Lower Blepharoplasty

As we age, the structural support of the eyelids weakens, leading to sagging skin and protruding fat pads under the eyes. Additionally, fluid retention can cause puffiness, while diminishing fat pads in the mid-cheek can create a noticeable groove known as the tear trough.

Factors like sun damage and alcohol consumption can accelerate these aging changes, further impacting the appearance of the under-eye area.

Lower eyelid blepharoplasty is aimed at rejuvenating the under-eye region, reducing signs of aging, and enhancing overall facial appearance.
Our surgeons have extensive expertise in various lower blepharoplasty techniques, including transcutaneous, transconjunctival, and fat redistribution methods. These techniques involve tightening supporting tissues, removing excess skin and fat, and addressing under-eye hollows to achieve natural-looking results.

What does lower blepharoplasty surgery involve?

• A lower eyelid blepharoplasty can be performed under different types of anesthesia, including local anesthesia, intravenous sedation, or general anesthesia, based on patient preference and medical history.
• Compared to upper blepharoplasty, it is a more intricate procedure.
• The surgeon makes a fine incision just below the lashes in the lower eyelids, extending to the corners of the eye.
• Excess fat is either removed or repositioned through this incision, and any redundant lower eyelid skin is tightened or removed.
• Younger patients with genetic predisposition to eye bags but no excess skin may opt for a transconjunctival blepharoplasty or scarless lower eyelid lift.
• This technique involves a small incision inside the lower eyelid, avoiding external scarring.
• Post-operatively, antibiotic cream is applied to the incision area, with instructions to use it three times a day for up to a week to prevent infection.
• Bandages or padding are rarely used after the procedure, and if needed, they are removed shortly after surgery..

Aftercare advice

• You are encouraged to start walking on the same day of your procedure.
• Pain is minimal after a lower eyelid lift and can be easily controlled with simple painkillers.
• Lower lid blepharoplasty may require up to four weeks for swelling reduction, but this varies from individual to individual.
• Cold compresses and sleeping in an upright position can speed up the disappearance of any bruising and swelling.
• Apart from the antibiotic ointment that you will be asked to apply regularly in the first week, wound care is very straightforward.
• You will be advised to keep the wounds dry for the first 48 hours. After that, you can gently wash – but not scrub – the area.
• You can resume normal washing after the sutures are removed – typically between days six and ten.
• You will be advised not to wear make-up for the first two weeks.

What are the risks?

• Eyelid position: For the first few days after your procedure, it is common for the eyelash of the lower lid to be pushed away from the eye. This is typically temporary and the result of swelling of the tissues..
• Scars: Scarring after a lower eyelid lift depends on the technique used. A transconjunctival blepharoplasty involves an incision behind the lower eyelid, so there will be no external scarring afterwards. The other approach consists of an incision made just below the lash line and, once healed, should be virtually invisible.
• Bleeding: Significant bleeding after a lower eyelid lift is a rare but severe complication that could result in permanent vision loss.
• Infection: The use of antibiotic cream for the first week after surgery means you should avoid this rare complication.
• Allergic reaction: In rare cases, an allergic reaction to the tape, stitches or solutions used has been reported. If you have an allergic reaction, you may require extra treatment.
• Increased or reduced sensation: This is a common change that happens after any surgical procedure but is usually temporary.
• Asymmetry: Everyone has some degree of asymmetry between the eyes, but a significant difference in appearance after eyelid surgery may require revision eyelid surgery. Meticulous planning and precise measurements are conducted to avoid this potential complication.
• Unsatisfactory result: Sometimes patients are not satisfied with the results of a lower eyelid lift, which is often due to unrealistic expectations about what can be achieved. During your consultation, your concerns will be discussed before explaining what is possible to achieve and ensuring you are fully informed about every aspect of surgery.

How is the procedure carried out?