Eyelid surgery, both for upper and lower eyelids, is called blepharoplasty. Blepharoplasty can be either functional or cosmetic in nature. The procedure can be performed on the upper eyelids, lower eyelids, or both at the same time.
There are multiple approaches to performing lower eyelid blepharoplaty, which is considered mainly a cosmetic procedure. Lower eyelid surgeries are safest to perform within an outpatient surgical center under a mild anesthetic and usually take about an hour.
In some lower eyelid surgeries, only fat needs to be removed to help the appearance. In these cases, a surgeon makes an incision through the inside of the lower eyelid. Since the incision is on the inside of the lower eyelid, there is no visible scarring.
The ideal patient for cosmetic lower eyelid surgery for fat removal is younger, with minimal lower eyelid skin aging and laxity.
Another approach to cosmetic lower eyelid surgery is to make an incision along the lower eyelid margin right below the eyelash line. With this approach, the laxity of the lower eyelid skin can be addressed along with fat removal. In some cases, there can also be fat repositioning of the lower eyelid to correct for tear trough deformities.
A tear trough deformity is an indentation at the orbital rim or the lower eyelid connection to the cheek which becomes more prominent as a person ages and the cheeks drop. This deformity can cause dark circles around your lower eyelids to become more pronounced. Injecting dermal fillers (Juvederm Ultra, Perlane, Radiesse) in this area, in conjunction with cosmetic lower eyelid surgery, can help to greatly resolve this deformity.
The surgical incision made with this type of lower eyelid surgery is called a subcilliary incision and heals beautifully with very little scarring.
As there is with any type of surgical procedure, there are risks and complications associated with this procedure. These complications, although not common, can include, but are not limited to bleeding, infection, change in eyelid function or appearance, scarring, ectropion (eyelids turning away from the eye), entropion (eyelids turning towards the eye), loss of eyelashes, trichiasis (misdirected eyelashes), dry eye syndrome and/or blindness.
When considering lower eyelid blepharoplasty, it is recommended that you choose a board-certified oculoplastic surgeon. This is typically an ophthalmologist who has been certified in plastic surgery in and around the eyes. It is very important for a surgeon to be familiar with the eyes and their functionality to best perform lower eyelid surgery.