Eyelid surgery

What is axillary fat grafting surgery?

The "aegyo sal" (or "eye bag") is a natural bulge located below the lower eyelashes, primarily related to the shape and contraction of the orbicularis oculi muscle. Some people naturally have less prominent aegyo sal, while others experience a gradual blurring of their natural aegyo sal due to loose skin around the eyes and prominent eye bags. In such cases, a suitable aegyo sal shaping method can be assessed based on eye shape, lower eyelid condition, and individual needs.

The "aegyo sal" surgery we usually refer to involves creating a natural, band-like bulge under the lower eyelashes through methods such as implanting artificial or autologous tissue, or adjusting the orbicularis oculi muscle. Compared to hyaluronic acid injections, surgical methods can usually create a more defined and stable aegyo sal contour, but the procedure still needs to be planned according to the original eye shape, the thickness of the skin under the eyes, the condition of the muscles, and whether there are eye bags.

What are the different methods of under-eye bag surgery?

The method for creating under-eye bags can be chosen according to individual eye area conditions and needs:

Artificial material implantation
Through small incisions around the eyes, suitable artificial materials (such as artificial dermis) are implanted into the lower eyelid to create a more defined "aegyo sal" (or "eye smile") contour. This method is suitable for those who desire longer-lasting results and can tolerate the surgery and recovery period.

Autologous tissue implantation
The procedure involves harvesting tissues from the patient's own fascia, dermis, and fat, which are then processed and shaped before being implanted into the lower eyelid. The advantage is that it eliminates the need for artificial implants, but it does create an additional harvesting wound.

Orbicularis oculi muscle adjustment
If a patient already has a certain level of under-eye bags, adjustments can be made based on the condition of the orbicularis oculi muscle to reshape a more prominent and firm under-eye bag line. Some patients can also be evaluated during blepharoplasty.

Alternatively, if surgery is not considered at the moment, an evaluation can also be performed.Hyaluronic acid injectionCreating under-eye bags. Hyaluronic acid injections do not require surgery and have a short recovery period, but the effects will gradually metabolize over time. It is also necessary to pay attention to the injection amount and location to avoid excessive bulging under the eyes.

What's the difference between under-eye bags and puffy eyes?

Eye bags and under-eye bags are both located under the eyes, so they are often confused, but in fact, their locations and causes are different.

The "aegyo sal" (or "silkworm eye") is located just below the lower eyelashes. It's a natural bulge formed by the orbicularis oculi muscle and usually becomes more noticeable when smiling, making the eyes look more bright and cheerful. Eye bags, on the other hand, are located lower and are mainly related to the bulging of orbital fat and loosening of the surrounding tissues, appearing as bag-like protrusions.

If you have noticeable eye bags, it is recommended to treat the eye bags first. After the eye bags improve, some people's aegyo sal (lower eye bags) will also become more prominent. If you still want to enhance the aegyo sal at that time, you can make further adjustments based on your original eye shape and the condition of your eye area.

Applicable to

Suitable candidates for under-eye bag surgery

People with naturally less prominent eye bagsI hope to increase the three-dimensionality of the area under my eyes and make my eyes look more expressive.
Those whose eye bags are not obvious when they smileThe original lower eyelid area was relatively flat; we hope to enhance its lines.
For those who want the effect of "eye bags" to last longerI don't want to maintain my hyaluronic acid levels through regular injections.
Those that are currently flat and lack a sense of three-dimensionalityThe goal is to enhance the visual depth of the eyes by creating a "skin bag" effect.
Those who have had eyelid surgery and whose under-eye bags are no longer noticeableThe appropriate improvement method can be assessed based on the condition of the periocular tissues.
Those who also want to address eye bags and under-eye bagsThe doctor can assess whether to combine this procedure with eyelid surgery for adjustment.

The appropriate method for creating aegyo sal (lower eyelid puff) depends on a comprehensive assessment of the original eye shape, aegyo sal condition, degree of skin laxity under the eyes, and whether there are accompanying eye bags.

Arsty Clinic眼整形醫療團隊

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Plastic surgeons customize exclusive electro-eye

Arsty Clinic醫師團隊皆為整形外科專業出身，具有完整的訓練及豐富臨床經驗，在手術中能針對不同問題情況做出適當的處理，且不定時參與日本、韓國、美國等臨床研習進修，與時俱進新的技術及美感。

Dr. Liu Chunxi

Bachelor of Medicine, Sun Yat-sen Medical University
Master's Program in Clinical Medicine, Chang Gung University
Ophthalmology Resident Physician at Chang Gung Memorial Hospital
Researcher Training in the Department of Oculoplastic Surgery, Chang Gung Memorial Hospital
Former attending physician of oculoplastic surgery at Chang Gung Memorial Hospital
Researcher in the Department of Oculoplastic Surgery at Manhattan Eye and Ear Hospital, USA
Graduated from UCLA Facial Plastic Surgery Program
Ophthalmologists of the Republic of China

Dr. Wei-Cheng Ching

前長庚顱顏Orthognathic Surgery中心主治醫師
一二代VASER Liposuction原廠雙認證
Certification for Facelift Surgery Training in the United States, South Korea, and Japan
Japanese | Korean | Taiwanese Facial Plastic Surgery Training and Certification
Japan | South Korea | Taiwan Secondary Reconstructive Surgery Training and Certification

Dr. Hsin-Yu Chen

眼整形(雙眼皮手術、Ptosis Correction Surgery、眼袋手術等）、耳整形(招風耳手術)
視覺年輕化項目(Endoscopic Forehead Lift、法令紋澎澎術、消除頸紋、自體脂肪臉雕…）
Vaginal cosmetic surgery (vaginal laser, radiofrequency ablation, G-spot augmentation, labia minora reduction, labia majora augmentation, etc.)
產後醫美門診(VASER Liposuction、Abdominoplasty、腹直肌縫合、肚臍整形…）
Anti-aging regenerative medicine

Frequently Asked Questions

Q: Will making my eyes look bigger if I make my under-eye bags bigger?

A: Not necessarily. The size of the aegyo sal (or "eye bags") needs to be in harmony with the length of the eye opening, the shape of the eye, and the proportion of the lower eyelid. Excessively increasing the volume may actually create a puffy appearance, or even make it look like eye bags. The key to a natural aegyo sal is usually the curvature, position, and proportion, not just the size.

Q: Will hyaluronic acid injections for under-eye bags turn into eye bags?

A: Under-eye bags and puffy eyes are different structures, so hyaluronic acid will not directly "turn" into under-eye bags. However, if the injection site, layer, or amount is inappropriate, or if the under-eye tissue is loose and prone to swelling, it is indeed possible to have a thicker, puffy appearance that looks similar to under-eye bags.

Q: Will eye bag surgery make my under-eye bags disappear?

A: It depends on the surgical method and the individual's periocular structure. Since the lower eyelid "aegyo sal" (or "eye bags") is closely related to the orbicularis oculi muscle, how the orbicularis oculi muscle and surrounding tissue are handled during blepharoplasty can affect the postoperative appearance of the lower eyelid. Therefore, if you are very concerned about your lower eyelid "aegyo sal," it is recommended that you proactively discuss this with your doctor before surgery.

Pre- and post-operative care for under-eye bag surgery

Preoperative preparation

Before undergoing under-eye bag surgery, it's necessary to assess the existing under-eye bag condition, eye shape, degree of skin laxity under the eyes, and whether there are any coexisting issues such as eye bags or tear troughs. If you have previously undergone eye bag, lower eyelid, or other eye surgeries, you should proactively inform your doctor as this is an important reference for surgical planning.
It is recommended to avoid eye makeup during the consultation and temporarily refrain from wearing colored contact lenses, magnifying lenses, and tinted contact lenses to allow the doctor to observe the original eye shape, under-eye bags, and lower eye contour. If you require glasses, you can bring them with you and remove them as instructed by the doctor during the examination or evaluation.
Before the procedure, patients should proactively inform their doctor of their personal health condition, allergy history, and any medications or health supplements they are currently using. If they are taking anticoagulants, antiplatelet drugs, or other medications that may affect blood clotting, they should inform their doctor in advance and should not stop taking the medication or adjust the dosage on their own.
If there is conjunctivitis, styes, skin infection, inflammation, or wounds around the eyes, surgery should be postponed until the symptoms improve, at which time the doctor will assess the appropriate time for surgery.

Postoperative repair

In the early postoperative period, swelling, bruising, tightness, or slight differences in appearance between the two eyes may occur. These symptoms usually improve gradually with recovery. Applying ice packs as directed by your doctor can help reduce postoperative swelling and discomfort.
After surgery, keep the wound clean and dry. Avoid rubbing or pulling around the eyes when washing your face, removing makeup, and moisturizing. Before the wound has healed, avoid activities that may increase the risk of infection, such as soaking in a bath, swimming, or going to a sauna.
During the recovery period, avoid massaging, pressing, or kneading the area under your eyes to prevent affecting the position of tissues or implants. When sleeping, you can also elevate your head slightly and try to avoid sleeping on your stomach or putting direct pressure on the area around your eyes.
In the early postoperative period, strenuous exercise, lifting heavy objects, and excessive exertion should be avoided. Alcohol consumption and excessively spicy or irritating foods should also be reduced to allow sufficient time for the tissues around the eyes to recover.
Follow your doctor's instructions for follow-up appointments to monitor the healing of your wound and under-eye area. If you experience significant pain, persistent redness and swelling, abnormal discharge, changes in vision, or other discomfort, contact your clinic immediately and return for a check-up. For varying degrees of swelling, bruising, and tightness, apply ice packs as directed by your healthcare professional in the early postoperative period. When applying ice, avoid direct pressure on the eyeball and surgical wound to prevent discomfort.