Lower Blepharoplasty Procedure

Lower blepharoplasty is cosmetic surgery of the lower eyelid. It is one of the most frequently performed cosmetic procedures and it aims to rejuvenate the lower lid and upper cheek areas. In a nutshell, the procedure removes or redistributes the fat and trims the excess skin to get rid of the bags and tighten the droopy skin of the lower eyelids. Dr. Alghoul is a highly specialized Chicago Facial Plastic Surgeon who specializes in cosmetic surgery of the eyelids and he personalizes this procedure to each patient to achieve the best aesthetic results.

Top-Rated Chicago Eyelid Surgeon Dr. Alghoul Explains Lower Blepharoplasty Surgery

When planning lower blepharoplasty (eyelid lift), Dr. Alghoul evaluates not only the lower eyelids but also the entire area around the eyes. A 3D photograph of the patient helps him clearly visualize the skin topography of the lower lid and cheek support. It also allows him to compare sides for symmetry. Several aspects of the eyes’ features are examined, including the shape of the eyes, the strength of the muscle around the eye (orbicularis oculi muscle), the laxity of the lower lid, the excess skin and the lines responsible for the dark circles. The cheek volume and bony support are also examined as they both play a critical role in the success of the operation.

Who is a good candidate for lower blepharoplasty?

Males and females with undesirable features of the lower eyelid/cheek area like bags, skin wrinkles, deep lines and dark circles.

How much skin and fat are removed?

There is a big misconception that the more skin and fat removed from the lower eyelid the better. On the flip side, taking out too much skin and fat can cause problems with hollowing of the lower lid and serious complications with eyelid position. Dr. Alghoul follows a balanced approach to lower eyelid surgery. The amount of skin and fat removed are dictated by each patient’s anatomy and specific features. Fat removal is always conservative and in many cases none of it is removed, but rather redistributed to enhance the volume of the area between the eyelid and the cheek.

What is a “tear trough” deformity?

A “tear trough” deformity is a line under the eye that starts from the inner corner of the lower lid (toward the nose) and extends outwards, separating the lower eyelid from the upper cheek. It looks like a depressed area under the eye if you’re looking at someone’s face from the side. It results from fibrous attachments between the skin and orbicularis muscle and the underlying bone. These attachments are known as the “retaining ligaments” of the face. The one responsible for the tear trough deformity is known as the orbitomalar ligament. This line or groove is responsible for the dark circles under the eye. This line is made worse when there is a fat bag immediately above it as this arrangement creates a peak and valley effect. We all have this line or groove under the eye to a variable degree. It is definitely more prominent in some people compared to others and it always worsens with age.

A mild tear trough can be camouflaged by adding volume to the area immediately adjacent to it. Hyaluronic acid hydrogel fillers and fat grafting are both acceptable methods to add volume. More severe ones, especially those that are associated with fat bags on top, are more successfully treated with lower blepharoplasty. The tight adhesions causing the deep line are released and fat is moved across that area from the eyelid to the cheek, creating a smooth transition and eliminating the peak and valley effect. As an experienced facial plastic surgeon in Chicago, Dr. Alghoul is pleased to offer all of these treatment methods.

Where are the incisions made for lower blepharoplasty?

This all depends on the type of technique performed. There are two types of lower blepharoplasty: transcutaneous and transconjunctival. In transcutaneous blepharoplasty, the incision is made immediately under the lash line and extends to the corner of the eye. The incision heals nicely and leaves an inconspicuous scar. This technique allows muscle and skin tightening and more control of fat contouring. In transconjunctival blepharoplasty the incision is made on the inside of the lower eyelid and no muscle cut is made. If there is excess skin, a separate skin incision is made under the lash line and the skin is trimmed. Each approach has its advantages and limitations. Dr. Alghoul will discuss with you in detail which approach will be best for you.

How long do the results last?

Results are long lasting. You will continue to age normally; however, the lower lids continue to look good and a repeat surgery is rarely needed. A tear trough correction is usually permanent.

What is the recovery time?

Lower blepharoplasty is performed as an outpatient procedure under general anesthesia. Bruising is common after surgery and usually resolves within a week. Swelling is also common and resolves gradually over two weeks. Skin sutures are absorbable. You may engage in light activity the day after surgery. Return to normal activity and going back to work may take up to one to two weeks. Abstaining from exercise is recommended for the first two weeks after the procedure. To shorten your recovery time, you are advised to avoid your usual intensity exercise for four weeks from the time of surgery. Lighter exercise is fine starting two weeks after surgery. Wearing sunglasses while outside during daytime hours, and reading glasses at other times, can camouflage the swelling around the eyes.

Where is the procedure performed?

Surgery is performed in the operating room either in the main hospital or at a surgery center.

Is lower blepharoplasty covered by insurance?

No. Lower blepharoplasty is a cosmetic procedure and is not typically covered by insurance plans in the U.S.

How much does lower blepharoplasty cost?

Lower blepharoplasty cost starts at $3,000 when it is done under sedation and averages $6,000 when done in the operating room under anesthesia. Cost may change depending on the surgery and additional adjunct procedure.

Who gets a “tear trough” deformity?

We all have this depression or groove under the eye to a variable degree. It is definitely more prominent in some people compared to others and it always worsens with age.

Are there alternatives to surgery?

A mild tear trough or depression can be camouflaged by adding volume to the area immediately adjacent to it. More severe ones, especially those that are associated with fat bags on top, are more successfully treated with a lower blepharoplasty. Hyaluronic acid hydrogel fillers and fat grafting are both acceptable methods to add volume. As an experienced facial plastic surgeon in Chicago, Dr. Alghoul is pleased to offer all of these treatment methods.

Contact Dr. Alghoul

If you’d like to schedule a consultation with Dr. Alghoul to discuss your lower eyelid surgery treatment options, please call (312) 695-3654 or contact us via email.