Lower Blepharoplasty

Lower blepharoplasty is a cosmetic procedure that removes small amounts of fat and skin from under the lower eyelid. Often combined with upper eyelid surgery, it rejuvenates and restores the area, reducing fullness under the eye for patients of any age. This surgery is a safe and effective way to restore a more youthful appearance for those with premature under-eye bags or dark circles. 

At Tehrani Plastic Surgery, we focus on the specific cosmetic wants and needs of every patient to provide comprehensive care. Dr. Ali Tehrani is a renowned double board-certified surgeon serving the communities of Apple Valley, La Jolla, and Newport Beach, CA. His artistic eye informs every surgical procedure to help his patients achieve their goals. Call (949) 706-7776 or fill out our convenient contact form to schedule a private consultation with Dr. Tehrani today. 

What is Lower Blepharoplasty?

Also known as lower eyelid surgery, lower blepharoplasty is designed to reinvigorate the under-eye by reducing, repositioning, or removing fat pads, and addressing excess skin. This area of the face is extremely disposed to the signs of aging. This includes muscle sagging, loss of skin elasticity, and the prolapse of local fat pads, causing an unattractive collection of tissue underneath the eye. ⁽¹⁾

The thin skin surrounding the eyes is extremely fragile and often starts showing signs of natural aging earlier than other facial areas. Lower blepharoplasty can remedy this by providing long-lasting correction. There are two main techniques performed to rejuvenate the lower eyelid: the transconjunctival and transcutaneous approaches.

Transconjunctival Approach

Most modern surgeons prefer more conservative approaches to blepharoplasty surgery. The transconjunctival approach achieves this, with an incision on the inside of the lower lid. ⁽²⁾ Dr. Tehrani places this incision near the inner lash line. There are three fat pads (nasal, central, and lateral) located underneath the lower eyelid. Dr. Tehrani can reduce these (typically the lateral fat pad) to correct under-eye bags without causing too much hollowing in the area. Surgeons choose this approach to conserve some fullness, reposition the fat pads, or for patients with good skin elasticity.

Transcutaneous Approach

During a transcutaneous approach, Dr. Tehrani makes an incision on the outside of the eyelid. He can still access the fat pads with this technique, and he uses it if a patient has large amounts of excess skin under the eye. The incision runs along the lash line, from one side of the eyelid to the other. He carefully separates the skin from the underlying muscle (orbicularis) and removes any loose tissue to smooth out the lower lid. ⁽²⁾

This technique is more invasive and requires longer recovery times compared to the transconjunctival approach. However, it can provide more dramatic results for patients. During your private consultation, Dr. Tehrani closely evaluates your eyelids to choose the best approach for your specific needs.

Benefits of Lower Blepharoplasty

Lower blepharoplasty:

This surgery is beneficial for many types of patients. Under-eye bags and dark circles can be genetic or age-related, often making patients look older or more tired than they are. This can have a large effect on a patient’s overall complexion, taking attention away from their most important attributes. Lower blepharoplasty is a quick procedure that provides long-lasting results.

Am I a Good Candidate for Lower Eyelid Surgery?

Lower blepharoplasty candidates may have the following under-eye characteristics:

You must be in relatively good health without underlying conditions like glaucoma, diabetes, or chronic dry eye to undergo surgery. If you smoke, Dr. Tehrani requires you to refrain from all tobacco and nicotine use for at least 2 weeks before your lower blepharoplasty. 

If your under-eye puffiness is age-related, you may also make a good candidate for upper eyelid surgery to correct drooping. Read more about this procedure and others on Dr. Tehrani’s blog.

Personal Consultation and Tehrani Plastic Surgery

To get to know you better during your private consultation, Dr. Tehrani will ask about your medical history. He will inquire about your cosmetic concerns and desires while examining your lower eyelid area. He will then create a customized procedure plan to help you reach your goals. If you are a good candidate for lower blepharoplasty, a member of the Tehrani Plastic Surgery will then schedule a surgery date.

If you are short on time and want to get a head start toward a rejuvenated appearance, consider filling out your patient forms before you arrive for this appointment. 

Preparation

Dr. Tehrani provides detailed instructions on how to prepare for your upcoming surgery. Please avoid the following:

You should get ample sleep and stay hydrated before your procedure. Though recovery time is typically short, it is still important to take the appropriate steps toward staying healthy beforehand. Inform your employer you will need 5 to 10 days off of work to properly heal. We also recommend preparing a section of your home for a comfortable recovery. Please find a loved one or trusted friend who can transport you to and from our surgery center. If you wear contact lenses, please leave these at home and wear glasses instead on the day of your surgery.

Lower Blepharoplasty Procedure

Depending on the chosen approach, Dr. Tehrani starts the procedure by marking the lower lids to organize and plan out the process. He makes his incisions along either the inside or outside of the lower lash line. After separating the skin from the muscle, he addresses the fat pads. Once the bulk is removed and any excess skin is trimmed, he delicately sutures the incisions and bandages the eyes. Lower blepharoplasty typically takes between 1 and 2 hours to complete.

Recovery & Results

Lower blepharoplasty downtime is typically 1 to 2 weeks. There is bruising and swelling around the eyes during and beyond this initial healing period. After the first week, Dr. Tehrani removes the stitches if they are not dissolvable. To avoid excessive swelling, patients should avoid strenuous activities for 6 weeks after this procedure. Though every patient is different, many achieve a full recovery in 2 to 3 weeks.

After surgery, your lower eyelids are smoother and less bulky. You may notice a difference right away, though full results are not visible until the swelling and bruising have resolved. The incision runs along the lash line, making it easily concealed after you are completely healed. Though nothing can prevent future signs of aging, the results of a lower blepharoplasty are long-lasting.

Complementary Procedures

Upper Blepharoplasty

To address upper eyelid sagging, upper blepharoplasty removes skin and excess fat from above the eye. Dr. Tehrani makes an incision along the natural upper eyelid crease and separates the skin from the underlying anatomy. He can then address the fat pads located near the brow line if necessary. After trimming excess skin, he closes the incision with thin sutures. Upper blepharoplasty is very often combined with lower eyelid surgery to achieve overall eye rejuvenation.

Brow Lift 

Another procedure typically combined with lower blepharoplasty is a brow lift. The brows often start to droop toward the eye with time, creating distracting shadows and aging the patient. A brow lift corrects this using an incision hidden in the hairline. Dr. Tehrani lifts the skin, tightens the brow muscle, and removes excess skin before suturing the incision. Depending on the degree of skin laxity and brow descent, a brow lift can also be performed endoscopically for a less invasive procedure.

Cost of Lower Blepharoplasty in Newport Beach

Tehrani Plastic Surgery offers multiple financing options to help you achieve your desired results. The total cost of lower blepharoplasty procedures varies between patients. To get a clear overview of lower blepharoplasty, schedule an initial appointment with us by calling (949) 706-7776. You may also visit one of our offices in Apple Valley, La Jolla, or Newport Beach, CA.

FAQ

References

1. Klinger M, Vinci V, Maria Angela Romeo, et al. Surgical Tips for Aesthetic Lower Lid Blepharoplasty: Prevention of Round Eye. Plastic and Reconstructive Surgery – Global Open. 2023;11(7):e5092-e5092. doi:https://doi.org/10.1097/gox.0000000000005092
2. Bhattacharjee K, Ghosh S, Ugradar S, Azhdam AM. Lower eyelid blepharoplasty: An overview. Indian Journal of Ophthalmology. 2020;68(10):2075-2083. doi:https://doi.org/10.4103/ijo.IJO_2265_19