Lower Eyelid Blepharoplasty

Lower Eyelid Blepharoplasty is the gold standard to correct puffy, sagging and tired-looking lower eyelids. During a short operation (normally 1 hour), excess skin and/or fat is removed from the lower eyelids to create a fresh and more youthful appearance. Lower eyelid blepharoplasty is customized to each patients’ individual needs.   Depending on the surgery, incisions can be made along a natural line or wrinkle of the lower eyelid just below the lash line to create discrete scars that are well hidden once fully healed or from inside of the lower eyelid for an invisible scar.  The ultimate goal of the surgery is to leave the patient looking natural and refreshed, like the bags and dark circles were never there.

Aesthetic outcomes can be enhanced when combined with other treatments such as Upper Eyelid Blepharoplasty, CO2 laser, Morpheus 8 or chemical peels. Intense sun exposure should be avoided one month following treatment.

WHAT TO EXPECT?

When only fat is removed or repositioned, the incision can be made on the internal surface of the lower eyelid. There is no visible scar in transconjunctival blepharoplasty. This approach minimizes the risks of complications associated with going through the skin. Not all plastic surgeons use this approach, so finding a surgeon specializing in eyelid surgery is important. The bags, which are herniated orbital fat pads, are trimmed or redraped as needed.

If there is skin laxity present, a small amount of skin may need to be removed. The incision is placed just below the lashes, and a conservative amount of skin is removed without changing the shape or position of the lower eyelid. By making an incision along the natural skin lines of the eyelid, it is possible to remove skin and/or fat leaving a thin, discreet scar along the natural skin crease of the lower eyelid. In patients with pre-existing eyelid laxity, a canthal suspension procedure (canthopexy) is performed to support the eyelid and prevent possible complications.

Lower eyelid blepharoplasty helps diminish lower eyelid ‘bags’ and excess skin. Initial bruising and swelling resolving in as little as one to two weeks, however, the final outcome of the surgery may not be seen for several weeks. It is noteworthy that the normal smile lines will still be present after skin tightening and are amenable to further improvement with neuromodulator (Botox) treatments.

The procedure may take anywhere from 1 to 2.5 hours, depending on what is being done. Swelling and bruising are variable and expected in the early postoperative period. Immediately after surgery, you may notice your vision is blurry due to the antibiotic ointment that has been applied during surgery. You will be asked to use this ointment at bedtime in the eye and on the wound. Artificial tears will be prescribed to prevent dryness in the postoperative period. The degree of swelling and potential bruising differs from patient to patient. We will give you cold compresses to use for 10 minutes every hour while awake for the first 48 hours to minimize bruising and swelling. It is encouraged to sleep with 2-3 pillows to help prevent fluid accumulation and swelling.

Regular daily activities can resume the day of or after surgery, but exercise and strenuous activity should be avoided for 2 weeks. I recommend no driving for one week. Patients return 1 week after surgery for examination and potential suture removal. Eye make up can be resumed 7-10 days after surgery. It is normal to have feelings of numbness along the eyelash margin, tightness of the eyelids and mild dryness temporarily. Most patients do not experience any pain after the surgery.

It is important to keep the eyes dry for the first 48 hours. Hair can be washed. The eyes can be gently washed from days 3-7 and once the sutures are removed at one week, normal washing routines are initiated.

Serious complications after lower eyelid blepharoplasty are rare. However, there are potential risks and complications as with any surgery: infection, bleeding, and poor wound healing. A detailed discussion of all possible risks and complications is made at the time of operative consultations and detailed with the written information summarizing discussions.

Blepharoplasty is designed to improve the appearance of the eyelids and most patients do not feel the need to have a second surgery. However, the natural ageing process will continue and results will vary between patients. Blepharoplasty results last between 7-15 years. Blepharoplasty can be enhanced by other surgical and non surgical procedures done at the same time.

WHAT ARE THE BENEFITS OF LOWER EYELID BLEPHAROPLASTY?

Lower eyelid blepharoplasty restores lower eyelid harmony. By removing excess skin and fat, the eyelid will appear smoother and better defined, giving a more youthful appearance.

External skin resurfacing with a chemical peel or laser treatment may be possible at the same time as surgery to increase the rate of healing and improve the appearance of your skin.