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Unsure About Lower Bleph Results - 3+ Years Since Surgery.

I had big bags for a young guy and finally had them removed about 3.5 years ago. Although the bags are gone, there is a lumpiness and asymmetry to my lower lids that I feel self conscious about. I wear glasses, and I can live with it with them on. But I'd really love to wear contacts instead - I'm just not comfortable with the results. At the last followup with the doc he said, "Maybe you're just looking too close." What do you all think, am I? Can I do something to improve the lids? Thank you.

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11 Doctor Answers | Asked by Otosi in Englewood, CO

Doctor Answers (11)
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Results from blepharoplast can look worse as we continue to age

A lot of times after blepharoplasty the results may look good initially and then worse as we continue to age and lose volume as this can cause hollowness or unevenness. A lot of times additional surgery is not indicated, but filler can even it out. The lumpiness looks like it may be from a fat pocket that is now coming out. From the picture, putting filler in the area by a real expert (which is off-label), if done correctly, can give a nice result. I would use a... more

Uneven lids after lower blephs

From looking at your pictures it would appear that there are some structural elements that may help the appearance if adjusted. It is more than likely a combination of fat and muscle elements. Revisions after lower lid surgery are seen in approximately ten per cent of cases. All teh best, Talmage J. Raine MD FACS

Talmage J. Raine, MD

5 reviews

Chicago Plastic Surgeon

Bumps in lower lid

Your result is excellent, any bumps you see were there before only now visible because the big bags are gone. they can be trimmed but not without an incision and some risk of lower lid malposition. I think your doc is right. live with it, it's really a good change all in all.

Fat injections can rejuvenate eyelids

Your surgeon removed the fat, which is traditional, but can make the lower lids look a little flat. I don't see the bumpiness, but maybe I can't if it's something can has to be felt.. However, I do see the muscle bulges just below the lashes on each side; if that's what you are looking at, it is normal anatomy. You can have fat injected to fill out the skin a little and relieve the flatness. This surgery is VERY technique-dependent, so find an experienced... more

Video on Lower eyelid bag treatment: Removing eyelid fat is not always the best option

This is the classic presentation. The lower eyelid lift not resulting in actually making the lower eyelid look more youthful. The bags are decreased but there is something just doesn't look natural about a lower eyelid lift. I would watch the video below and go to my website for more information. There I discuss my theory on facial beauty, fat injections for lower eyelid bags (seems strange to some), and the Young volumizer. Thanks for reading, Dr Young see video

Philip Young, MD

6 reviews

Bellevue Facial Plastic Surgeon

Muscle bulge after Blepharoplasty is causing puffy eyelid look

I agree with the other doctors. Your bags have been removed but you have a bulging left lower eyelid muscle called the Orbicularis Oculi Muscle. This can be reduced by surgical excision but I would try a tiny amount of Botox or Dysport first

Lower eyelid surgery can have two approaches

I think you have a great result if your surgery was done transconjunctivally (incision made on the inside of the eyelid) because the fat excess is gone. The photos suggest that you had this approach. This approach cannot deal with heavier eyelid muscle (orbicularis oculi) that sits infront of a type of cartilage support that strengthens the eyelid (this is just inferior/below the edge of the lower eyelid and is called the tarsal plate). That muscle "roll" needs to be reduced... more

Eyes look good after lower eyelid surgery

Your lower eyelids look good and you have a nice result from your lower eyelid surgery. The bags, seen in your before photos, are gone and the lumps that you see just below the lower eyelid lash margin is the normal shape of the lower eyelid muscle...which is normal. You need nothing further IMHO.

Bulge After Eyelid Surgery Due to Muscle

The fat removal from the previous surgery did remove the lower "bag" that you see in the pre-op photo. The bulge in the lower eyelid that persists is the muscle of the lower eyelid that holds the lid against the eyeball and squeezes the eyelid shut. Attempts to thin this muscle are met with varying degrees of success and run the risk of weakening the muscle to the point of functional impairment (inadequate motion of the eyelid, incomplete closure of the eyelids, change in... more

Don't let people treat the muscle roll.

First, you have had a very nice lower eyelid surgery result. It is a procedure that can be fraught with issues especially with such a big eye and you appear to have done great with this. Weakening the muscle roll along the lower eyelid will immediately compromise its function. The muscle is there to hold the eyelid against the eye so it acts to protect the eye and move tears around. BOTOX or surgery to debulk this muscle will create immediate functional (comfort)... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Lower lids bags

From the photos it looks like the lower lid fat was removed from inside the eyelid but you may have thickened eyelid muscle which protrudes. It appears to have been present before surgery. There may be less invasive ways to treat this (thin the muscle) with injections of Botox possibly. Surgical debulking of the muscle carries some risks. Finally filler treatment may soften the transition and improve appearance. There may also be a component of fluid... more