A lower blepharoplasty is a surgical procedure to address sagging skin, excess fat, or bot,h in the lower eyelid. While it’s a fairly straight-forward procedure with a quick recovery, it is one that can completely rejuvenate your entire face. 
The reason for this big payoff is two fold. The eyes are typically the first thing that you perceive about someone’s face which means, unfortunately, that aging in this area is particularly noticeable. The eyes are also an outward expression of your personality. If they are looking “run down,” it can make you feel that way as well. Dr. Stafford Broumand of New York City walks us through lower eyelid surgery and why it is so important to see a heavily-experienced surgeon.
What is a Lower Blepharoplasty?
The skin around the eyes is extremely delicate. It is constantly moving as you smile, squint, frown and laugh. The end result is that your eyes are often one of the first areas to show the earliest signs of aging. In the upper eyelids, this manifests as excess sagging skin. People will often complain about their eyes looking “hooded” or “heavy.” But in the lower eyelids, aging shows up in three ways:
- excess skin
- bulging fat
- a combination of the two
Eyelid surgery, or blepharoplasty, is a procedure to surgically remove bulging fat or bags under the eyes and/or excess, loose skin. While some patients have other subtleties that need to be addressed, these are the two main components.
Critical: Do Not Change Character of the Eye
“The eyelids are the gateway to the character of a person,” explains Dr. Broumand. This is one of the reasons why it is so important to see a really experienced surgeon who will rejuvenate your eyes without changing them. “From my standpoint, I think it’s a great operation because it improves the overall look of the face,” he continues. “Our goal with lower eyelid surgery is not to change the character or the presentation of the face,” because it is vital that the patent’s personality still be apparent in his or her eyes.
Though extremely effective, lower eyelid surgery is a delicate surgery. “It’s on a teeter-totter,” explains Dr. Broumand, and “if you go too far [by removing too much skin or fat], you shift that balance.” Your surgeon has to understand not only the subtleties of how the skin and fat work around the eye, but also how the eyes interact with the rest of the face.
Lower Eyelid Surgery
The procedure itself is fairly simple. It can be performed either under local anesthesia in an office, or under general anesthesia in a hospital or surgery center. Dr. Broumand uses the transconjunctival approach with his lower blepharoplasty patients. With this approach, the surgeon makes an incision not at the edge of the eyelid, but actually inside the lower lid through which he or she can access any excess fat and/or skin.
The nice thing about this approach is that any subsequent scar is completely hidden. The benefits of a blepharoplasty are also noticeable immediately. However, you can expect to be bruised and swollen for about 5-10 days, so you will need time to recuperate. The payoff is eyes that look more alive, awake and youthful. And, bottom line, when your eyes look better, you feel better about yourself.
Blepharoplasty: Alone or in Combination
When a patient comes in for a lower eyelid surgery consultation, Dr. Broumand assesses the whole face, since everything works together. A lower blepharoplasty can be performed alone or in combination with an upper blepharoplasty, brow lift or facelift. Also, there are non-surgical treatments that may help to push off surgery. These include Botox for the crow’s feet, a TCA peel, chemical peel, or CO2 laser to address hyperpigmentation and skin texture issues, and fillers for the tear trough or hollows under the eyes.
A youthful eyelid is a fuller eyelid. This is why fillers, or a patient’s own fat, can rejuvenate the upper and/or lower eyelid by increasing volume. All of these procedures are extremely safe and can be performed at the same time to deliver a fresher, more awake look without changing the character of your face. In Dr. Broumand’s office, their motto is: “Less is more.” You never want to lose the sparkle in a patient’s eyes by taking too much away. “Doing less gives you a better outcome in eyelid surgery,” he shares.
Patient Satisfaction is Extremely High
Lower blepharoplasty is a surgery with a high patient satisfaction rating. It’s a quick operation with relatively little downtime that produces amazing results. It’s also a great operation for both men and women. In fact, there is almost a 50/50 split between the genders for lower eyelid surgery. “The bags under the eyes make men look tired and makes women look aged,” explains Dr. Broumand.
The key to a successful result is to see a surgeon with the skill and expertise to understand the delicate balance of how much skin or fat to remove and when to leave well enough alone.
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