Lower Eyelid Surgery (Lower Blepharoplasty): A Patient-Friendly Guide

Overview of the Procedure

Lower eyelid surgery, or lower blepharoplasty, is a surgical procedure designed to reduce puffiness, remove excess skin, and improve the overall appearance of the lower eyelids. It can be performed for both cosmetic and functional reasons.
blog blog Blog blog

Why is it performed?

  • Reduces under-eye bags and puffiness.
  • Removes or tightens excess sagging skin under the eyes.
  • Improves the appearance of dark circles caused by shadowing from excess tissue.
  • Enhances overall facial aesthetics, creating a more youthful and refreshed look.

Type of Procedure

  • Surgical: Requires incisions to remove or reposition fat and tighten skin.

  • Alternative treatments:

    • Non-surgical options: Dermal fillers to smooth under-eye hollows.

    • Minimally invasive: Laser resurfacing or radiofrequency for mild skin tightening.

Benefits of the Procedure

Conditions Addressed

  • Prominent under-eye bags caused by fat deposits.

  • Loose, sagging skin contributing to an aged appearance.

  • Wrinkles or fine lines in the lower eyelid area.

Expected Improvements

  • A smoother, more youthful under-eye contour.

  • Reduction in puffiness and excess skin.

  • Enhanced self-confidence with a more rested and alert look.

Success Rates & Effectiveness

  • High patient satisfaction (over 90% report noticeable improvement).
  • Long-lasting results, typically 10–15 years.

Preparation Before the Procedure

Pre-Procedure Requirements

  • Medical evaluation: Eye examination, general health check.
  • Medication adjustments: Avoid blood thinners (aspirin, ibuprofen) and herbal supplements that increase bleeding risk.

Lifestyle Adjustments

  • Stop smoking at least 4 weeks before surgery to promote better healing.
  • Maintain a healthy diet and stay hydrated for optimal recovery.
  • Arrange transportation and post-surgery assistance.

Step-by-Step Description of the Procedure

How It’s Performed

  1. Anesthesia: Local anesthesia with sedation or general anesthesia.

  2. Incision placement:

    • Transcutaneous (external incision): Below the lower lash line.

    • Transconjunctival (internal incision): Inside the eyelid, with no visible scar.

  3. Fat removal or repositioning:

    • Excess fat is either removed or redistributed to create a smoother appearance.

  4. Skin tightening (if needed):

    • If there is excess skin, it may be trimmed and tightened.

  5. Closure:

    • Sutures or skin glue are used to close the incisions.

    • Protective ointment is applied to aid healing.

 

Duration of the Procedure

  • 45 to 90 minutes, depending on the complexity.

Risks and Potential Complications

Common Side Effects

  • Swelling, bruising, and mild discomfort (temporary).

  • Dry or watery eyes.

  • Temporary light sensitivity.

Possible Complications

  • Infection (rare, managed with antibiotics).

  • Bleeding or prolonged swelling.

  • Temporary blurred vision or difficulty closing eyes (resolves with time).

  • Asymmetry (may require minor revision surgery).

Risk Factors

  • Older age (slower healing in some cases).

  • Underlying health conditions (e.g., dry eye syndrome, diabetes, thyroid disorders).

  • Smoking (higher risk of complications and delayed healing).

Recovery and Aftercare

Expected Recovery Timeline

  • First few days: Swelling and bruising peak.

  • 1 week: Stitches removed, major swelling reduces.

  • 2–3 weeks: Most patients return to normal activities.

Pain Management

  • Prescribed or over-the-counter pain relievers.

  • Cold compresses to minimize swelling.

Activity Restrictions

  • Avoid strenuous activities for 2–3 weeks.

  • Sleep with head elevated to reduce swelling.

  • No smoking, alcohol, or excessive sun exposure during healing.

Follow-Up Appointments

  • Within a week post-surgery to check healing.

  • Additional visits as needed for scar care and final assessment.

Long-Term Outcomes and Lifestyle Considerations

How Long Do Results Last?

  • Typically 10–15 years, but aging continues naturally.

  • Results last longer with good skincare and sun protection.

Lifestyle Tips for Lasting Results

  • Use sunscreen and wear sunglasses to protect delicate under-eye skin.

  • Maintain a healthy diet and hydration to support skin elasticity.

  • Avoid smoking and excessive alcohol consumption to prevent premature aging.

Maintenance Treatments

  • Periodic Botox or fillers to maintain results.

  • Laser resurfacing for fine lines over time.

 

Frequently Asked Questions (FAQs)

Discomfort is mild and managed with pain relievers.

  • No visible scars if the incision is inside the eyelid (transconjunctival approach).

  • If an external incision is used, the scar is hidden along the lash line and fades over time.

Yes! It’s often combined with upper blepharoplasty, facelift, or Botox.

  • Usually after 2 weeks, once incisions have fully healed.

 

Additional Patient Resources

Trusted Medical Sources

Support Groups & Testimonials

  • Online forums (e.g., RealSelf, patient blogs) provide firsthand experiences and support.

If you’re considering lower eyelid surgery, consult with a board-certified plastic surgeon to discuss your goals and suitability for the procedure.