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Lower Eyelid Blepharoplasty

With normal aging, the lower eyelid may stretch allowing the underlying fat to become more visible resulting in an appearance referred to as lower eyelid bags. Additionally, the lower eyelids may show dark circles resulting from a depression under the eyelid bags.  Together, this change in the lower eyelids may create a tired or aged appearance. Lower eyelid blepharoplasty removes protruding fat in the lower lids and contours the hills and valleys of the lower eyelid to create a smoother transition between the eyelid and cheek and restore a more youthful appearance.


Treatment for Eyelid Bags in Honolulu

Dr. Sweeney and Dr. McDevitt perform lower lid blepharoplasty through a hidden incision on the backside of the eyelid, avoiding a visible scar. During the surgery, the puffiness in the lower lids is removed and contoured to provide a customized lower eyelid appearance.

Lower eyelid blepharoplasty may also be combined with laser skin resurfacing or microneedling with radiofrequency technology to tighten the skin of the lower eyelid to compliment the cosmetic outcome. Similar to when a balloon deflates and shows lines, when the lower lid fat is removed, laxity in the skin may then show wrinkles. For this reason, many of our patients elect to combine skin tightening with the lower lid blepharoplasty.

Lower eyelid blepharoplasty is performed in our office surgical suite under light sedation. Patients can recover at home the same day as the procedure and be performing their normal activities the very next day.

Lower lid blepharoplasty is associated with risks and should only be done by expert eyelid surgeons. Dr. McDevitt and Dr. Sweeney routinely correct problems associated with unsuccessful lower lid surgery done by surgeons less familiar with eyelid surgery. This is called a revision blepharoplasty and may involve skin grafts, eyelid spacers, or a midface lift.

Nobody knows your eyelids like an oculoplastic surgeon. Trust your lower lid blepharoplasty to the experts and call today for a consultation for your lower lid blepharoplasty.

The vast majority of insurance companies do not cover lower lid blepharoplasty surgery. This is because the lower lid puffiness and dark circles are considered cosmetic in nature and do not block the vision as the aging upper eyelids do.

While a lower eyelid blepharoplasty may have the longest lasting effects to counter aging, some alternatives to surgery can assist patients looking to avoid surgery. Lower eyelid filler does not treat the puffiness in the lower lids but with successful injection of filler, the dark circles under the eye may be reduced and the contour between the eyelid and cheek smoothened. Additionally, radiofrequency technology such as Morpheus8 and Accutite may be used to tighten the overlying skin and possibly melt away some of the fat of the lower lid. Additionally, skin tightening alone either with laser or long term topical retinoid creams may soften some of the lower lid wrinkles.

Lower lid blepharoplasty will remove the protruding fat that causes puffiness. The doctors will remove and contour the fat that can be safely accessed. Dr. McDevitt and Dr. Sweeney actively avoid overcorrection, which can cause eyelid outturning, or a hollow appearance. While blepharoplasty is aimed at reducing the dark circles under the eye, occasionally the dark circle may still be somewhat visible postoperatively and further treatments may be needed. Additional treatments may include filler to the upper cheek, additional skin tightening, or even further surgery.

The first week after lower lid blepharoplasty may show bruising and swelling that can be reduced with postoperative icing. Patients can expect most bruising to resolve after 2 weeks and most swelling to resolve after 3 weeks. Approximately 10% of the swelling in the lower lids can take up to 8-12 weeks to fully resolve. While this degree of swelling is not visible to the average person, you may notice this swelling when monitoring your postoperative progress.

Dr. Sweeney and Dr. McDevitt customize all their eyelid procedures to be harmonious with the patient’s appearance. For cosmetic blepharoplasty surgery, removing and/or redistributing lower eyelid fat will be discussed and planned for surgery to meet your goals.

Yes, they can. Dr. McDevitt and Dr. Sweeney routinely combine upper and lower blepharoplasty with or without skin resurfacing. Patients commonly request for this because they want to take on the bruising and swelling all at one time and regain a more youthful appearance in the upper and lower lids symmetrically.

The results of a lower lid blepharoplasty provide a rejuvenated appearance to the face and lower lids. However, lower lid blepharoplasty does not stop aging and your body may develop more lower eyelid fat and lower lid wrinkles years after surgery. The gains made with blepharoplasty will not be lost, however, patients may request for a touch up blepharoplasty 20+ years after it is initially performed to maintain a refreshed look.