Lower Blepharoplasty

Lower blepharoplasty is a procedure that is also known as eyelid surgery or an eye lift. The surgery addresses the skin or both the muscle and the skin below the eye. Lower blepharoplasty repositions “bags” under the eye, or the fat that protrudes, and places them in a better position. Lower blepharoplasty also treats wrinkles, fine lines and sagging that can cause the lower eyelid to move away from the eyeball and more of the white below the iris (the sclera) to show. The surgery improves the look of puffy and tired-looking eyes by tightening the skin around the eyes and providing a more youthful appearance.

Am I a Good Candidate for Lower Blepharoplasty Cosmetic Surgery?

A GOOD CANDIDATE for lower blepharoplasty includes:

• Patients with droopy eyelids, due to excess fat, that might also impact the line of vision
• Patients with” bags” under their eyes that make them look tired or older
• A person with wrinkles, excess skin and fine lines under the eyes
• Patients who want a younger, more youthful look to the eyes
• Someone with too much sclera that is showing due to aging or genetics

The following patients are NOT GOOD CANDIDATES for lower blepharoplasty:

• Patients with serious eye conditions
• Patients with skin that is very saggy under the eyes and in the lower facial area
• Patients with baggy eyes due to allergies or thyroid disease

How is Lower Blepharoplasty Cosmetic Surgery Performed?

Lower blepharoplasty is performed under general or local anesthesia. The surgeon begins the procedure by making a 1 or 2mm incision below the lash line and towards the outer corner of the eye. Once the incision is made, the flap of skin with muscle is raised so any excess fat can be repositioned or completely removed by the doctor. Then, the flap of skin is pulled upwards and towards the outer cheek to eliminate and improve the look of any wrinkles or sagginess. The fat pads are evenly draped across the orbital rim that is located along the upper cheek bone. The flap is sutured into place and any excess skin is trimmed away. The incisions are closed with sutures or skin glue.

Alternative Techniques

Patients with fat pads that bulge outward, but without excess skin on the lower eyelid region, may use a transconjunctival incision. The surgeon makes an incision on the inside lower eyelid for the removal or reposition of the fat pads. There is not any skin removal with this technique.

In upper blepharoplasty, the surgeon makes an incision along the natural crease of the upper eyelid to correct any sagging of the upper eyelids by repositioning or removing the fat pad while also tightening the tissue and muscles with dissolvable sutures. In addition, any excess saggy skin is eliminated.

The lower eyelid can also be rejuvenated through the use of hyaluronic acid (HA) fillers such as Restylane or Juvederm. These fillers are injected under the skin to plump up the undereye area and smooth out any wrinkles. Dermal filler results are temporary and need repeat treatments to maintain the results.

What is the Cost of Lower Blepharoplasty Cosmetic Surgery?

The cost of lower blepharoplasty depends on the technique used by the doctor and the amount of work that needs to be performed. The cost also depends on any fees charged by the doctor or the facility and the area of the country where it is performed. In general, the cost is anywhere from $2500-$7500.

Recovery and Downtime

At the start of the RECOVERY period, there will be some discomfort, swelling, bruising and irritation at the incision site. The use of cold compresses for the first day or two can help with any discomfort and minimize the swelling. The amount of bruising varies per patient and can result in black and blue eyes for around 3 weeks. Any sutures will be removed within 5 to 7 days. The amount of DOWNTIME is small and patients can return to work 2-3 days after the procedure. It takes around 2 or 3 weeks for the swelling to subside. During this time period, patients should avoid strenuous exercise. When going outside, patients should use darkly tinted sunglasses to protect the eyes from the sun during the recovery period.

Results

The results of lower blepharoplasty are visible once a portion of the swelling and bruising goes down. Patients who had an amount of skin removed can immediately see some results as the skin will look tighter. The final results may not be completely apparent until all of the residual swelling has gone down. In general, the results last for 10-15 years before the skin begins to lose its laxity and starts to sag again.

Limitations for Lower Blepharoplasty Cosmetic Surgery  

Some common limitations of lower blepharoplasty include:

• The amount of volume that can be replaced while still providing natural looking results
• It is not a permanent solution as the skin will eventually begin to lose it laxity again
• The amount of fat that can be repositioned towards the outer half of the orbital rim

Risks for Lower Blepharoplasty Cosmetic Surgery

Common risks of lower blepharoplasty include:

• Difficulty closing the eyes completely
• Infection
• Swelling
• Bruising
• Dry eyes
• Eyelid retraction, or a pulling downward, of the lower eyelid
• Ectropion, or an outward rolling, of the lower eyelid
• Asymmetry with the results
• Lumps under the eyes
• Bleeding behind the eyeball leading to blindness
• Scarring
• Temporary or permanent changes in vision
• The need for revision surgery

A Younger Appearance to the Eyes

Lower blepharoplasty helps a patient achieve a younger appearance by plumping up the area directly under the eyelid. It also improves the appearance of dark circles by creating a smoother transition from the area of the lower eyelids to the upper cheeks. Patients interested in having lower blepharoplasty should schedule a consultation with a board-certified surgeon experienced in performing this type of procedure. An experienced surgeon can examine the patient and determine if lower blepharoplasty will give the desired results.

Written by Cosmetic Town Editorial Team - MA

Based on an exclusive interview with Christopher Zoumalan, MD in Beverly Hills, CA