Should I remove my eye bags surgically or non-surgically?

Eye bags are practically synonymous with the tired look caused by an aging face. The face pace of living and generally high stress levels have accelerated the natural aging processes in many people, and more people are now suffering from eye bags. Fortunately, they are a common problem and eye bag removal procedures are well-established, with both surgical and non-surgical approaches to do so. However, most people do not understand the differences between them.

What are the differences between surgical and non-surgical eye bag removal, and which one should you go for?

What causes eye bags?

As mentioned, eye bags are a result of multiple aging processes. Firstly, the region beneath our eyes contain a fat deposit known as the suborbital fat pad, which accumulates with age. The skin beneath our eyes is thinner than the surroundings. Hence, the accumulated fatty deposits can easily bulge and form a visible “bag” beneath the eyes.

Additionally, collagen production slows down as we age. Being the support structures of our skin, the lack of collagen will cause the skin to lose elasticity and sag. This worsens the bulging effect of the fat deposit beneath the eyes, leading to the stereotypical “tired” look associated with old age.

Surgical approaches to remove eye bags – Lower blepharoplasty

There are generally 3 procedures to consider for surgical eye bag removal.

• Transconjunctival blepharoplasty only

The most popular surgical approach to eye bag removal is Transconjunctival Lower Blepharoplasty, also known as the “Scarless Eye Bag Removal” surgery.
During the procedure, the surgeon makes a small incision on the inner side of the lower eyelid. The fat pads and other excess tissue are removed from this incision before it is closed with absorbable sutures.
This procedure leaves no visible scars as there are no incisions made on exposed skin. Once the initial swelling and bruising has subsided, there will be no obvious signs that you underwent surgery, other than your missing eye bags.

• Transconjunctival blepharoplasty with Pinch blepharoplasty

In more severe eye bags where there is visible skin sagging, the surgeon may recommend a pinch blepharoplasty to remove excess skin, in addition to removing the fat via transconjunctival blepharoplasty. Like the name suggests, this is done by “pinching” and cutting the lax skin just beneath the lower eyelids.
This excision is done along the edge of the lower eyelid which helps conceal the scar, making it less conspicuous.

• Transcutaneous blepharoplasty with mid cheek lift

In the most severe cases, simply removing the fat pads from beneath the eyes is insufficient as the sagging skin can extend from them lower eyelid all the way to the midcheeks. This lax tissue have to be lifted as well to completely get rid of the tired looking appearance. Therefore, the surgeon has to make an incision on the skin surface to remove fat pads both below the eyes and within the midcheek tissue. Also, the surgeon will lift the midcheek tissue from this incision and remove any excess sagging skin before closing the incision.

Similarly, the surgery scar is made along the edge of the lower eyelid to conceal it.

Non-surgical approach – AGNES and Secret Radiofrequency (RF) treatment

AGNES and Secret RF are both radiofrequency treatment effective at addressing eye bags. Both treatments work by using micro-needles to deliver RF energy into the subcutaneous tissue. This energy breaks down the fat pads under the eyes, which will be transported away by our body.
AGNES uses fixed-depth, insulated micro-needles to deliver precise RF energy concentrated at the tip of the micro-needles while Secret delivers more controlled RF energy spread over the entire fat pad. When used together, AGNES and Secret RF complement each other to provide a well-rounded treatment to effectively break down the fat pads beneath the eyes. When coupled with a suitable laser treatment to tighten the skin, the results can even be comparable to surgical removal in some cases.

Comparison between surgical and non-surgical approaches

• Procedure length

Scarless eye bag removal surgery typically takes between 1 to 2 hours to complete by itself. For procedures involving pinch blepharoplasty or a midcheek lift, the entire procedure can take up to 3 hours.

On the other hand, each session of AGNES and Secret RF takes between 20 to 30 minutes to complete.

• Number of sessions needed

Only 1 session of eye bag removal surgery is required to completely remove the eye bags, with the occasional rare case that may need another follow-up surgery

AGNES and Secret RF on the other hand, typically require a minimal of 2 to 3 sessions for optimal results

• Downtime

Depending on the extend of surgery, surgical eye bag removal can have a downtime of between a few days to 2 weeks. AGNES and Secret RF on the other hand, have practically no downtime.

• Results of the procedure

In general, surgical eye bag removal tends to have slightly better results than the non-surgical approach, especially for more severe cases as the fat pads and sagging skin are completely removed. The results are usually immediately apparent after the initial swelling subsides. Depending on individual conditions, the results can last for 10 years or more, even for a lifetime.

Non-surgical approaches on the other hand, may have limited effects on more severe cases as it relies on natural metabolism to transport the broken-down fat away. In addition, other treatments may be required to tighten the lax skin for optimal effects. Also, the most optimal results are usually only visible after a month after several sessions. These usually last between 3 to 5 years, or possibly longer depending on conditions.

• Scarring

AGNES and Secret RF are non-invasive treatments that do not leave any scars. Similarly, transconjunctival blepharoplasty (Scarless eye bag removal surgery) do not leave any visible scars as well since in incision is made on the inner side of the lower eyelid.

On the other hand, pinch blepharoplasty and transcutaneous blepharoplasty do make incisions on the skin surface and leave visible scars. However, they are usually barely noticeable as these scars are lined along the edge of the lower eyelids and concealed within the eyelashes.

Risks and possible complications

Other than some mild redness and swelling, AGNES and Secret RF have practically no side effects. Surgical eye bag removal on the other hand, do carry some risks such as:

• The surgical wounds may become inflamed or infected.
• Nerves around the eyes may be disturbed, resulting in blurry and/or double vision.
• If the lacrimal apparatus (tear glands and associated structures) are disturbed, the patient may experience excessive tearing or dry eyes post-surgery.

All these complications can be easily avoided in the hands of a skilled and experienced surgeon. Do consult a reputable plastic surgeon for your surgical eye bag removal procedure.

Summary

Type of Double Eyelid Surgery	Surgical	Non-surgical AGNES and Secret RF
Procedure length	1 to 2 hours for simple surgery Up to 4 hours for complex procedures	20 to 30 mins
Downtime	Several days, depending on the extent of surgery	Almost no downtime.
Effectiveness	Works for most, if not all eye bag related problems	Effectiveness is limited for more severe cases.
When are results seen?	Immediately visible after swelling and bruising subsides	After about a month, after about 2 to 3 sessions
Scars	Scars are either not visible or inconspicuous	No scarring at all
Longevity of effects	10 years or more.	Usually 3 to 5 years.
Risks and possible complications	Risks are higher than non-surgical approaches, but generally still a safe procedure	Generally risk-free without side effects.

Conclusion

Eye bag removal procedures are some of the most sought-after aesthetic procedures around. However, many people are still hesitant to commit as they do not full understand the differences between surgical and non-surgical removal procedures. If you are still unsure, do contact us to arrange a consultation with our doctors. Clifford offers both surgical and non-surgical eye bag removal procedures performed by our highly experienced doctors and plastic surgeons. They will help you make an informed decision with their professional expertise.