Lower Eyelid Surgery

Bring the sparkle back to your eyes

Sagging under-eye bags—a common concern in older adults—can make the face appear tired, dull, and older than it truly is, even with sufficient rest. Lower eyelid surgery (lower blepharoplasty) offers a precise solution: it removes excess bulging tissue, tightens the skin around the eyes, and restores a refreshed, youthful look—along with renewed confidence.

Causes of Lower Eyelid Bags

Lower eyelid bags appear as puffy or bulging tissue beneath the eyes and develop through several contributing factors. These can be grouped into three main categories:
1.Degeneration of peri-ocular tissues The most common cause in people aged 40–60: natural changes in skin, muscle and orbital fat lead to a permanent bulge that massage or eye creams cannot correct.
2.Genetics Some individuals are born with an anatomical lower eyelid structure that predisposes them to early fat prolapse. Even at a young age, hereditary traits—combined with unfavourable lifestyle habits—can make under-eye bags more prominent than in the average person.
3.Lifestyle and environmental triggers
In addition to age and genetics, daily habits can accelerate the formation of under-eye bags—for example: …

Sleeping late or getting insufficient rest hampers lymphatic drainage around the eyes, leading to fluid accumulation.
Excessive salt intake causes the body to retain sodium, resulting in under-eye puffiness.
Intense screen use and frequent eye-rubbing inflame the delicate skin and accelerate its degeneration.
Smoking and alcohol consumption speed up collagen breakdown and impair blood circulation.
Chronic allergies or sinusitis can trigger lymphatic congestion or inflammation beneath the eyes, making the lower lids appear temporarily swollen.

Lower Eyelid Surgery at Bangkok Eye Aesthetics (BEA Clinic)

Lower-eyelid (under-eye bag) surgery removes or redistributes bulging fat that makes the eyes and face look tired or puffy. At BEA Clinic the incision is hidden on the inside of the lower lid (transconjunctival approach), leaving no external scar. Under-eye bags are usually caused by an abnormal accumulation or forward prolapse of orbital fat—an age-related change that, if left untreated, can lead to loose, wrinkled skin beneath the eyes.

Two main techniques are available:
1.Fat repositioning – the prolapsed fat is reshaped and moved to fill tear-trough depressions.
2.Fat excision – excess fat is removed when repositioning is not required.
If significant skin laxity is present, the surgeon may also excise surplus skin through a fine incision hidden just below the lash line.

Before any transconjunctival or alternative method is chosen, our ophthalmic surgeon personally evaluates every case in detail with the patient. This ensures that the selected technique is both safe and precisely matched to the individual’s concerns.

Who is a candidate for Lower Eyelid Surgery?

In principle, virtually anyone can benefit, but the procedure is especially recommended for those who:

Have noticeable bulging fat pads that make the under-eye area look puffy and fatigued
Show loose, wrinkled lower-lid skin that creates a prematurely aged appearance
Have asymmetrical under-eye bags on the two sides
Exhibit outward sagging of the lower lid or drooping outer corners due to ageing

What can I expect?

During lower blepharoplasty, incisions are typically hidden within the lower eyelid. While most incisions are concealed, some individuals may require a small incision along the lash line. It's normal to experience swelling and bruising for a few days following surgery, but these side effects usually subside quickly with proper care. Final results are typically visible within 1-3 months.
Although complications are rare, potential risks include excessive hollowing under the eyes, numbness, bleeding, infection, and the need for revision surgery. Consulting with an experienced ophthalmologist can help minimize these risks.