Lower Eyelid Bags & Dark Circles
The eyelid is one of the first places on the face that shows signs of aging. The thin eyelid skin, the underlying eyelid muscle and the fat around the eye are some of the many factors that lead to an aged appearance. As we age the eyelid skin becomes wrinkled and thinned allowing the dark muscle under the skin to be more evident (dark circles). The purple hue often seen on lower lids is the blood product within the muscle, as the skin can be as thin as 0.3mm thick in the lower lid. The eyelid fat also moves forward and downward to produce a heavy, swollen appearing lower eyelid “bag.” The bag then produces a shadow leading to even more evident dark circles and a prominent tear trough.
There are many ways to combat lower eyelid bags and dark circles depending on what factors are causing this appearance. Some patients may benefit from volume augmentation with a dermal filler such as Restylane to create a smoother eyelid cheek junction. Others may need improvement in the texture and quality of the skin on the lower eyelid that can be achieved by laser resurfacing and light treatment. Not all patients will need surgery since some patients will improve with noninvasive techniques. There is no one right treatment for every lower lid and each patient’s treatment must be individualized. Dr Zatezalo has a variety of ways to correct the appearance of the lower eyelid bags and dark circles.
If you are a surgical candidate, Dr Zatezalo may offer you a lower lid blepharoplasty surgery. Again, there are many ways to perform a lower lid blepharoplasty.
Traditionally both skin and fat were removed from the lower lid to produce a smooth and a less prominent lower eyelid. However, with time the lid may appear hollow and dark if excessive fat is removed. A more novel approach to the lower lid calls for repositioning of the fat over the cheekbone and into the tear trough. This technique augments areas deficient in volume to produce a rejuvenated appearance and a smoother transition from the eyelid to the cheek. A titrated fat repositioning may also be more appropriate if there is a large amount of orbital fat and a shallow tear trough.
Lower lid fat reposition blepharoplasty is performed under intravenous sedation. Dr Zatezalo has several locations where he operates, but he only used board certified anesthesiologists. The incision is made inside of the lower lid to access the fat pads which may be repositioned. After the fat is addressed, any loose skin on the lower lid is removed or lasered. There are several ways to remove the skin on the lower eyelid which Dr Zatezalo will discuss with you. You will have a fuller more rejuvenated appearance and a smoother lid cheek junction after the fat is repositioned. If the skin quality of the lower eyelid is an issue, a resurfacing laser can be used. Dr. Zatezalo has several lasers which allow for improvement of skin quality on the face and especially around the eyes. After blepharoplasty surgery, most patients will have bruising and swelling since the eyelid tissue has many blood vessels. There are several ways to minimize swelling and bruising which can be addressed.
Correcting lower eyelid dark circles and bags require attention to detail and a high level of skill which is the premise for consulting with an oculoplastic surgeon with extensive experience in this area. Lower eyelid blepharoplasty is an outpatient procedure that Dr Zatezalo performs regularly.
*This webpage is for informational purposes and is not intended to be, and should not be relied upon as, medical advice. Any medical concerns should be addressed with a physician.
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Bethesda is in southern Montgomery County, Maryland, just northwest of Washington, D.C. It takes its name from a local church, the Bethesda Meeting House (1820, rebuilt 1849), which in turn took its name from Jerusalem's Pool of Bethesda. North Bethesda has 14 neighborhoods, the centrally-located, urbanizing district of White Flint is the commercial and residential hub of North Bethesda. The Pike & Rose development and the Pike District is an initiative of Montgomery County to brand and market this region as "North Bethesda's Urban Core".