How bags form: Bags arise when the fat surrounding the orbital rim has shifted out of place. “Aging around the eye is a complex process. With time, the delicate structures of the skin, muscle, tendons and ligaments in the eyelids become weak and are no longer connected to one another,” says Boca Raton, FL, oculoplastic surgeon Steven Fagien, MD. Repeated movements force the skin and muscle to weaken, becoming less effective in holding fat in place “as tissue expands, fat protrudes and creates contour changes that contribute to an aged appearance,” says Dr. Steven Fagien.
How to eliminate them: Lower blepharoplasty permanently gets rid of under-eye bags since fat and skin are repositioned and the muscles are tightened. “Because of the anatomical changes that occur with aging, the under-eye often significantly benefits from surgery,” says Orange County, CA, facial plastic surgeon Cory Yeh, MD. “We used to remove a lot of the fat pads, which resulted in an unnatural hollow look and did anything but rejuvenate the eyelids,” says Dr. Steven Fagien. “Today, cosmetic eyelid surgery is about reversing the aging structural changes of the eye. The muscles need to be retained and resuspended, fat needs to be repositioned
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