What Is Low BLEPHAROPLASTY (Eyelid Surgery) Eyelid Surgery)?

Your eyes are often the first thing people notice about you and are an important aspect of your overall appearance. As we age, the tone and shape of our eyelids can loosen and sag. Heredity and sun exposure also contribute to this process. This excess, puffy or lax skin can make you appear more tired or older than you are. Eyelid surgery or blepharoplasty (pronounced “blef-a-ro-plasty”) can give the eyes a more youthful look by removing excess skin, bulging fat, and lax muscle from the upper or lower eyelids. If the sagging upper eyelid skin obstructs peripheral vision, blepharoplasty can eliminate the obstruction and expand the visual field.

Fat in the lower eyelids can be removed or repositioned through an incision hidden on the inner surface of the eyelid. Laser resurfacing or a chemical peel can be performed at the same time if desired, to smooth and tighten the lower lid skin. If there is excessive skin in the lower lid, the incision is made just below the lashes. Fat can be removed or repositioned through this incision, and the excess skin removed. The incision is then closed with fine sutures.

As a board-certified, fellowship trained oculoplastic surgeon with extensive training and experience, Dr. Selena Fu customizes each treatment to reflect each patient’s unique anatomy, skin condition, aesthetic concerns and lifestyle— an approach that consistently delivers excellent results for her patients.

Call for a personal consultation today, Dr. Fu will discuss the surgical and non-surgical options that will provide your best possible outcome. Insurance may cover all or a portion of reconstructive eyelid surgeries.

What to Expect for Lower Blepharoplasty (Eyelid Surgery)?

Before the Surgery:

Consultation – Your surgeon will assess your concerns (e.g., under-eye bags, excess skin, fat deposits) and discuss the best approach.
Medical Evaluation – You may need tests to confirm you’re fit for surgery.
Pre-Surgery Instructions – Avoid smoking, alcohol, and certain medications like blood thinners.
Anesthesia – Usually performed under local anesthesia with sedation or general anesthesia.

During the Surgery:

Incision Placement – The surgeon may choose one of two techniques:
- Transconjunctival Approach (inside the eyelid, no visible scars).
- Subciliary Approach (below the lash line, leaving a fine scar that fades over time).
Fat Repositioning or Removal – Reduces puffiness and smooths under-eye hollows.
Skin Tightening – Excess skin may be trimmed for a more youthful appearance.
Closure – The incision is closed with fine sutures or dissolvable stitches.

Recovery Process:

First Few Days
- Swelling and bruising are normal and peak within 48 hours.
- Mild discomfort, dryness, or tightness in the lower eyelid.
- Cold compresses help reduce swelling.
- Sleep with your head elevated.
First Week
- Avoid strenuous activities.
- Sutures (if not dissolvable) are removed after 5–7 days.
- Wear sunglasses to protect your eyes from sunlight and wind.
Weeks 2–4
- Most swelling and bruising subside.
- Light makeup can be used to conceal any residual bruising.
- Gradual return to normal activities.
Long-Term Results
- Final results appear within 3–6 months.
- Scars fade and become nearly invisible.
- Results typically last for many years, though aging continues.

Risks and Potential Complications:

Temporary blurry vision or dry eyes.
Asymmetry or mild tightness in the lower lid.
Infection or prolonged swelling (rare).
Ectropion (outward turning of the eyelid) in severe cases.

Who is a Good Candidate?

Individuals with under-eye bags, puffiness, or sagging skin.
Non-smokers in good health.
Those with realistic expectations about results.

FAQ for Lower Blepharoplasty (Eyelid Surgery)

1. What is lower blepharoplasty?

Lower blepharoplasty is a cosmetic surgical procedure that removes excess skin, fat, and wrinkles from the lower eyelids to reduce under-eye bags and improve overall eye appearance.

2. Who is a good candidate for lower blepharoplasty?

Individuals with noticeable under-eye bags, puffiness, or sagging skin.
People in good health without severe eye conditions.
Non-smokers with realistic expectations about the results.

3. What are the different types of lower blepharoplasty?

There are two main approaches:

Transconjunctival blepharoplasty – The incision is made inside the eyelid, leaving no visible scars. Ideal for patients with excess fat but good skin elasticity.
Subciliary (skin incision) blepharoplasty – The incision is made just below the lower lash line to remove excess skin and fat.

4. Will there be visible scars after the surgery?

No visible scars with the transconjunctival approach. For subciliary blepharoplasty, the scar is minimal and fades over time.

5. How long does the procedure take?

The surgery usually takes 1 to 2 hours, depending on the technique used and the complexity of the case.

6. What type of anesthesia is used?

Local anesthesia with sedation or general anesthesia, depending on the patient’s preference and surgeon’s recommendation.

7. What is the recovery time for lower blepharoplasty?

First few days: Swelling and bruising peak within 48 hours. Use cold compresses.
First week: Sutures (if non-dissolvable) are removed in 5-7 days.
2-4 weeks: Most bruising and swelling subside, and normal activities can resume.
3-6 months: Final results become more noticeable.

8. Is the surgery painful?

Discomfort is usually mild. Patients may feel tightness, dryness, or slight irritation, but severe pain is rare. Pain medication can be prescribed if needed.

9. What are the potential risks of lower blepharoplasty?

While rare, possible complications include:

Infection
Temporary dry eyes or blurred vision
Swelling and bruising
Eyelid asymmetry
Ectropion (outward turning of the lower eyelid, very rare)

10. How long do the results last?

Results typically last 10-15 years, depending on aging, genetics, and lifestyle habits. While the procedure does not stop aging, it significantly rejuvenates the eye area.

11. When can I return to work?

Most patients return to work within 7-10 days, depending on the extent of swelling and bruising.

12. Are there any restrictions after surgery?

Avoid heavy lifting and strenuous activities for at least 2 weeks.
Do not rub or strain the eyes.
Wear sunglasses outdoors to protect against sun exposure.
Avoid alcohol and smoking, as they can slow healing.

13. Can lower blepharoplasty be combined with other procedures?

Yes, it is often combined with procedures like upper blepharoplasty, facelift, or laser skin resurfacing for a more comprehensive rejuvenation.

14. How much does lower blepharoplasty cost?

Costs vary depending on location, surgeon expertise, and whether additional procedures are performed. In the U.S., prices typically range from $3,000 to $7,000.

15. How can I prepare for the procedure?

Stop smoking at least 4 weeks before surgery.
Avoid blood-thinning medications like aspirin and ibuprofen.
Arrange for someone to drive you home after the procedure.

If you’re considering lower blepharoplasty, it’s important to consult with a board-certified surgeon to discuss your goals and determine the best approach for you.