As we age there are several anatomic changes occurring in the face:

  • Downward descent of the soft tissue leads to deeper lines and folds
  • Loss of elasticity results sagging and puffiness around the eyes
  • Loss of facial fat leads to deflation and hollows
  • Changes in the color and texture of the skin

In lower eyelid surgery, the under eye bags are removed or repositioned in order to smooth out the transition between the lower eyelid and the cheek. Eyelid skin may also be removed or tightened in order to rejuvenate the lower lids.

Lower eyelid surgery can be performed alone or in combination with other facial procedures like upper eyelid lifts, mid-face lifts, or brow lifts.

Who is a candidate for lower eyelid surgery?

A lower eyelid blepharoplasty is great for patients of any age who have excess skin on their lower eyelids or puffiness of the lower lids. These changes may be caused by gradual aging of the face or by inherited variation in lower eyelid fullness. The average age range for someone undergoing lower eyelid surgery is generally 35-65 years old. Important factors include:

  • you are physically healthy
  • you have a positive outlook and realistic goals for what can be accomplished through surgery

What are my treatment options?

The treatment for excess lower eyelid skin is a procedure called a lower eyelid blepharoplasty.

Two Types of Lower Eyelid Blepharoplasty

  1. Transconjunctival
    1. This approach allows a hidden incision on the back side of the eyelid. The fat that causes the puffiness is sculpted or repositioned. No skin is removed using this technique. If additional skin tightening is required this can be accomplished through laser or chemical peel at the time of surgery.
  2. Transcutaneous
    1. An incision is made across the lower eyelid beneath the eyelashes. Fat is sculpted or repositioned to address the puffiness. A strip of skin is then removed and the skin incision is closed then removable or dissolvable stitches.

Your surgeon may also discuss a canthoplasy or canthopexy – this is a technique to tighten the lower lid at the outside corner same time as the lower eyelid blepharoplasty to provide support the eyelid. 

What are the risks?

It is important to have a detailed discussion on the risks associated with surgery as they can vary between the type of brow surgery performed.

In general the risks include: anesthesia risk, bleeding, infection, inflammation, scarring, possible need for additional surgery.

It’s important that you address all your questions directly with your surgeon.

What can be expected afterwards?

In general, initial wound healing may take 7-10 days. Sutures will be removed when deemed appropriate by your surgeon.

Most patients return to work after 10-14 days depending on which technique is used and the degree of bruising and swelling. Additional healing will continue over the course of several weeks as the swelling subsides and incision lines continue to heal.

It may take several months for you to completely recover from surgery.

Following your physician’s instructions is essential to the success of your surgery.

Why choose an Oculofacial Plastic Surgeon?

Oculofacial plastic surgeons are the only type of surgeons that have training in both surgery of the eyes and soft tissues of the face.

When having procedures performed around your eyes the utmost care must be taken in order to preserve the delicate function of the eyes. There are both aesthetic and functional implications to surgery in this area. That is why we recommend having your surgery performed by an expert – an Oculofacial Plastic Surgeon.