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Nothing is permanent but a lower blepharoplasty will result in improvement that is long lasting. With time a minor touch up may be required. Repositioned fat may move but is usually easily corrected.
The effects of lower lid blepharoplasty should last a very long time if performed properly, but no surgery is truly permanent. Your skin will continue to age and stretch, orbital fat can further bulge forward, and muscle tone can decrease causing drooping of the lower lid. If done at a relatively young age, you may need it touched up again as you get older. Taking good care of your skin with prolong the results.
Usually if performed well, the lower lids do not need repeat to remove fat which causes the puffiness. The skin may need some tightening surgically or with a laser or peel. Continuing with good skin care to maintain tone will prolong your result.
In our practice, we do not perform lower lid fat re-positioning due to the amount of complications and we have seen from the procedure. We remove a portion of the fat that is bulging disproportionate to allow rejuvenation of the lower lids. The fat can return, but usually 10-20 years later. For many before and after results of Blepharoplasty, please see the link and the video below
Yes, the surgery is permanent. That being said, it doesn't stop time. You will continue to age. Your skin will get thinner and develop more wrinkles. You will get more fat bulges with time.