Do you find yourself looking tired or sleepy all the time, even when you are feeling as fresh as a cucumber? Are you tired of your tired eyes or with being told that you look tired all the time? We know this can feel exhausting!
While some people might have droopy eyelids or puffiness under their eyes from a young age, others may find it comes with aging. With age, most people develop puffy bags under their eyes, or their upper eyelids start to droop. It can make one look tired, sleepy, or older than their real age.
If you find this relatable, you might be a candidate for eyelift surgery, also called blepharoplasty.
Blepharoplasty is the surgical removal of excess skin, muscle, and fat in the upper or lower eyelids, which can reduce sagging and puffiness in the eyelids. For a quick rundown on how the procedure works and what you can expect from an eye lift or an eyelid surgery, you can check out our other blog.
Here, we’ll focus on everything you need to know about lower eyelid blepharoplasty. This eye lift procedure involves surgical removal and/or repositioning of the fat under the eyes and, if required, removal or tightening of any unnecessary lower eyelid skin. Local anesthesia with sedation or general anesthesia will be administered before the procedure.
Just as no two sets of eyes are the same, your doctor may need to customize the approach to your lower eyelids based on your unique features and individual desires in order to achieve the best results.
Here are some of the surgical techniques used in lower eyelid blepharoplasty.
1. Transcutaneous Lower Blepharoplasty
The bags under the eyes can be treated through an incision just below the eyelashes called a transcutaneous blepharoplasty. The decision to make this external incision depends upon how much skin needs to be removed or the amount of skin that requires tightening. If there is a lot of excess skin that needs to be trimmed, an external incision would be necessary. And since the incision is ~ 1 mm from the eyelashes, it would be virtually invisible.
2. Transconjunctival Lower Blepharoplasty
One of the most popular techniques used for lower eyelid blepharoplasty, called the transconjunctival approach, is performed by creating incisions on the inside of the lower eyelid. These incisions allow fat repositioning without causing damage to the eye muscle, and there is no scar or stitches. The fat transposition within these incisions addresses any present eye hollowing. Portions of fat below the eyes that are responsible for the puffiness are removed through this hidden cut.
3. Fat Transposition or Fat Transfer Lower Blepharoplasty
Instead of removing the fat bags under the eyes, which give a hollowed look, the fat transposition technique utilizes the excess fat from the lower eyelid bags to fill in the tear trough at the eyelid-cheek junction—the hollowed area underneath the eyes that creates dark circles. A small incision is done on the inside of the lower eyelid to transpose/transfer the lower eyelid fat. In cases where no under-eye fat bags are available for transposition, fat can be transferred from a different part of the body, like thighs or belly. The procedure is usually combined with a canthopexy procedure to correct the lower eyelid and cheek laxity simultaneously.
Postoperative care and recovery
Lower eyelid blepharoplasty is an outpatient procedure that allows you to return home the same day. The surgery usually takes about 1 hour, and obvious bruising and swelling may typically last for 2-3 weeks. The eyes are usually left open after surgery, though your vision may be temporarily blurry due to minor corneal swelling and the use of eye lubricants during the procedure. However, your vision will recover fully in 2-3 days. And most patients are able to return to work within the first week.
Depending upon your treatment, your doctor will give you certain after-care instructions for a safe and speedy recovery.
However, here are some common instructions to consider.
1. Apply cold compresses during the first 48 hours to reduce swelling and bruising
2. An ointment, antibiotic, steroid, or drops might be recommended for the first postoperative week
3. Strenuous activity must be avoided for 2-3 weeks after surgery
4. A follow-up visit is scheduled within a week of surgery, and non-absorbable stitches, if any, are removed.
5. In case of any concerning symptoms such as bleeding or signs of infection, patients are instructed to contact the doctor immediately.
Are there any non-surgical options for lower eyelids?
Apart from the surgical treatment options, there are other non-surgical or minimally invasive treatments to make your eyes look fresh and younger. Dermal fillers such as Juvéderm, Restylane, and others can be injected to fill in any hollowness in the lower eyelid, especially in the tear trough region. At times when eyelid bags are caused due to wrinkles in the skin, Neurotoxins such as Botox can also be injected to soften the wrinkles around the eyes. Other skin treatments, including skin resurfacing and chemical peels, might also be considered.
However, please be advised that a person’s skin may not always respond to these non-surgical treatments. In such instances, a surgical treatment option would be recommended as the only alternative. Also note, that the results of lower eyelid surgery last for years—much longer than short-term or temporary results from non-surgical eye lifts. Moreover, in the long run, the cost of repeated injections could add up to be more than eyelid surgery.
If you are considering getting an eye lift or blepharoplasty, you can read further about the procedure and recovery times. And if you are looking for a plastic surgeon with years of experience and satisfied patients, you can visit the office of Dr. Edmund Fisher. You can check out some of the before & after examples of his blepharoplasty results here. If you need assistance to help you determine which procedure is best for you, you can contact us or schedule a consultation with Dr. Fisher.