealing with a true eyebag and not what is commonly referred to as a pseudo eyebags. In this case the bulge is due to a hypertrophied lower eyelid muscle which can be improved by the simple administration of a toxin to relax the muscle.

So assuming that we are dealing with a real eyebag , there are a few considerations worth mentioning.

1. The severity of the eyebags which takes into account the fat bulge , the laxity of the eyebag skin and the associated tear trough depression. In addition any hollowing of the midface cheeks will aggravate the appearance of the eyebag.

2. Is the patient looking for a surgical correction or a non surgical option . This is where the preference of the patient comes into play although we all know that surgical lower blepharoplasty gives a better and more permanent result.

I will therefore limit my short discussion to what I would normally offer my patients if they are seeking a non surgical alternative.

1, For mild to early moderate eyebags if the patient does not want a procedure with any downtime I would recommend a filler correction to “ hide “ the eyebag . The correction can usually be improved by doing some skin tightening treatment of the lower eyelid region either with a momopolar RF device like Exlilis ot a HIFU device like Ultraformer III which has a dedicated 2mm hand piece especially suited for this area. This treatment is usually done before the filler . In some cases the addition of a filler to the mid Cheek is required to improve the outcome,

2 For moderately severe eyebags where filler injection plus skin tightening is inadequate to hide the eyebags , I would recommend the NILER procedure ( Non incisional Laser eyebag Rejuvenation ) . This procedure was named by me in 2009 when I first started using the Accusculpt laser with a 600 micron 1444nm wavelength fibre optic handpiece. This wavelength of light is primed to induce a lipolysis effect thus eliminating the fat bulge . It also has a skin tightening effect on the area treated . However there is usually swelling after the procedure which can last from 3-7 days. In cases whereby there is a significant undereye hollowing as well a filler would be required at 8 weeks post laser to improve the appearance. Because there is removal of the fat bulge the results do last longer than with fillers alone.

Whatever treatment option you decide upon it is important to discuss with your doctor the aesthetic outcome you are hoping to achieve before making a decision .

Hope this helps.

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