The procedure to correct fullness and bagginess around the eyes is called blepharoplasty. The result is long lasting and may never have to be repeated.
As we age, the skin and tissues around the eyes start to loosen and relax. Extra tissue in the upper lids develops and creates a fold which can fall down onto the eyelashes. Occasionally vision can be impaired if there is a great deal of extra skin in the upper lids. In the lower lids, there may be puffiness as well as lines and wrinkling from loose skin. Heredity plays a role in the timing and degree of change that occurs. Sometimes, young adults have upper lid fullness and/or puffy lower lids and opt to have the procedure done.
There is a natural cushion of fatty material around the eye which is held in position by a thin membrane. The relaxation of this membrane causes the puffiness in the lower lids as well as some of the puffiness in the upper lids. Eyelid surgery removes the extra skin and tissue in the upper lids, eliminates the puffiness in the lower lids and tightens some of the surrounding skin as well. As a result, the eyes look more awake and the face has a more rested and vital look.
The procedure is normally done on an outpatient basis at one of the ambulatory surgery centers or, on occasion, in the doctor's office. In the upper eyelid, an incision is made in the natural crease line and excess tissue is removed. The incision is then closed with a stitch that runs underneath the skin. In the lower lid, an incision is sometimes made on the inside lower part of the eyelid where the fat causing the puffiness is removed. If the skin itself needs tightening, a small incision is made on the outside of the lower eyelid just below the eyelashes, and the extra skin is removed.