Lower Eyelid Blepharoplasty

Bags & Dark Circles

Lower blepharoplasty is a common procedure used for treating bags and dark circles. It is usually performed using local anesthesia and sedation.

To improve the lower eyelid bags, incisions are placed inside the eyelids (transconjunctival approach). This is necessary to minimize the risk of eyelid sagging or retraction.

Not all plastic surgeons use this approach and that is why it is so important to find a surgeon specializing in eyelid surgery. When excess skin is present the incision is placed just below the lashes. Dr. Braunstein in Morristown, New Jersey combines trimming and/or repositioning of the lower eyelid fat to reduce the prominence of eyelid bags, while simultaneously filling depressions around the eyes (dark circles).

In patients with pre-existing eyelid laxity, a canthal suspension procedure is performed to address this and decrease the risk of post-operative complications.

What is lower eyelid surgery?

The lower eyelids are one of the first areas on the face to show the signs of aging. Undereye bags and dark circles can make someone look drawn and tired even when they feel energized and rested. Lower blepharoplasty with Dr. Braunstein involves surgical sculpting and contouring of the lower eyelids. This is a delicate procedure that significantly improves under eye bags, dark circles and loose eyelid skin. Incisions are usually inside the eyelid with no visible scars. When skin tightening is necessary, the incision is placed just under the eyelashes where they are virtually imperceptible.

What is lower eyelid surgery?

Lower blepharoplasty addresses the presence of dark circles, lower eyelid bags, sagging eyelid skin and the overall tired appearance. A youthful lower eyelid is vertically short with a smooth transition between the eyelid and the cheek.

With age, tethering of facial ligaments, volume loss in the cheek area and protrusion of eyelid fat (bags) create an elongated lower eyelid appearance, with visible lines separating the eyelid and the cheek.

Bulging and hollowing create shadows that appear as dark circles. Thin eyelid skin does little to camouflage prominent blood vessels or the underlying muscle. While upper blepharoplasty primarily addresses the excess skin, lower eyelid surgery is more multifaceted.

Depending on the patientโ€™s individual needs, it may involve removal and/or repositioning of the lower eyelid fat (the bags) through eyelid surgery, removal of the excess eyelid skin, eyelid tightening, or a combination of these.

How is the lower eyelid procedure done?

The surgery can be performed either in the office or at the surgery center with deeper anesthesia.

  • During an evaluation, the eyelid fat compartments, eyelid skin tone and texture, overall eyelid position and laxity, and the appearance of the mid-face and cheeks are assessed.
  • A transconjunctival lower blepharoplasty would be best suited for a patient with lower eyelid bags (bulging eyelid fat) and good skin tone.
  • During this operation, incisions are placed inside the eyelids (in the conjunctiva) and the fat pockets are trimmed and repositioned to create a smoother contour.
  • When sagging eyelid skin is also present, transconjunctival blepharoplasty is combined with an external approach where an incision is made just under the eyelashes and excess skin is removed.
  • In most patients, this is often combined with a canthopexy, which tightens the eyelid to protect it against gravitational and aging forces.
  • Fat transposition
  • Successful cosmetic surgery is more about what is kept than what is taken away. In patients with lower eyelid bags, aggressive removal of lower eyelid fat can result in hollowness and appear โ€œdone.โ€
  • In lower blepharoplasty with fat transposition, the fat is moved to fill in the hollow areas to create a smooth transition between the lower eyelid and the cheek. This creates a natural and youthful appearance.

How long does the procedure last?

Due to the multifaceted nature of the lower blepharoplasty eyelid surgery, the procedure may take anywhere from 45 minutes to 2 hours and the recovery time from 1-3 weeks.

As with upper blepharoplasty, selecting a surgeon with an intricate understanding of the eyelid and facial aging process, knowledge of the anatomy and experience, guiding the selection of the best procedure for each individual patient, will result in the best possible outcome.

What is the recovery from the dark circle treatment?

After the procedure patients are instructed to apply ice, rest and avoid strenuous activity. Swelling, bruising and irritation are expected in the early post-operative period. Healing time varies between patients, with age, general health and medications affecting the individual healing time.

Dr. Alexandra Braunstein proudly provides Morristown, Madison, Summit, Chatham, Far Hills, Bernardsville, Somerset, Wayne, Westfield, New Providence, Dover, New Jersey and surrounding areas with advanced eyelid surgery procedures fixing bags & dark circles under the eyes. Call 973-998-8701 for an appointment today.

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