Lower Eyelid Blepharoplasty

Lower Eyelid Blepharoplasty

Blepharoplasty is the plastic surgery operation for correcting defects, deformities, disfigurations of the eyelids and aesthetically modifying the eye region of the face.

What does Blepharoplasty do?

Blepharoplasty resolves any functional problems (like blocking of vision and intense pain) or cosmetic problems (like asymmetrical eye shape in the face) in and around the area from the eyebrow to the upper portion of the cheek by excision and removal or repositioning of the excess tissues (unnecessary skin and adipocyte fat).

Goals of blepharoplasty

There are certain operative goals of a blepharoplastic procedure

  • Restoration of correct functioning of affected eyelids
  • Restoration of aesthetics in tye eye region (by eliminating excess skin from the eyelids)
  • Smoothing the underlying eye muscles
  • Tightening the support structures
  • To produce a smooth transition from the lower eyelid to the cheek

What is the difference between blepharoptosis and blepharoplasty?

Blepharoptosis (also known as ptosis surgery) is the medical corrective surgery used as a treatment method for ptosis.

Blepharoplasty is the formal name of eye lift surgery, the cosmetic procedure for the eyelids to improve the appearance

In what cases in blepharoplasty necessary

If the eyelids become swollen permanently due to excess fat inside them or if there are puffy eye bags under the lower eyelid ruining the appearance of the face, blepharoplasty is used as a treatment surgery option.

If the lower eyelid ages, the excess skin, muscle and fat may cause an unattractive bulge to develop below the eye. The bulging of the orbital fat may be caused by the weakening of orbital septum that occurs due to aging. This requires transcutaneous blepharoplasty where an incision is made through the skin to resect excessive orbital fat and redundant muscle and skin if needed.

But a new transconjunctival blepharoplasty is fast becoming the alternative technique to the transcutaneous blepharoplasty – in this method, the incision is made through the lower lid conjunctiva, thereby avoiding external incision. This also means there is no visible scar and this method is also helpful in clearing many lower lid malpositions.

Why choose transconjunctival blepharoplasty?

There are a few notable complications in transcutaneous blepharoplasty that include

  • Change in the shape of the aperture after surgery
  • Inferior sclera show
  • Malposition of lower eyelid

The above complications do not arise as frequently in transconjunctival blepharoplasty, especially if the patient has minimal laxity in skin and would not require skin excision. The transconjunctival blepharoplasty is also safer and more effective due to minimal complications.

While the transcutaneous blepharoplasty involves making changes in the orbital septum that might mean eyelid malposition after the surgery, the transconjunctival blepharoplasty does not violate the orbital septum.

The transconjunctival blepharoplasty is preferred for younger patients who do not need skin excision and older patients who have mild to moderate skin redundancy.

Functional need for blepharoplasty

A functional blepharoplasty is performed for medical reasons to remove loose skin from upper eyelid.

The medical conditions that might require blepharoplasty are:

  • Eyelids drooping low enough to avoid impair vision
  • Irritation from excess folds of eyelid skin rubbing together
  • Forehead discomfort from overused muscles to lift eyelids

Cosmetic need for blepharoplasty

As with any cosmetic surgery, the cosmetic blepharoplasty is performed with the goal to improve the appearance and acquire the desirable cosmetic effects instead of being medically necessary. It is performed to correct droopy or sagging eyelids that occur due to aging. The eyelid skin stretches and the muscles weaken, making the fat bulges more prominent. The condition might also be hereditary or acquired due to lifestyle changes. Though these surgeries are cosmetic in nature, they are performed by ophthalmologists and oculoplastic surgeons

Lower eyelid surgery – the why and how

Eyes are the most prominent features in the face and reflect the body’s health condition clearly. A drooping fat lower eyelid causes eye bags that give a tired appearance to the face. Blepharoplasty is performed in the lower eyelid and is a form of eyelid surgeryyelid surgery or blepharoplasty corrects tired looking puffy eyes and sagging lower eyelids and is more cosmetic in nature because there isn’t much obstruction in vision. Puffy eyes that cause under eye bags due to lower eyelid fat prolapsed, loose skin accommodated as fat pockets, and unrecognised problems with lower eyelid support are treated by blepharoplasty of the lower eyelid.

to remove under eye bags, loose skin and loose tissues in the lower eye area.

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Who requires lower eyelid blepharoplasty

Anyone with a permanently tired look even with plenty of sleep, under eye bags throughout the day and not just during tired nights, excess skin around the eyes, can go for lower eyelid blepharoplasty surgery.

Doing a lower eyelid blepharoplasty can have a great effect on the aesthetic of one’s face. The appearance of tiredness due to eye bags can be corrected with the lower eyelid blepharoplasty surgery. The face also gets a youthful appearance when the sagging eyelids are toned.

Dr. Debraj Shome is a surgeon who specialises in ptosis surgery (blepharoptosis) and blepharoplasty. He takes special care to ensure pleasing cosmetic after effects of surgeries that have both medical and cosmetic requirements.


About Dr. Debraj Shome

Debraj Shome-2
Debraj Shome, MD, DO, DNB, FRCS (Glasgow), FICO (USA), MNAMS, MBA (Healthcare Management, Vanderbilt University, USA), is Consultant Facial Plastic Surgeon, Oculoplastic Surgeon & Cosmetic Surgeon at Nova Specialty Surgery, Mumbai, India..Read more

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