Is it better to have the Lower Eyelids surgery from the inside of the eyes?

The approach/incision for lower blepharoplasty is critical to not only the best results but also to avoid any unnecessary complications such as eyelid retraction, eyelid ectropion, or change in eye shape. Transconjunctival lower blepharoplasty involves making incision inside the lower eyelid with quick recovery, no visible scarring, and avoiding any of the mentioned complications. See following video and link for more details. See an oculoplastic surgeon for evaluation.

There is no skin scar.  It does not damage the muscle that hold the lower eyelid up against the eyelid.  It heals better and has much fewer complications.  The reason that not all surgeon use it is that you have surgeons out there who are not comfortable operating close to the eye.  Typically these are general plastic surgeons who lack specialized training needed to work close to the eye.

Hello and thank you for your question. There are several options for surgical techniques of the lower eyelid.  The best procedure truly depends on your individual anatomy.  An in-person consultation would be very helpful for you.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

 Thank you for sharing your good question. There are several ways to attack puffy eyelids. Sometimes, it's better to go through the skin, while other times approaching the fat from behind the lid is preferred. The most important decision is choosing the right doctor for the eyelid surgery. Make sure you see a specialist who is very experienced. Good luck,

Performing lower blepharoplasty from the inside, allows us as surgeons to reach the fat pockets directly without having to affect the muscle that holds the eyelid against the eye, or the layer that separates the front of the eyelid from the eye socket contents. Throuh the back approach, the fat can be removed or moved into a better position to correct the tear troughs, with fewer risks. Leaving the front of the eyelid layers intact, is safer and leads to more natural results. If skin tightening is also necessary, laser resurfacing or a skin pinch can be performed at the same time.