What type of options based off my photos would be recommended for lower eyelids?

Lower eyelids, giving me a fatigued tired look or makes me appear to be emaciated or sick. I also had a secondary question, i was also wanting gynecomastia surgery I don't believe I have much glandular tissue but definitely some soft fatty tissue also a issue since childhood. The question is it possible to have both procedures done together and could it cut some cost? I know I need a consult but was curious about possible feed back and if I could get some advice and maybe cost estimates. Thanks.

Doctor Answers 15

Do what these posting surgeons have not suggested-Examine your own eyelid.

Put your finger on top of the "bag."  What you are feeling is your bony orbital rim. That is not fixed with lower eyelid surgery which addresses skin muscle and fat.  That means that lower eyelid surgery will be a fail for you.  What I recommend instead is hyaluronic acid filler for the lower eyelid.  The best part is this is a service that is performed as an office visit without surgery.  Treatment lasts about a year.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Options for lower lids

Mid-face filler such as Juvederm Voluma along the zygoma, in combination with CO2 resurfacing of the lower lids is a good options for your eyelid/ orbital rim anatomy. You may want to find a specialist in your area who can discuss or provide SculpSure for the gynecomastia - this would be an off-label use, but likely effective in eliminating excess fatty tissue without surgery. (All of the above can be done in an office setting which lowers the expense.) Best wishes with your decisions.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Lower lids

Angel2728, You are an excellent candidate for a "SOOF lift blepharoplasty". Seek our an experienced surgeon that does "only faces" with top notch photos. See the video and good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews

Eyelid surgery

From your phots I would like to see your entire face. It appears you have herniated fat pads causing the under eyelid bulging. It appears you have exposure of your lower eyelid orbital rim. I also perform cheek lift to reposition the cheek pad to give the lower eyelid more support and cover up the appearance of the orbital rim 

Deborah Sillins, MD
Cincinnati Plastic Surgeon
4.6 out of 5 stars 12 reviews

Under eye bags...how should I treat them?

What you are seeing is essentially a fat herniation in the lower lid area.  This is deepening the "tear trough" area and makes it appear as though you are unrested or have dark circles under the eye.  It can be addressed in two ways: non-surgically with filler placed in the tear trough to camouflage the bag -OR- surgery to correct the fat herniation (which can be accomplished either through the inside of the eyelid or with a well camouflaged external incision -- the decision depends on a physical exam).  Gynecomastia surgery can certainly be performed simultaneously with this procedure.  In my practice, for example, my associate can perform body surgery at the same time that I am performing facial surgery.  We find that patients like this set up as it saves on OR and anesthesia fees.  Either way, seek out the consultation of a board certified facial plastic surgeon or plastic surgeon to discuss your eyelid issue.  

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 49 reviews

lower lid blepharoplasty procedure

From the limited photographs presented, it appears that there is herniated fat bags in the lower lids for which a trans-conjunctival approach lower blepharoplasty can accomplish rejuvenating the lower lids. This involves a conservative removal of the skin from the inside of the eyelids, so that there is no external incisions. Gynecomastia surgery and eyelid surgery can be performed simultaneously under the same anesthesia. For more information and many examples of eyelid surgery,  please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Lower transconjunctival blepharoplasty

Based on the pictures you posted, I would favor a lower transconjunctival blepharoplasty with fat transposition into the tear troughs. Your cheek volume and position should also be evaluated and taken into account during the planning process. Good luck! 

Elba Pacheco, MD
Annapolis Oculoplastic Surgeon
4.2 out of 5 stars 6 reviews

What type of options based off my photos would be recommended for lower eyelids?

Thank you for your question.  When examination is necessary for proper answer, however based on your photo a trans-conjunctival lower blepharoplasty with arcus release and fat grafting to plump the depression beneath her lower eyelid may be her best option.  The eyelid procedure can be done at the same time as your gynecomastia procedure if your plastic surgeon is comfortable doing both procedures.  Many plastic surgeons doing eyelid surgery only do oculoplastic surgery.

If you do not want to undergo a surgical procedure on your eyes injections of Restylane into the depression beneath her lid can camouflage the appearance of lower eyelid bags.  For more information please read below:

Lower eyelids...

You appear to be a good candidate for a combination procedure of fat removal plus injection into the trough underneath. It is important not to remove too much fat - only enough to knock the bag down some. At the same time, some fat is harvested from the body, processed, and injected into the crease under the eyelid. That creates a nice, smooth eyelid as a result and looks very natural.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 206 reviews


Thank you for your question. Blepharoplasty can create a more rested appearance in your eyes. It can also remove some of the fatty tissue in the under eyelid area. I suggest that you consult with a board certified facial plastic surgeon for an in-person examination and for the next steps to a successful solution.

Best wishes,

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 120 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.