Lower eyelid surgery, also called lower blepharoplasty, is a type of cosmetic surgery designed to restore a youthful appearance to the lower eye area.  As we age, the skin and the underlying thin layer of muscle of the lower eyelids become droopy, resulting in issues from fine wrinkles to a festoon of skin folds. As an added complication of aging, the fat pockets about the eye protrude forward causing the lower eyelids to appear puffy and baggy. These changes make someone appear tired and old. If the lower eyelid area shows a circular, trough-like depression and the patient has sagging cheeks, a midface lift might be the best way to obtain optimal rejuvenation of the area.

How is Lower Eyelid Surgery Performed?

Lower eyelid surgery is generally performed under local anesthesia.  Through an incision made just under the lower lash line, excess skin and muscle are removed from the eyelids. Fatty tissue beyond normal boundaries is removed, leaving just enough to make the eyelids appear natural and youthful. In some cases, the removed fat may be used to help fill out the trough­-like depression under the lower eyelids.  At times, volume increase through fat grafting may be necessary in some areas.

If the lower eyelids have protruding fat but not significant skin excess, the fat can be removed through the inner surface of the eyelid through a procedure known as transconjunctival blepharoplasty.  This procedure results in no external markings. A chemical peel or laser resurfacing may be coupled with this procedure to improve skin tone.

Lower eyelid surgery is often combined with procedures such as midface lift, upper blepharoplasty, and face lift depending on the results the patient wants to achieve.

Who is a Good Candidate for Lower Eyelid Surgery?

Individuals who are in good general health with significant puffiness and wrinkling of the eyelids are good candidates for lower blepharoplasty. People with existing eye conditions such as dry eyes, glaucoma, retinal problems and thyroid related eye conditions should consult an eye doctor before proceeding with this type of plastic surgery.

Recovering from Lower Eyelid Blepharoplasty

It is common for the eyelid area to be swollen and bruised after lower blepharoplasty, the severity of which varies among individuals. On average, it takes about 10 days for the swelling and bruising to diminish. Keeping the head elevated and applying a cold compress to the eyes are essential steps to a speedy resolution. Patients should be ready to be in public after a week to 10 days with makeup. However, healing is a gradual process and final settling of all the changes may take six months or more.

Complications of lower eyelid surgery are infrequent. The most common complication is excessive bleeding, which may cause prolonged bruising and swelling. Due to the particular anatomy of the lower eyelids, the eyelids may pull downward during the early healing phase in some individuals. In most cases, this is a reversible change. Infection and visual impairment are far more rare complications.

Lower Eyelid Surgery Results

Lower eyelid surgery improves the contour of the lower eyelids and gives the lower eye area a cleaner and softer look. The overall appearance of the face is more alert, rested, and youthful.

Before and After

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