Surgery for Saggy-Baggy Eyelids


Humans have four eyelids-two upper lids and two lower lids. The upper and lower eyelids may contain wrinkles, loose skin, and bulges due either to hereditary factors or the aging process. Pouches or bags of the upper and lower lids are generally due to herniation of the fat normally localized within the eye socket. These fatty hernias may be removed in the lid plastic procedure. Fatty pouches are often seen in the 20-30 year age group, sometimes younger, and can often be corrected at that time. There is little rationale to wait for some arbitrary age before having surgery. When the problem exists, it should be corrected.

Upper lid surgery is usually done at the same time as the lower lid surgery but either can be done as an isolated procedure. Upper and lower eyelid plastic surgery may be done with or without a face-lift, brow lift or other surgery.

In some patients the herniated fat producing “bags” or bulges in the lower lid can be removed without making an incision in the skin. The incision is made behind the lower lid thereby eliminating a visible scar. It is not possible to remove loose skin or sagging wrinkles when this method (behind the lid) is used but skin resurfacing (laser, peeling or dermabrasion) can be performed at the same time in order to minimize many of the fine wrinkles.