Long term results of lower blepharoplasty?

Dear kristg,It is nice to see another one of your posts. You are approaching surgery preparation the correct way - gathering as much information as possible. If you see a board certified facial plastic surgeon who has the proper experience and training, then you will be less likely to be disappointed with your surgery outcomes. Patients commonly
ask how long eyelid surgery will last. Because tissue is being removed, one will always look better than they
would have had they not had the surgery. The reality is that we will continue to age and therefore, there will
always be changes and aging in this area. We are fortunate that eyelid changes do not occur as rapidly after
surgery as changes in other areas might.

Some individuals may
require repeat surgery, but most often we find that whether they have surgery
done at age 30, or at age 50, rarely does this procedure need to be
repeated. This seems to be connected to
the fact that the fatty tissue does not recur. Plus, the eye is located within the bony structure and appears to be
protected somewhat by the gravitational and environmental effects of aging as
contrasted with what happens with the cheeks, jowls, and neck area. These areas might need a follow-up procedure
after a complete facelift.Sincerely,Ross A. Clevens, MD, FACS

There are some patients who may be unhappy with any type surgery and lower lid bleph is no exception.  A lower lid bleph is a difficult surgery in that the skin is very thin here, and unforgiving.  With the thin skin, any irregularities in the fat pad may be noticed.  Many surgeons now will reposition the fat into the tear trough instead of removing it.  This can help prevent later hollowing of the lid which can occur with aggressive fat removal.  Excessive skin excision can result in ectropion.  And not recognizing eyelid laxity which can occur with aging can result in a poor lid contour post-op.  When done correctly the results can be excellent and will last for years.  Get some opinions, especially from some oculoplastic surgeons to discuss the surgery and your concerns.      

 Thank you for the question.As long as the surgeon is conservative with fat and skin removal, you should have no bad side effects down the road. Overly cautious surgery is the best surgery. See an oculoplastic surgeon for consultation and to evaluate if your particular eyelids have any unusual issues. Good luck.

Things have changed greatly in eyelid surgery over the last 20 years. Most surgeons have modified their techniques to correspond with newer information regarding fat distribution and bone resorption with aging. For instance, when I was trained, we were removing large amounts of fat from around the eyes, which, over time, left the eyes appearing hollowed out. Now most surgeons remove much less fat , choosing instead to redistribute the fat, and can achieve a more natural, long lasting youthful appearance to lower lids. I would recommend a Board Certfied Plastic Surgeon who has a special interest in eyelid surgery and experience with the latest techniques.

With a conservative well-done lower blepharoplasty, the results should be not only good, but also last for years.  This is however, one of the trickier surgeries in the plastic surgery toolbox, so it's important to have a surgeon with a light hand, conservative approach, and good analytical skills.  This is not an area of the face to take risks or push the limits.With any treatment, medication, or doctor, you will always find some people that are not happy with the results.  If it was easy, everyone would do it.  If the surgery "didn't work" however, you wouldn't find patient getting it and surgeons performing it for decades (or close to 100 years in this case).Any patient and their surgeon who has a complication will wish they had never had (or performed) the procedure.  Be sure to do your homework and consult surgeons to find someone competent and experienced.  Your health is worth it.  I've attached a link to an article for you for more information.

The goal of lower eyelid blepharoplasty is to remove a conservative amount of the fatty deposits creating the puffiness look. The secondary goal is to remove excess skin, when present ,on patients over age 50. The fat  is removed through a trans-conjunctival approach on the inside of the eyelids. If there is excess skin present, a pinch technique of excess skin is removed from the lash line, and closed with tissue glue in our practice. It is very important to seek out and expressed eyelid surgeon for natural results. For many examples, please see the link and the video below. 

A lower blepharoplasty can give long term very satisfying results. I am not sure exactly what you are concerned about.

When the surgery is done on the proper patient for the right indication, the result is very good and very long lasting. For young people with lower lid bags, the results last over 20+ years. Even older patients when the right surgery is done, the results are great and last for many many years.

Long term results should be good for at least 10 years if properly performed. If the procedure was not performed well, that is when people will not be pleased. You do not want to over resect fat or skin. I would recommend you see a board certified plastic surgeon who performs this procedure regularly.