Lower Eyelid Blepharoplasty (Bags or Dark Circles)

Lower eyelid bags and dark circles are two of the most common reasons patients see us for a cosmetic surgical consultation. Commonly, patients are concerned about people commenting that they appear tired or less rested. There are many reasons for the development of dark circles and lower eyelid bags and we will explore those in detail below.

Any rejuvenation plan needs to consider all the variables and design an individualized plan for each patient. The eyelid area is delicate and any treatment plan should respect the nuances of anatomy of this region while respecting the functional relationship between the eyes and the eyelids. Unfortunately most plastic surgeons who perform multiple types of surgeries utilize a “standard” approach toward eyelid surgery. Owing to their relatively limited exposure to the eyelid region, they tend to follow a generalized surgical technique.

As you will see, not everyone needs the same treatment, and not every surgery is “cookie cutter”. In our practice, cosmetic eyelid treatments are performed under the direct supervision of a fellowship trained ophthalmic plastic and facial reconstructive surgeon. We specialize in the art of eyelid rejuvenation, and promise you the expertise that you seek in reaching your aesthetic goals.

WHAT CAUSES LOWER EYELID BAGS AND AGING?

  • Genetics: The blue print of life is handed down from our parents. Thus, it is very common for patients to take after their parents when it comes to their skin.
  • Lifestyle: Reports show that approximately 30 percent of aging is genetic, and 70 percent is up to you – how you care for and protect your skin, your body, and the lifestyle you lead. During your initial evaluation, we will delve deep into these factors to offer you a personalized treatment plan that offers lasting results.
  • Thinning of skin: With age, our skin stretches, which leads to excess skin folds/wrinkles on upper and lower lids.
  • Fat Herniation: With age, a structure called septum thins, which causes fat in the eye socket to bulge forward.
  • Loss of volume: As part of the aging process we continue to lose volume in the face, which contributes to bags.
  • Changes in facial bones: Facial bones are dynamic and change with age, which contributes to eyelid bags.
  • Lack of sleep: Sleep serves an essential role in eliminating toxins and rehydrating facial tissue.
  • Caffeine, alcohol or smoking: Studies have shown that diuretics such as coffee and alcohol accelerate aging.
  • Sun exposure: Sun exposure can significantly accelerate the aging process.
  • Diet: A balanced diet is key. Green vegetables and diet rich in antioxidants help slow down the process of aging.
  • Allergy: Redness, itching, darker pigmentation and thickening of the eyelid skin may be a sign of allergy.

I DON’T THINK I AM READY FOR SURGERY. IS THERE ANYTHING ELSE LESS INVASIVE TO HELP WITH DARK CIRCLES?

Every patient is different. There are a multiple reasons why people get dark circles and every patient’s needs are unique. Identifying the underlying cause is the most important and effective way to treat them. Also, not every patient needs surgery. In fact about 50% of the patients that see us for eye rejuvenation will not need surgery and they will benefit from minimally invasive procedures such as volume restoration, Botox, lasers, peels and eye creams.

During the initial consultation, Dr. Bedi and her team will perform a detailed review of your risk factors and suggest a holistic treatment plan that is personalized to you. Based on the results of your comprehensive skin evaluation, we will offer a carefully selected plan that may include advanced cosmeceuticals as well as laser based therapies to help you achieve your desired aesthetic goals.

WHAT ARE THE SURGICAL OPTIONS FOR LOWER EYELID SURGERY?

Trans-conjunctival Lower Lid Blepharoplasty:
This involves making the incision behind the eyelid. This is the most ideal procedure for younger patients or those with very little loose skin on the lower eyelid. The incision is then used to access the prolapsed orbital fat for repositioning or removal. If the patient has redundant skin, a pinch of skin could be removed, or the patient may need lasers or chemical peels to address this variable.

Trans-cutaneous Lower Lid Blepharoplasty:
The incision is made about 1 to 2 mm below the eyelashes on the lower eyelid. This procedure is best performed on older patients or those that may have significant redundant skin. This procedure can also be combined with a SOOF lift to achieve more harmonious cheek and lower lid junction.

CAN OTHER PROCEDURES BE COMBINED WITH BLEPHAROPLASTY?

Because of their close proximity to the eyelids, the eyebrows and cheeks play an important role in the final aesthetic outcome of the procedure. During the initial evaluation, depending on your needs, a browlift or a mid-facelift procedure might be recommended in combination with the blepharoplasty.

HOW LONG DOES LOWER EYELID BLEPHAROPLASTY SURGERY TAKE?

A typical primary eyelid surgery takes between one to two hours. No patient is ever rushed to achieve the best results.

WHAT TYPE OF ANESTHESIA IS USED?

Most eyelid surgery can be performed under local anesthesia. Before your operation, relaxing medication is given to make you feel relaxed and less anxious. A numbing medicine is placed in the skin of the eyelid. During the procedure you will be comfortable and relaxed. If desired, local anesthesia with sedation can be performed under the supervision of an anesthesiologist. We will review this option at the time of your consultation to ensure your comfort during the procedure.

WHAT IS RECOVERY LIKE FOR LOWER LID BLEPHAROPLASTY SURGERY?

Depending on the person’s previous medical history there will be some swelling and bruising around the eyelids for one week. Most patients can return to work after 5 to 7 days. There is minimal eye discomfort after the procedure. Ice packs are recommended for the first 2 days to decrease swelling.

I AM INTERESTED! HOW SHOULD I PROCEED?

If you are considering this procedure we encourage you to schedule a private consultation with Dr. Bedi. During this visit, she will provide a comprehensive evaluation and discuss your aesthetic goals. If you are a suitable candidate depending on your gender, ethnicity, and age, a customized procedure will be tailored for you.

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