A lower blepharoplasty, or more commonly referred to as lower eyelid surgery, is not just about removing the excess skin and fat beneath the eyes that contribute to their aged appearance. An equally important goal is to preserve the normal function and look of the eyelid.
The list below shows the different techniques used in blepharoplasty surgery and their adjunct procedures as well.
* Standard technique. It uses an incision placed directly below the lash line, allowing the surgeons to remove the excess skin and fat. However, the most important element is how much skin and fat can be [safely] removed without causing unnatural appearance and complications.
Lid retraction—or pulling down of the eyelid—is one of the most difficult complications, as it generally requires an extensive reconstructive surgery. For this reason, experienced plastic surgeons will always avoid over-aggressive methods, which can also lead to poor scarring and dry eye syndrome.
* Transconjunctival approach. It uses a hidden incision on the inside of the lower eyelid, so the risk of visible scar is eliminated entirely. But the technique is only suitable for patients with no or very little excess skin and whose main problem is the fat deposit under their eyes.
But instead of removing the fat altogether, most doctors prefer removing just a little and/or redistributing the fatty tissue to create a smooth transition between the lower lid and the upper cheek.
* Dermal fillers injections. While they are commonly used to correct soft tissue atrophy (shrinkage) that leads to the skeletonized eye socket, they are also helpful in smoothing out the under eye bags.
Dermal fillers can be injected right below the under eye bags so the cheeks and the lower lids will be at the same level.
* Laser skin resurfacing. It works by minimizing the appearance of fine lines and wrinkles. While it promotes skin tightness to some degree, it has no or very little effect on the redundant or loose skin.
The results of blepharoplasty lower lid are near permanent—i.e., the vast majority of patients will not need a touch-up for at least 10 years. However, it is a highly technical procedure that carries more potential risks such as lid retraction, making it important to achieve good results the first time around.