lower eyelid bag surgery blepharoplasty



Dr. Ramesh can help people with following eye complaints:






What causes eyelid bags?

Eyelid bags can be caused by extra skinherniated fat padshollowness and shadowing, or pigment in the skin. Dr. Ramesh's latest research paper on treatment of eyelid bags discusses the underlying causes and best treatments for these.


The lower eyelid is full of fat that normally surrounds the eyeball and acts as a "shock absorber". As people age, the tissues that hold this fat behind the eyeball stretch out, allowing this fat to descend downwards and appear as a "bag".


As you blink hundreds of times per day over years, the repeated stretching force on the skin, combined with sun damage, causes thinning and stretching of the skin. This skin can appear wrinkly, or like "crepe-paper".


The border between the eyelid and the cheek is formed by a ligament called the "orbital retaining ligament". As people age, this ligament stretches and the cheek descends. When the cheek fat drops lower, it exposes the underlying bony orbital rim and creating a dark circle over this bone.

eyelid bags

herniated fat

extra skin


What is Dr. Ramesh's experience?

Dr. Ramesh has performed thousands of eyelid surgeries and is one of the most experienced surgeons in the United States for this procedure. He has published multiple scientific publications on orbital decompression and is a highly sought-after national and international speaker on this topic.

Most importantly, Dr. Ramesh has refined and published his own modifications of the surgery that provides better results with a significantly reduced risk of complications. In this way, Dr. Ramesh’s advanced techniques allow for a more predictable and durable outcome after surgery.

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Dr. Ramesh speaking about eyelid bag surgery at the Cosmetic Surgery Forum

Flawless Skin

What more should I know?

1. Is eyelid bag surgery permanent?

Eyelid bag surgery is permanent with long-lasting results. Patients do not typically need repeat surgery for bags, although they may experience skin changes with prolonged sun exposure. It is important to WEAR SUNSCREEN and a good moisturizer to maintain the results of surgery.


2. Can creams help with eyelid bags?

Eyelid creams cannot typically help eyelid bags when they reach a certain point. Surgical treatment usually offers the best and most predictable treatment. However, it is important to have a good skincare regimen (possibly including a retinol) to maintain results after surgery. These can be found in our skincare shop.

3. Can I combine droopy eyelid surgery with eyelid bag surgery?

Dr. Ramesh commonly performs upper eyelid and/or lower facial surgery in combination with eyelid bag surgery. You can learn more about upper eyelid surgery here. 

4. What is an oculoplastic surgeon?

An oculoplastic surgeon is a facial plastic surgeon who has dedicated his/her career to focusing on the delicate interplay between the eye and the eyelids. An oculoplastic surgeon certified by the American Society of Ophthalmic Plastic and Reconstructive Surgery will have the most experience in providing safe, effective, and long-lasting results.?

5. How long is surgery and recovery? Am I under general anesthesia?

Surgery usually lasts 60-90 minutes. Patients are under twilight anesthesia or light sedation, which minimizes risks. Patients are bruised and swollen for 7-10 days but are able to open their eyes and see. There are no patches or bandages over the eyes after surgery. While complete healing takes 2-3 months, your eyes will already be more open and refreshed after the initial week.

Before and After Surgery

How are eyelid bags treated?


In younger patients (less than age 40), the tissues have typically not stretched so much that patients need surgery to get aesthetic improvement. In these cases, treatment with lower eyelid filler can hide early hollowness and smoothen the eyelid-cheek countour.


In older patients, or younger patients with genetic eyelid bags, surgery can be the safest and best way at permanently treating the eyelid bags. A surgical plan is customized to each patient based on their skin type, skin quality, amount of eyelid and cheek fat, laxity and descent of tissues, recovery time, and facial structure. Options include scarless surgery, chemical peel or laser resurfacing, fat transfer from the abdomen, and adjunctive procedures including brow lifting, face and neck lifting, or facial implant placement.


35 Clyde Road, #104

Somerset, NJ 08873

phone: 609-608-0142

fax: 855-644-0469