Will lower blepharoplasty solve this issue? (Photo)

Question

The area under my eyes has become hollow and congested with veins in recent years. They also are puffy at times. The area where my lower eyelid meets my cheeks is not a smooth transition. It’s almost like my orbital bone is visible and you can see the dip where my eye socket is. Not interested in fillers as I’ve had them before and I’m not a candidate due to puffiness in the under eye area. Would I be A good candidate for a lower Bleph?

David Samimi, MD · Answer

Thanks for sharing your question with us. Your concern about seeing the bone underneath your eyes is a common concern with patients. The soft tissue over the orbital rim: skin and orbicularis muscle is very thin, and the ideal treatment would be to put something to cushion that transition between the lower eyelid and cheek. Filler is the easiest and initially inexpensive option but as it sounds like you know, it has a very high rate of looking unnatural even in the best of hands. When it comes to surgical options, I would highly advise against having lower lid fat removed, this will just lead to more hollowing. Although I feel you notice this issue way more than others do, if you are set on doing something, the best chance of a natural looking and safe results would likely be lower eyelid transconjunctival blepharoplasty with fat repositioning, and given that there isn’t much fat to reposition you should consider doing concurrent fat grafting with a provider very experienced in this technique as there is little room for error. Best luck on your journey!

Randal Haworth, MD, FACS · Answer

The medical procedure known as blepharoplasty, or eyelid lift surgery, is designed to reduce the appearance of sagging skin and swelling in the eye and eyelid area. It is a commonly performed cosmetic surgery for both males and females. 3 variants of the lower blepharoplasty exist.

Fat can be carefully transferred to the “hollows” below the eye to produce a smooth transition from the lower eyelid onto the upper cheek.

I hope this helps,

Good luck.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photo your under eye area looks fine. I do not recommend you a lower eyelid blepharoplasty. For more upward and tense looking in your eye are I suggest you a endoscopic brow lift surgery. If you can provide photos with better lighting, from the side of your face and 1 meter away I would be able to make a proper evaluation. Best Regards!

Donald B. Yoo, MD, FACS · Answer

For a smoother eyelid to cheek transition, transconjunctival lower blepharoplasty is a great option. Excess fat is removed from the lower eyelid to reduce puffiness, under-eye bags and wrinkles which helps restore a more youthful appearance. Results are certainly surgeon dependent, so it's important to do your research in finding an experienced surgeon. Have him/her evaluate you in person and discuss your options. Goodluck! @drdonyoo

Soon-Dong Kim, MD · Answer

It seems that there are some probs. First of all, as you mentioned, you have puffy undereyes. In that case, we recommend Transconjunctival Fat Reposition to make firm. Another problem is congested veins, but it's because of thin skin. It can be solved with fat graft after the fat reposition surgery. We can do it at the same time or separately (to check the result after the first surgery). But even after the surgery, the fine wrinkles will be remained, only Botox can make it better. If you have further questions then please leave the message:) Thank you!

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

What you are seeing underneath your eyelid is a depression caused by the attachment of your lower eyelid skin to the orbital bone by a structure called the Arcus Marginalis.

A specific type of lower blepharoplasty can problem but you will not find many people who utilize this technique.

This technique is done through a transconjunctival incision on the inside of the lower eyelid.  A small amount of excess lower eyelid fat that is causing puffiness is removed and portions of it are saved to placed back in as a free fat graft.

The arcus marginalis is then released from the bone so that the eyelid skin is free to move down on the cheek without the depression.

Happy small portion of the fat is placed is a fat graft over the bone to prevent the arcus marginalis from reattaching and creating a dark circles under the eye.

Will lower blepharoplasty solve this issue? (Photo)

Answers (6)

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