The lower eyelids are a focal point for many patients’ complaints, giving a “tired”, or “unhappy” look. Lower blepharoplasty is an excellent option for patients who wish their looks to better match how they feel.

A common complaint with lower eyelids are “eye bags” which can trouble patients as young as their 20s, as some of us are born with larger amounts of fat in the eyelids and around the eyes. Later in life, bags under the eyes can be caused by a relaxation in the tissues that support the fat pads, leading to pseudoherniation (or “bulging”) of the orbital fat pads. Either way, removal or repositioning of the fat is a great option via lower eyelid lift, as these fat pads tend not to grow back once removed.

Along with eyelid bags, another concern for lower eyelids is excess skin.  A conservative removal of this skin can have excellent results that rejuvenate a sensitive area.  This removal of skin along with sculpting of the orbital fat pads can be done in the office setting under local anesthesia or at an outpatient surgery center with sedation.  Wherever the surgery is carried out, the results are striking, as you can see in our patient’s transformation below.

Lower blepharoplasty can be carried out via a skin incision just under the eyelashes, or on the inside of the eyelid without any external scar.  The approach used is dependent on an individual’s anatomy and concerns. An in person consultation with Charlotte’s premier facial plastic surgeon, Dr. Summit Kundaria, will tell which is the best option for you.

The patient above is enjoying the results of her upper and lower eyelid lift.  She wanted natural improvement with a more “fresh”, or “rested” look, but that was still consistent with her age.  As you can see in this animation, her results 2 years after surgery are holding up well.

She has less skin resting on her upper eye lashes, which opens the eyes and allows more light enter the eyes.  This is felt by the patient as a physical weight lifting off of their eyes.  In its advanced stages, the skin can actually weigh down the eyelid until it obstructs vision.  Gaining a visible strip of upper eyelid skin above the eye lashes has a powerful effect on the whole face, both in terms of how it looks and feels.

Her lower eyelids have less skin and the bulging fat pads have been conservatively sculpted to look more youthful without looking “hollow”, which can happen with more aggressive fat removal.  Many people ask about visible scarring after eyelid surgery.  This patient’s upper and lower eyelid lift surgery left her with “visible scars”, but they are visible only to the most trained eye, while the results are visible to all.

The patient above wanted improvement in his lower eyelid bags, and had prominence of the medial and central orbital fat compartments, as depicted by the arrows in the pictures above.  These were asymmetric (with a larger fat pad on the right side), which was present at rest and even more when smiling.  You can see the improvement he had both at rest and when smiling.  Given his younger age and lack of redundant skin of the lower eyelids, a “scarless” approach was used, with all scars on the inside of the eyelid.

The lower eyelid lift is done with a conservative approach, with a partial removal of the lower eyelid fat pads, rather than an aggressive removal, which can make the eyes look “sunken” or “hollow”.  A conservative sculpting of the fat pads retains a more natural look, with better long term results.