I have dark deep creases under eyes, fatty bulge, and deep tear through. Am I a Good Candidate for Lower Blepharoplasty? (photo)

I was so grateful for all professional advice received on previous post.Looking for answers again. I have dark deep creases under eyes, above them small fatty bulge, tear through area also deep. I am concern surgery may create a more sunken look or accentuate the dark creases? Not interested in fillers.Is Blepharoplasty for me? fat repositionning?Is there enough fat to reposition? Should I see an oculoplastic surgeon? Recommendations in Montreal?This tired look took my self confidence away!

Doctor Answers 17

Possible candidate for lower blepharoplasty

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I would say that you are a good candidate for lower blepharoplasty.  There are a variety of techniques that could be used to improve your appearance and each surgeon may have a preference of one over the others.  Unfortunately, I do not have a recommendation for a particular surgeon in Montreal, but I would recommend seeing either a facial plastic surgeon, plastic surgeon, or occuloplastic surgeon for a consultation.  In that consultation, you should be able to get your options for surgery.    

San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Lower eyelid blepharoplasty - good candidate

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You would be a good candidate for a lower eyelid blepharoplasty with fat repositioning with resuspension of the orbicularis muscle and a small amount of skin removal.  You would also benefit from a lateral suspension of the malar fat pad.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Lower Eyelid Surgery Techniques

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In general, depressions or creases underneath the eye that have a small fatty bulge respond well to procedures that reposition fat.  An experienced plastic surgeon who is skilled in blepharoplasty or an experienced oculoplastic surgeon can give a nice result. In the last several years, techniques have evolved that can likely help you a great deal with surgery, but experience is very important.  Reviewing post-operative pictures can help you be realistic about what can be achieved.

Transconjuctival blepharoplasty candidate

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Obviously an in person exam would be critical but based on  your photos and young age I would likely recomend a transconjunctival lower lid blepharoplasty. The results look very natural with no external incisions. I dont think you would need a fat transfer but that would be an option. A surgeon in your area with extensive experience in lower lid blepharoplasty would be recomended. Below is some information to help better understand the procedure.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

Lower eyelid surgery

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From your photos, it looks like you do have fat bulges in your lower eyelids. They can be removed easily with surgery. It is hard to tell whether you have excessive skin or wrinkled skin as the skin has to be dealt with as well. Ablative laser can be used to shrink your lower eyelid skin at the same time the fat is removed.If you have excessive skin, then it needs to be removed.


David Ellis MD FRCSC

Toronto Facial Plastic Surgeon

Art of Facial Surgery

David A. F. Ellis, MD
Toronto Facial Plastic Surgeon

Blepharoplasty improving eyelid contour

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It appears that you would be a good candidate for lower eyelid blepharoplasty.  I think it is likely that fat repositioning would be indicated to help fill the tear troughs.  Skin tightening could be accomplished with either a resurfacing procedure or a pinch excision.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Lower eyelid surgery to correct deformities

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I would recommend a lower blepharoplasty with minimal fat removal, and fat repositioning or grafting to the hollow areas, or tear trough. You should have enough excess eyelid fat for this. A transconjunctival approach is ideal for you, using an incision inside the lower lid. A conservative laser or chemical peel will tighten the skin adequately and help the dark circles most likely. A facial plastic or occuloplastic surgeon is recommended, or a general plastic surgeon who performs frequent blepharoplasty.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

Lower blepharoplasty candidate

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 You are  a great candidate for a lower transcontinental blepharoplasty for removal of  fatty deposits and a pinch  technique for excess skin.   The skin pinch involves a small incision on the external portion of the  eyelid at the lash line and a very conservative amount of skin is removed. The incision is closed with Histocryl tissue glue. For example similar to your own, please see our photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Candidate for lower blepharoplasty

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Based upon the photos you submitted, it appears that you would be a good candidate for transconjunctival lower blepharoplasty perhaps with fat transposition. Depending upon your skin type a pinch or a laser procedure to tighten the lower lid skin may also be helpful. I am sure there are many qualified physicians in the Montreal area.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Candidate for lower blepharoplasty in patient with a forward set globe?

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You appear to be a good candidate for lower eyelid surgery, but not for conventional lower eyelid surgery.

Your eyes project forward (proptotic globe, forward set globe), and a midface technique (such as a superficial cheek lift) that supports the lower eyelid would be necessary to avoid pulling down of the lower eyelid.

Fat repositioning or reduction would also be possible.  Lower eyelid consultations often take us 1 hour because the many issues raised in the consultation, methods available, review of publications, etc. take time to explain.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.