Lower Eyelid Blepharoplasty

Lower Eyelid Surgery – Blepharoplasty

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Age related changes often show around the eyes first. Crow’s feet can be improved and prevented with good quality daily skin care – including a sunscreen, neuromodulator use such as Botox or Dysport, and filler when appropriate.

Volume loss under the eye occurs as we lose both bone and soft tissue with age. The orbit (eye socket) enlarges with age as the bone comprising it resorbs. The skin also becomes thinner with age, leading to crepe like appearance and wrinkles. In some cases, the orbital fat herniates due to loss of support from both the boney orbital rim and the soft tissue overlying the deeper orbital fat.

Volume replacement with filler can often improve the hollowness that occurs with age under the eyes. In some cases what appears like a problem with excess orbital fat is actually volume loss around it. The solution is not removing the fat (leading to more volume loss and hollowing under the eyes) but restoring lost volume under the eye, which conceals the fat and creates a more youthful look.

It is important to be aware that loss of volume below the eyes can give the appearance of bags, or excess fat. Removing fat, the traditional recommendation, can result in more hollowness, which is not youthful. In many cases, the restoration of volume with precisely placed filler gives the best improvement. An accurate analysis of the anatomy will lead to the correct diagnosis, optimal intervention and best outcomes.

In cases where thinning of skin and boney changes lead to an excess of skin under the eyes not improved with filler, surgically removing the excess skin is warranted. This procedure is performed under local with optional IV sedation. Drs. Bomer and Bouzoukis use a tissue sparing skin pinch technique. This heals with minimal scarring and prevents the downward retraction of the lower lid that can occur with other techniques.

Some patients have excess orbital fat that requires surgery. A small percentage of patients have congenital excess orbital fat, which has been present most of their life. Fat removal lower eyelid Blepharoplasty – eyelid surgery improves the under eye appearance in these cases.

Many cases of an age related appearance of excess fat can be improved with filler, but occasionally surgery to remove fat is indicated. The fat is removed from an incision made on the inside of the eyelid (transconjunctival). This minimizes scarring within the eyelid that can pull down the lid and lead to a rounded appearance of the eye.

The recovery time for lower eyelid surgery is minimal.