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What to ask about Lower Eyelid Surgery

Lower eyelid surgery, or lower eyelid blepharoplasty, is surgery aimed at correcting the aging of the lower eyelids. This article is a primer for anyone considering lower eyelid surgery. A thorough consultation with a qualified surgeon is still required.

Blepharoplasty is defined as “any operation which corrects a defect in the

eyelids.” This can be an upper eyelid procedure or a lower eyelid

procedure. While it is important to know about both, lower eyelid

surgery poses a greater challenge. Lower eyelid blepharoplasty

usually aims to get rid of bags under the eyelids and produce a

less tired look. It is important to consult with a qualified

surgeon before undergoing any surgical procedure and this article

poses a few questions to ask the surgeon during a consultation.


What type of incisions will you use?


There are several approaches that can be used to access the lower

eyelid. Some incisions are made on the inside of the lower eyelid

and are not visible. Others are made just below the lash line and

when healed, are nearly imperceptible. The approach used depends

on many factors and the surgeon can discuss these thoroughly.


Is my lower eyelid loose?


When performing lower eyelid surgery, it is important to ensure

that the lower eyelid is tight enough. If the eyelid is not tight

enough, there is a greater risk of pull down of the eyelid after

surgery and resulting dry eyes and eye exposure. To test if the

lower eyelid is loose, the surgeon will pinch the lower eyelid

and pull it out. If it takes a long time to retract or requires

a blink or two to return to a position against the eye, the lower

eyelid is loose. If the lower eyelid is loose, a procedure can be

performed to tighten the lower eyelid. This can be performed at

the same time as lower eyelid surgery and should be discussed

before proceeding with surgery.


Will this surgery take away the bags and lines under my eyes?


Most patients who have bags under the eyes have what is called

pseudoherniation of fat. This means that the fat that normally

exists around the eyeball has pushed out past the edge of the

bone of the eye socket, producing the bags. In some patients, the

bags under the eyes are actually on the cheek and lower eyelid

surgery will not fix this. In addition, if discoloration of the

skin is a concern, it is important to ask the surgeon if just

operating on the lower eyelid will fix the discoloration. Most

of the time, the dark circles under the eyes are due to shadows

from the fat. At times though, this discoloration is due to

pigment in the skin. If pigment is the problem, additional

procedures may be required to address just the discoloration

below the eyes.


What is my recovery time?


While every patient is different, bruising, swelling, and bleeding

are generally the limiting steps for return to normal activities.

Different approaches to the lower eyelid will produce different

amounts of bruising and swelling. Be sure to consult with your

surgeon about expected time away from normal activities.


Above all, research the procedures you are thinking of having and

research the credentials of the surgeon you are considering. While

this is not a complete list of questions you might want to ask, it

is a starting point. It is of utmost importance to discuss your

expectations with your surgeon to ensure that your goals can be



D.J. VerretFind Article, MDFacial Plastic & Reconstructive Surgery

Source: Free Articles from


Dr. Verret is a facial plastic and reconstructive surgeon in Plano, Texas.  He is board certified in Otolaryngology Head & Neck surgery and is fellowship trained in facial plastic and reconstructive surgery.

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