Lower Eyelid Blepharoplasty
Our eyes are the focal point of the face. When asked what they notice when meeting a person for the first time, the usual response is the eyes. Many of our patients opt to have eyelid surgery to rejuvenate sagging, droopy eyelids and surrounding skin. Some people, often due to genetic influences, have more issues with their lower eyelids and under eye bags.
Dr. Eftekhari performs lower blepharoplasty to remove under eye bags and rejuvenate the eyes and face.
How does lower blepharoplasty surgery remove under eye bags?
The lower eyelids are one of the first areas on the face to really show the signs of aging. Lower blepharoplasty, colloquially known as under eye bag removal, involves surgical sculpting and contouring of the lower eyelids. This is a delicate procedure that significantly improves sagging skin and under eye bags. This surgery tightens sagging lower eyelids and removes excess skin, as necessary. Incisions are usually placed just below the eyelashes or inside the eyelid. These incisions heal very well without a noticeable scar in most cases.
Who is a good candidate for lower eyelid surgery?
The thin skin on our lower eyelids does not age gracefully. This is especially true in the high altitude and consistent sunshine of Utah. We spend a lot of time outdoors here, and that contributes to wrinkles in eyelid skin and under eye bags.
If you have excess lower eyelid skin and puffy bags beneath your eyes, this could be an excellent procedure for you. Patients often come to Dr. Eftekhari seeking to specifically to address their under-eye puffiness. This procedure will make you look more alert and refreshed.
Good candidates for blepharoplasty still have good tone in their facial muscles and tissue. Reality is — if you’re over 40, lower (and possibly upper) blepharoplasty will help you get rid of that tired appearance.
How is lower blepharoplasty performed?
These are delicate surgeries, but Dr. Eftekhari is board-certified and specializes in these procedures. Under his care, you’ll be sure to love your rejuvenated eyes. In the lower eyelid, there are two options for the incision. It can be made just below the lower lid eyelashes (subciliary) or behind the lower eyelid on the pink tissue (conjunctiva). Going through the conjunctiva (transconjunctival blepharoplasty) is Dr. Eftekhari’s preferred way to manipulate the lower eyelid fatty tissues because it is a scarless procedure. In some patients, excess skin can also be removed. Some patients also have a midface lift performed to tighten the lower eyelid and enhance the aesthetic result.
Dr. Eftekhari pays particular attention to fat in both eyelids, but particularly in the area under eyes. Some doctors remove too much fat, leaving the patient with a hollow appearance in that area. Dr. Eftekhari is focused on getting the a natural appearance with a fantastic aesthetic result. Instead of removing all the fat, Dr. Eftekhari can in some cases reposition the fat into the tear trough hollow below the eye to maintain a natural look. For each patient, Dr. Eftekhari develops a customized treatment plan.
What is the difference between upper and lower blepharoplasty?
The term blepharoplasty is used for both upper and lower eyelids, and in both cases it means improving your natural appearance to make you look less tired, angry or sad. The difference is in which part of your face most contributes to that -- is it the upper eyelids or the under eye bags? Most patients have obvious aging across both eyelids and under their eyes, and they opt for Dr. Eftekhari to work on both upper and lower eyelids at the same time. But some people have most of their visible aging on the lower lids and the area under the eyes. They opt for just lower blepharoplasty. Lower eyelid surgery targets the skin below the eyes to a degree, rather than just the eyelids.
Frequently Asked Questions
Are there non-surgical options to treat under eye bags?
For some people, the dark circles under their eyes can be treated in a non-surgical fashion with hyaluronic acid gel filler. Hyaluronic acid is a natural component of our bodies -- think about it as the lubrication that allows the cells in our body to slide past each other (extracellular matrix). Products like Juvederm, Restylane, Belotero, Versa and Voluma are hyaluronic acid that has been cross-linked to make it more viscous - like maple syrup - and longer-lasting so that it can be injected into the face and add volume. Dr. Eftekhari has extensive experience with filler - and unfortunately with fixing filler that was done inappropriately around the eyelids by other injectors.
There are certain products that perform better around the eyes, and Dr. Eftekhari will discuss this with you at your appointment. Dr. Eftekhari performs all filler injections himself. He is very careful about recommending filler because 1) it is only appropriate for certain candidates 2) it is not permanent - your body absorbs under eye filler after 1 year 3) if done poorly, it can cause boggy, bluish swelling in the lower eyelids.
Filler can treat certain kind of dark circles under the eyes, especially for patients in their 30s and 40s. But for patients that have a lot of excess under eye fat or wrinkled skin, lower blepharoplasty may be a better and much longer-lasting option. This will restore the natural appearance better than filler in most cases.
Is under eye bag removal covered by insurance?
Some patients have a droopy lower eyelid or malposition called ectropion or retraction. If this causes severe dryness of the eye, then sometimes the lower eyelid can be tightened as a medical procedure. Unfortunately, any procedure that is seeking to rejuvenate the under eye area or treat the under eye fat or wrinkles is not covered by insurance.
What is recovery like after lower blepharoplasty?
Recovery from eyelid surgery is not difficult. We’ll send you home with a cold compress and eye ointment. Use of that compress can really make a difference in your swelling and any subsequent bruising. This recovery doesn’t involve acute pain and you’ll often be able to manage it with over-the-counter pain medication. Your stitches will dissolve on their own. You will have some residual swelling, but you will already see a large improvement in your eyes. Your full results will show over the next couple of weeks as the last swelling runs its course.
Most patients can return to work after three days.
How soon will I be able to see my results from lower eyelid surgery?
Swelling will hide your results for the first week, although you’ll be able to notice the changes almost immediately. Once you are past the bruising and swelling, you’ll be amazed at how much more alert you look.
Most people feel that eyelid surgery, whether upper or lower or combined, takes about a decade off of your facial age.
How long does lower eyelid surgery take?
These are not long surgeries. Lower eyelid surgery usually takes 45 minutes per side.
Can I get under eye bag surgery if I have had PRK or LASIK surgery?
LASIK and PRK surgeries address the shape of the cornea and in no way affect the eyelids. Patients who have had either of these vision correction procedures can have blepharoplasty. Dr. Eftekhari wants his patients to wait three months after having LASIK/PRK before having this procedure, just to be sure the cornea has fully healed.