Genetic factors, environmental conditions, diet, sleep routine, negative effects of weight changes; it all causes aging and sagging of our skin. If this sagging and loosening occurs in the area that we describe as the middle face, starting from the bottom of the eye and expanding to the sides of the nose, we may look older than we actually are. As the mid-face area sags, the under-eye bags form, and these bags create an old and fatigue appearance.

In order to reverse the negative alterations in the midface region, surgical interventions are often needed. Today, having both facelift and eyelid surgery in the same session provides a youthfull, recovered and dynamic appearance. However, recovery takes a little longer period of time. If only the mid-face area is intervened and the under-eye bags are left, the under-eye bags need to be removed with a separate surgery. This leads to two operations instead of one. Since the presence of the under-eye bags directly affects the image in the midface area, it is important to perform both operations in one session.

Why do the under-eye bags form?

When the aging process begins, the soft tissue in the mid-face area from under the eyes to the corners of the nose shrinks and hangs down in people who are more prone due to the skeletal and connective tissue structure. However, before this tissue sags, it acts as a barrier that prevents herniation by supporting the fat pads in the lower eyelid. Since there is loosening and sagging on the face, and there will be sagging in the tissues inside, this support disappears. The under-eye skin is thinning, and the bag-shaped structure goes down.

Does the under-eye aesthetic surgery affect the face lift surgery?

Even if a successful face lift surgery is performed, without removing the under-eye bags, the desired rejuvenation and recovery cannot be fully achieved. Integrity is very important in the treatment of the under-eye tissue problems. The importance of this issue should be explained to the patients very well in the pre-operative interview. We cannot achieve a more vigorous and healthier appearance without removing the saggy skin under the eyes. For this reason, since the midface and lower eyelid are areas that are aesthetically and functionally interconnected, it is the most ideal option to treat them together. Although this is an ideal option medically, it is important to make a personalized treatment plan and to consider the priorities and wishes of the patient. Some patients want to solve both problems in a single session, while others want these two surgeries to be done separately. In this regard, the patient should be informed about the results to be obtained medically, and the patient’s preference should be respected.

Is there a non-surgical treatment option that will alleviate the mid-face aging?

Each patient’s living conditions, diet, smoking, alcohol intake habits, working conditions, genetic heritage, etc., are the factors that directly affect the skin structure. Constant weight gain and loss will cause skin sagging, both on one’s body and face. Our whole face appearance is affected by these factors. While aging is more noticeable in some people and surgery is the only option, in others it can be resolved without the need for surgery. While the patient’s under-eye bags are surgically removed and rejuvenation is achieved in the eye area, several sessions of adipose tissue can be transferred simultaneously. This is a good option for patients who do not have serious sagging and loosening in the mid-face area, and who can recover only by making fat tissue insertions. Although it varies from person to person, a more voluminous face is obtained with 3-4 sessions of fat tissue transfer.

When do under-eye bags appear?

This also varies from person to person according to the skeletal structure of the body, the condition of the connective tissue and surrounding tissues. Since some people have under-eye bags in their 20s due to this structure, young people complain about the negative image created by these bags and want to have the surgery. In some people, even though they are 50-60 years old, do not have any under-eye bags. In patients who develop under-eye bags at a young age due to structural reasons, a much older appearance occurs in their 40s.

Is it risky to undergo facelift and lower blepharoplasty surgeries at the same time?

Mid-face lift and removal of the under-eye bags or lower blepharoplasty can be performed together. Anesthesia conditions are adjusted accordingly. The tissues under the eyelid are lifted over the bone as a whole and moved to where they should be, no external tissue is added. It is almost as if the tissue is taken from one place and brought to another place and, while doing this, an image suitable for the facial anatomy emerges. When removing the bags under the eyes, there are no permanent scars as very small incisions are made from the area under the eyelashes. Swelling and bruising may occur for several days. These bruises disappear in about 2-4 weeks. Keeping the head up also prevents edema. Stitches are removed within the first week. The eye area also regains its normal color and texture over time. Since the eye skin is thinner, the recovery process is somewhat slower. The color difference that occurs after the surgery disappears completely after 6 months.