Case Overview

A 54-year-old female patient presented to our clinic with significant bilateral upper eyelid ptosis and prominent lower eyelid fat herniation, commonly known as under-eye bags. She reported that the drooping upper eyelids had begun to affect her peripheral vision and that she frequently felt she looked tired and much older than her actual age. She had been considering eyelid surgery for several years and was finally ready to move forward with a trusted specialist.

Assessment and Treatment Planning

Dr. Helena Stroud conducted a thorough ophthalmic and aesthetic evaluation, including a visual field test to document the functional impact of the upper eyelid drooping. Photographs were taken from multiple angles to assist with surgical planning. A bilateral upper and lower blepharoplasty was recommended — addressing excess skin and fat on the upper lids and repositioning herniated fat pockets on the lower lids to eliminate puffiness and smooth the under-eye contour.

Treatment Process

The procedure was performed under local anesthesia with oral sedation in our accredited surgical suite. Upper eyelid incisions were placed precisely along the natural lid crease, allowing Dr. Stroud to excise the excess skin and a small amount of underlying fat. Lower eyelid incisions were made just below the lash line, through which the protruding fat was carefully repositioned and secured. The procedure lasted approximately two hours, and the patient was discharged the same day with detailed aftercare instructions.

Results and Patient Feedback

At the two-week follow-up, swelling and bruising had resolved significantly, and the patient's eyes already appeared dramatically more open and refreshed. By the six-week mark, the incision lines had faded to near invisibility within the natural eyelid creases. The patient described the results as transformative, noting that she no longer felt the need to raise her brows to see clearly and that friends and colleagues had commented on how well-rested and vibrant she appeared. A follow-up visual field test confirmed meaningful improvement in her peripheral vision.