True under-eye bags — the persistent puffiness beneath the lower eyelids present throughout the day regardless of sleep — are caused by the forward herniation of the periorbital fat pads. The fat that normally cushions the eyeball inside the eye socket is held in position by the orbital septum, a thin fibrous membrane. With age and genetic predisposition, this septum weakens and stretches, allowing the fat to herniate forward and bulge visibly beneath the lower eyelid skin. This is a permanent structural change — not caused by fluid retention, tiredness or lifestyle — and it cannot be reversed by sleep, cold compresses, eye creams, vitamin C serums, retinol or any topical product. Eye creams can improve skin texture and provide mild brightening, but they cannot address the underlying fat compartment that is causing the structural bulge. Surgery is the only clinically proven permanent solution.

These are the two primary techniques for lower blepharoplasty, each appropriate for a different anatomical presentation. The transconjunctival technique places the entire incision inside the lower eyelid on the conjunctival surface — completely invisible externally with no external scar whatsoever. Access is through the inside of the lid to the fat pads, which are removed or repositioned. This technique is ideal when the primary problem is fat prolapse with good skin elasticity — most commonly patients in their 20s and 30s. The subciliary (transcutaneous) technique places a fine incision just beneath the lower lash line, healing to a virtually invisible line in the natural shadow of the lashes. This permits the surgeon to address both the fat pads AND remove excess lower eyelid skin — making it suitable for patients with both fat prolapse and skin laxity, most commonly from the mid-40s onwards. Your surgeon assesses your fat distribution, skin elasticity and eyelid tone at consultation and selects the appropriate technique — or combination — for your specific anatomy.

This depends on the cause of your dark circles — and this is one of the most important distinctions your surgeon will assess. Dark circles have three main anatomical causes: (1) Structural shadow — created by a fat pad bulging above and a hollow tear trough below, casting a dark shadow. Surgery corrects this type very effectively, either by removing the fat (eliminating the bulge) or repositioning it into the hollow (filling it). (2) Pigmentation — true melanin hyperpigmentation in the skin, often genetic, common in darker skin types. Surgery does not address this type — it requires skin treatment (lasers, pigmentation creams, chemical peels). (3) Vascular show-through — thin skin through which the orbicularis oculi muscle or blood vessels appear bluish. Combination approaches are sometimes needed. At your consultation, your surgeon will determine the precise cause of your dark circles and advise on what can realistically be improved with surgery and what may require additional treatment.

The fat that is removed during lower blepharoplasty does not grow back — that specific anatomical correction is permanent. In practical terms, most patients enjoy excellent results for 7–15 years or more. Because natural ageing is an ongoing process, some patients — particularly those who have surgery at a relatively young age — may notice gradual changes in the under-eye area over the years as remaining fat shifts and skin continues to relax. However, the under-eye appearance after surgery remains significantly better than the pre-surgical baseline for the vast majority of patients throughout their lifetime. The procedure is considered permanent in terms of having addressed the structural prolapse — and is dramatically more durable than any non-surgical alternative (fillers last 6–12 months; laser treatments require repeat sessions). A small number of patients choose revision surgery many years later, but this is the exception rather than the rule.

With the transconjunctival technique, there is zero external scar — the incision is entirely inside the lower eyelid and is never visible from any external viewing angle. With the subciliary technique, the incision is placed within the natural shadow beneath the lower lash line. In the first few weeks, this may be visible as a fine pink or red line, but over 2–3 months it fades to a pale, flat scar that is essentially indistinguishable from the natural lower eyelid skin texture at normal social viewing distance. The vast majority of subciliary patients report complete satisfaction with scar appearance and describe it as effectively invisible. Post-operative sun protection (wearing UV-protective sunglasses outdoors) is the single most important factor in ensuring the scar fades well — it prevents the healing skin from developing post-inflammatory pigmentation, which is more of a consideration in darker skin types common in South India.

During the procedure there is no pain — local anaesthesia with sedation ensures you are comfortable and relaxed throughout. Days 1–2 after surgery: the eyes feel swollen, heavy and bruised, with a tight sensation — cold compresses every 20 minutes provide significant relief. Mild soreness is managed with prescription pain relief. Days 3–5: swelling peaks and then begins to visibly reduce; bruising starts to yellow and fade. The eyes feel gritty and dry — lubricating drops provide comfort. Days 6–10: most patients are surprised how much has settled. Many feel comfortable going outside with sunglasses. External sutures (subciliary) are removed at day 5–7. Weeks 2–4: eyes look noticeably refreshed — residual mild firmness and subtle swelling continue to settle. Most patients describe the experience as significantly less uncomfortable than they anticipated. The most consistent feedback: "The recovery was much easier than I expected."

Lower blepharoplasty has no effect on eyesight or vision. The procedure works entirely on the fat and skin of the lower eyelid — none of the structures responsible for vision (the eyeball, retina, lens, optic nerve, cornea or iris) are accessed or affected in any way. The eyeball is carefully protected throughout surgery with lubricating drops and, where appropriate, corneal shields. Immediately after surgery, vision may appear mildly blurry — this is entirely due to the lubricating eye ointment used during surgery, and it clears within hours. Lubricating eye drops prescribed for the post-operative period may also cause brief blurring after instillation, which resolves within minutes. Long-term eyesight is completely unchanged by the procedure. This is an absolute reassurance — vision is never compromised by correctly performed lower blepharoplasty.

Lower blepharoplasty on both lower eyelids typically takes 45 minutes to 1.5 hours, depending on the technique. It is performed as an outpatient day-surgery procedure — no overnight hospital stay required. You are monitored in recovery for 1–2 hours and discharged home the same day. Return to work: most patients are comfortable at desk work within 7–10 days, often concealing any residual bruising with sunglasses or, for women, light make-up from about day 10. Exercise: light walking from day 3 is fine; strenuous exercise, weight training and anything that raises blood pressure significantly should be avoided for 3–4 weeks. Swimming: avoid for 4 weeks. Contact lenses: resume from week 2–3 as advised by your surgeon. Eye make-up: can typically resume from week 2 once the wound has healed. The final settled result — with all residual swelling resolved — is visible at 2–3 months, and most patients are delighted with what they see from as early as week 3–4.

Lower blepharoplasty is a safe, well-established procedure with a high satisfaction rate when performed by a qualified cosmetic surgeon. Expected temporary effects include swelling, bruising, dry and gritty eyes, light sensitivity and temporary numbness or tightness around the eyelid — all normal parts of healing that resolve within 1–3 weeks. Rare complications include: haematoma (blood collection requiring drainage), infection (treated with antibiotics), temporary difficulty fully closing the eyelid (ectropion or scleral show — usually resolves as swelling settles; may require canthopexy in rare cases), asymmetry between the two eyes (minor, often related to differential swelling rather than surgical error), under-correction (less improvement than expected — rare with experienced surgeons), or over-correction (a hollow, sunken appearance from excessive fat removal — specifically avoided at Maynee through conservative surgical planning). Serious complications affecting vision are extremely rare when surgery is performed by a certified surgeon in an appropriate clinical facility. The most important protective factor is choosing a qualified, experienced surgeon.

Eye bag removal surgery cost at Maynee in Chennai depends on several factors assessed at consultation: the specific technique appropriate for your anatomy (transconjunctival, subciliary or fat repositioning — or a combination), whether any skin removal is required, the type of anaesthesia planned (local with sedation or general), and whether any complementary procedures such as upper blepharoplasty are being combined in the same session. Because every surgical plan is fully personalised after a thorough lower eyelid assessment by a certified cosmetic surgeon, we do not publish fixed pre-set prices. A complete, transparent cost breakdown covering all surgeon fees, anaesthesia, facility charges and post-operative care with no hidden charges is provided at your consultation. You leave the consultation with full clarity on the planned procedure, the realistic expected result and the complete cost — with no obligation to proceed.