Would I benefit from a lower blepharoplasty w/muscle sling? (photo)

I have been feeling as though my eyes have aged considerably over the past few years. Feel as though I've lost volume in my face as well. I am 37 years old and am hoping to get rid of the bags under my eyes, dark circles and space between my eyes to where my cheeks start. Will a lower blepharoplasty w/sling accomplish this? I am very nervous about doing facial surgery. Also don't want my eye shape to change. Anyway to adjust my brows so they are even?

Doctor Answers 6

Lower blepharoplasty

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Lower lid blepharoplasty should ideally preserve most or all of a patient’s lower lid fat, unless there truly is marked excess that is bulging outward. Fat can not only be treated by removal – it can also be restrained, and it can even be repositioned into areas of hollowness such as the tear trough. In addition, fat can be added to areas of hollowness in and around the lower lids to camouflage or ‘correct’ adjacent areas of fullness. I frequently perform structural fat grafting of the lower lid / cheek junction at the time of lower blepharoplasty, to add lower lid support and to blend the contour of the lid and cheek.
Fat grafting of the lower lid area requires experience and meticulous technique. As the area is covered by a very thin layer of skin and muscle, overcorrection must be absolutely avoided. My approach is to graft fat to the point that the area looks aesthetically ideal, then stop and wait 3 months to assess fat survival. As fat survival is variable, additional fat grafting procedures may be performed based on the results of the first. In most cases of post-surgical lower lid hollowness, two to three fat grafting procedures are required to restore adequate subcutaneous fullness in this area.  

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Lower lid blepharoplasty

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You appear to be fairly young with no skin excess. You are a good candidate for transconjunctival blepharoplasty. This is a safer procedure than an external approach as you don't disturb the skin and muscle layers. The recovery is therefore easier

Ben Lee, MD - Account Suspended
Denver Plastic Surgeon

Lower lid cheek junction can be corrected with several options

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Your photos show good skin character, but as you suggest, may be developing volume depletion at the young age of 37.  There are several options such as injectable fillers, fat transfer, or surgical blepharoplasty.  I would explore the non-surgical options before jumping to a surgical procedure.  I agree with Dr. Steinsapir's comments previously expressed in response to your question.  Regarding your brows, there is an underlying asymmetry of your eye structures that warrants consideration, more than what I can determine based on just one photo.  Best to have an in depth exam and discussion with a qualified surgeon to evaluate how this is bothering you.

Lower blepharoplasty for eye bags

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At 37 years of age there does not appear to be any  skin that needs to be removed from the lower lids since the skin tone is adequate. The herniated 3 fat pads of the lower lids create the puffy look which can be addressed through trans-conjunctival approach lower blepharoplasty. For many examples please see  the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Would I benefit from a lower blepharoplasty w/muscle sling?

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Based solely on your photos and without an examination it looks to me like any manipulation of the skin or muscle is unneccessary. A transconjunctival approach to sculpt the internal fat pads would probably e all that is necessary.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Have you seen a surgeon or is this question based on internet research?

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I can virtually guarantee that a lower eyelid muscle sling surgery will change the shape of your lower eyelid and not in a positive way.  Frankly I do not see that your mid face issues warrant this type of surgery which is basically a mid face lift variant.  It is hard to precisely know what you need without an actual examination.  Thank is because lumps in bumps in the lower eyelid contour can look the same but be caused by different things and need different surgical approaches.  I have you tried under eye fillers.  If you have not, I would encourage you to start there.  For quite some time, you might be very happy with the effects of that approach.

The issue with the upper eyelids is that you are beginning to develop upper eyelid ptosis and you have a compensatory brow lift.  Slight asymmetry in this process is pretty normal.  Surgery is generally used to correct this issue.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.