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What causes baggy eyelids?

The bags are made of tiny pads of fatty tissue. The tendency to develop them is often hereditary. Even though they are made of fat, they often occur in thin people.

Are sagging eyelids sometimes a sign of an illness or poor health?

Certain disease states such as low thyroid hormone levels and kidney conditions may tend to make the face puffy and the eyelids baggy. It is a good idea to have a thorough check-up by your family doctor. Regardless of what caused the drooping eyelids, they can almost always be eliminated by surgery, and doing this does not make an illness worse.

Will insurance or Medicare pay for this surgery?

Rarely will insurance pay for this surgery. Repair of the upper eyelids may partly be covered by insurance or Medicare when photographs show them hanging down so far they actually obscure the vision.

How much does this surgery cost?

That depends on what needs to be done. The exact cost will be determined for you when you are seen in the office.

How long does the operation take?

One or two hours depending on how much needs to be done.

Where is the surgery done?

Usually in the office, to save the patient the cost of hospital fees.

Can the vision be affected?

The vision is often made better by allowing wider opening of the lids after the wrinkles are removed. Very rarely is the vision made worse. Serious loss of vision can occur, but is very rare. Temporarily, for the first two days, the eyelids are held partly closed by a suture and the patient can see but with some difficulty. For several more days there is filmy mucus in the eyes and tears that cloud the vision. Minor problems due to dryness may last for several months and may require eye drops.

How do the eyes feel after surgery?

The skin of the eyelids is tighter and stiffer for weeks to months. The normal blinking reflex that keeps the eyes lubricated and comfortable is interfered with and the eyes feel drier. The eyes often do not close completely at night, at least in the first few months, and it may be necessary to use an eye ointment while sleeping or a sleep mask.

Will the bags come back?

Never to the extent that would be present had they not been removed. They usually never return.

Are there visible scars?

The upper lid incision is hidden in a fold so that it cannot be seen with the eyes open. The lower lid incision is hidden by the eyelash or a skin crease or is made internally.

How long before a person can be seen in public?

Usually within a week the sutures are removed, and by covering any discoloration with make-up, the patient is often made quite presentable.


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 William Roy Morgan, M.D., F.A.C.S  Last modified: January 22, 2015