Bangpakok Hospital

Lower blepharoplasty

Under-eye bag surgery, also known as lower blepharoplasty, is a surgical procedure designed to correct sagging of the lower eyelids. The procedure involves removing or repositioning protruding excess fat and trimming loose skin to create a firmer and smoother appearance.

After surgery, the face may appear fresher and more youthful. The results may last for up to 10 years, depending on the individual’s skin condition, lifestyle, and natural ageing process. Lower eyelid surgery may also help improve the overall balance of the eyes, creating a brighter and more refreshed appearance while enhancing confidence.

Causes of Under-Eye Bags

Under-eye bags may be caused by several factors, including:

  • Genetics
  • Age-related deterioration and sagging of the skin beneath the eyes, causing the underlying fat to become more prominent
  • Lifestyle factors such as frequently rubbing the eyes, crying, insufficient sleep, or prolonged eye strain
  • Regular alcohol consumption
  • Poor blood circulation and fluid retention around the eyes
  • Allergies, including eye allergies and allergic rhinitis
  • Certain medical conditions, such as kidney disease, heart disease, or thyroid disorders, which may cause fluid retention and swelling beneath the eyes

Preparing for Under-Eye Bag Surgery

  • Inform the doctor of any medication allergies, underlying medical conditions, and medications taken regularly. Patients with conditions such as high blood pressure or diabetes should have their condition properly controlled before surgery.
  • Avoid muscle-relaxing injections around the eyes, forehead, and between the eyebrows, as well as dermal filler injections in the upper face, for at least one month before surgery.
  • Patients taking antiplatelet or anticoagulant medication should inform their doctor. These medicines may need to be discontinued at least two weeks before surgery to reduce the risk of excessive bleeding. Do not stop any prescribed medication without medical advice.
  • Avoid dietary supplements and herbal products, such as fish oil and certain vitamins. Stop smoking and drinking alcohol for at least two weeks before surgery.
  • Inform the medical staff immediately if any abnormal symptoms occur around the eyelids within two weeks before surgery, such as a stye, swelling, irritation, or a rash.
  • Bring sunglasses and prescription glasses to wear after surgery, if required.
  • Do not wear contact lenses, retainers, dentures, jewellery, or valuables on the day of surgery.
  • Do not wear facial makeup on the day of surgery, as makeup residue may increase the risk of infection.
  • Bathe, wash your hair, and cleanse your face thoroughly before arriving for surgery.
  • Wear comfortable, loose-fitting clothing with buttons at the front. Avoid clothing containing metal components.
  • Arrange for someone to accompany you home after the procedure. Driving yourself home is not recommended.
  • It is advisable to take at least three days off work and minimise eye strain after surgery to reduce irritation and support recovery.

During the First Two Hours After Surgery

  • Lie on your back with your head elevated at an angle of approximately 30–40 degrees or use two pillows. Avoid sleeping on your side.
  • Apply a cold gel pack immediately around the eyes and forehead. Do not place the gel pack directly on the surgical incision.

Care After Returning Home

  • Apply a cold gel pack during the first one to three days after surgery. Cold compresses may help constrict the blood vessels and reduce bleeding and swelling. Keep the surgical wound dry.
  • If minor bleeding occurs, gently wipe the area with sterile gauze and apply light pressure until the bleeding stops.
  • During the first week, sleep on your back with your head elevated at an angle of approximately 30–40 degrees or use two pillows. Avoid sleeping on your side, particularly during the first three days.
  • If swelling or bruising develops on the third day, apply a warm compress that is not excessively hot, alternating with a cold compress.
  • From the fourth day onwards, apply a warm compress twice daily to help reduce swelling and support blood circulation.
  • Minimise prolonged eye use during the first seven days and avoid wearing contact lenses. Prescription glasses are recommended instead.
  • Normal daily activities and work may be resumed as appropriate. Avoid rubbing the eyes during the first six months, as this may affect the surgical sutures and cause unevenness.

Surgical Wound Care

  • Moisten a cotton swab with sterile saline solution and gently clean the surgical incision. Do not rub or scratch the wound.
  • If minor bleeding occurs, gently press the area with a cotton swab for a few moments until the bleeding stops.
  • Clean the wound twice daily, in the morning and evening.
  • Gently pat the wound dry and apply Terramycin ointment or the medication prescribed by the doctor after each cleaning.
  • Take antibiotics, anti-inflammatory medication, and medication to reduce swelling as prescribed.
  • Pain-relief medication may be taken every four to six hours if required, according to the doctor’s instructions.
  • Follow all postoperative instructions carefully.
  • The doctor will normally arrange a follow-up appointment approximately seven days after surgery to examine the wound and remove the sutures.
  • Wear sunglasses when going outdoors to protect the eyes from sunlight, dust, and small airborne particles.

Food and Beverages After Surgery

  • Avoid dietary supplements and vitamins for approximately two weeks after surgery.
  • Avoid spicy foods, fermented or pickled foods, and alcoholic beverages for approximately one month.
  • Avoid smoking for approximately one week after surgery. Smoking and alcohol may increase blood circulation to the face, worsen swelling, delay wound healing, and increase the risk of inflammation or infection.
  • To support wound healing, consume foods that are high in protein and vitamin C, such as eggs, milk, meat, oranges, and lemon juice.

Possible Symptoms After Surgery

  • Bruising may occur around the eyes. The severity varies depending on each person’s skin condition and usually improves within two to four weeks. A warm compress may help the bruising resolve more quickly.
  • Some patients may experience more eye discharge than usual or a feeling of tightness around the upper eyelids. These symptoms generally improve within two to three weeks.
  • The final shape and appearance of the eyes may take approximately three to six months to fully settle.

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Please contact our staff to make an appointment before receiving the service.Tel. 02-129-5500

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