They say that the eyes are the gateway to the soul! As we age the eyes themselves change little in appearance however the area around the eyes change quite considerably with puffiness, excess skin and wrinkles which are collectively referred to as eye bags and crows feet. Age related changes in the anatomy of the area are responsible for the visible changes that we see.
Eye Bag Ageing
There a number of different ways in which the anatomy around the eyes changes with time.
Change in size of the bony orbit that supprots the eye in the skull
Fat around the eye
Weakness in the muscle around the eye
Excess and wrinkled skin
The change is shape of the orbit as we age accentuates the border between the lower eyelid and the cheek. This leaves a depression and an obvios shadow. The change in bony orbit also has an impact on allowing fat to escape from directly beneath the eye and push forward giving a bulge.
Regarding fat around the eyes this gives the appearance of puffiness this is due to movement of fat, which normally cushions the eyeball. This fat instead of cushioning the eyeball, in its socket, bulges forward into the area below the eye giving the appearance of puffiness. The reason for the movement of fat is weakness in the septum that is meant to keep the fat in place and recession of the bony edge of the orbit.
Another factor in ageing of the eye is the muscle that controls eye tightening. This muscle is called the orbicularis Oculi and redundancy and laxity of the muscle also results in puffiness as well as giving the impression of extra skin in the area of both upper and lower eyelids.
The last factor to consider is excess skin with ageing. This is due to years of repetitive stretching and relaxation of the skin around the eye with time. This movement of the skin is due to eye closing as well as facial expression that involve the eye such as smilling. In most individuals this is seen as wrinkle at the outer aspect of the eyes know as crows feet but can also contribute to skin folds above the eyelid and also bags below the eye in the lower eyelid area.
Eye Bag Treatment
Treatment to improve the appearance of the eye area include both surgical and non surgical methods. Surgery also known as blepharoplasty can be performed either to the upper and lower eyelid area and I use a combination of techniques to achieve a more lasting youthful look. These include removal of skin, tightening of the orbicularis occuli muscle, removal of fat, tightening of the septum.
The upper and lower eyelids can be operated on separately if only one area is off concern or together if both areas require treatment.
Eye bag Surgery is either performed with the patient awake i.e. under local anaesthetic with numbing injections or with the patient asleep i.e. under general anaesthetic and the patient guides this choice. In a majority of cases the procedures are performed as a day case. Post operatively very few patients complain of much pain. There will be bruising in the operated area due to the skin being thin around the eyes but this commonly settles within 10 - 14 days.
Lower Eye Bag Treatment - Lower eyelid blepharoplasty
Upper Eye Bag Treatment - Upper eyelid blepharoplasty
Things to expect following the procedure include;
- swelling and bruising for approximately 2 weeks
- the fact that there will be a scar. this scar can sometimes be red and lumpy and take a few months to settle down
- watery eyes
- dry eyes
- some residual skin excess (taking too much skin will cause problems)
The scar will be permanent but is usually faint.
Complication are rare but things to be aware of include;
- red eye
- overcorrection ( taking too much skin away) - this will result in the distortion of the eyelid shape
- very rare incidence of blindness (1 in 1000,000)
- deep vein thrombosis and pulmonary embolism