Is 38 too young for lower bleph (fat removal)? (Photo)

Question

I had two consultations for lower bleph and buccal far removal. The 1st surgeon I actually scheduled with will do the lower bleph in the office under twilight. He suggested a fat transfer to under eyes as well but I don't want that. I had another consultation and the dr would not do the lower eye procedure saying when I am 68 I may need another surgery and revisions are tricky. I understand that but my eye bags really bother me and there are no alternatives.Is it really necessary to wait?

Robert Singer, MD · Answer

38 is not too young to do a blepharoplasty if the appearance of your lower lids concern you.  Most expert experienced artistic plastic surgeons have a variety of procedures, both non-surgical and surgical, at their disposal to produce excellent cosmetic results in the appropriately selected patient: temporary fillers, micro-fat grafts, and blepharoplasties.  Each has benefits and drawbacks and depends on desired outcome and individual anatomy.

In a patient with your inherited anatomy, a blepharoplasty will produce the best and longest lasting cosmetic result.

Following the advice of anyone who would presume to tell you exactly what to do without taking a full medical history, examining you, feeling and assessing your tissue tone, discussing your desired outcome and fully informing you about the pros and cons of each option would not be in your best interest. Find a plastic surgeon that you are comfortable with and one that you trust and listen to his or her advice. The surgeon should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Sam Speron, MD, FACS · Answer

Thank you for this question. I hear this a lot from many patients in their 30s, and even 20s. Age is not the most important factor when concerned about eyelid sagging or asymmetry.  Yes, sagging eyelids can be corrected with blepharoplasty or cosmetic eyelid surgery of either the upper or lower eyelids. It is one of the first cosmetic surgeries people usually get. While the average age might be 30 to 50's, some patients get this done in their 20s. It really depends on your genetic makeup and anatomy in addition to what exactly is bothering you.  The lower blepharoplasty will help get rid of the under eye fat bag that are bothering you. It is also important to know that surgery doesn’t last forever, the average cosmetic surgery lasts about 7-15 years but can be longer for some people.

I would recommend that you see a board-certified plastic surgeon who is a member of both ASPS & ASAPS and has plenty of experience in eyelid surgery. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps answer your question. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Michal Brichacek, MD · Answer

Lower eyelid surgery is a complex problem, and if performed poorly can lead to significant issues. 
Based on your photos, it looks like you have tethering of the orbital malar ligament, fat herniation over top of the ligament, and some cheek hollowing. I feel that the best option for your would be release of the orbital malar ligament through a transconjunctival approach, together with transposition of the medial fat pad, and conservative reduction of the lateral fat. You may not even require any external skin removal, and may find that this alone is adequate. 
Fat grafting to the area could help in addition to this, but you may find you are happy without out. Filler is always an option if you aren't sold on fat grafting.

Leyla Arvas, MD · Answer

Hi, before eyelid surgery you can try under eye filler with cheekbone filler. These two would make you happy. Redensity II is a safe intervention that could be applied to the under-eye area. The procedure is performed with the help of very fine needles. This technique is applied to the upper part of the bone, not under the skin.

Mehryar (Ray) Taban, MD, FACS · Answer

There is no specific age requirement for lower blepharoplasty. What is most important is the technique. It is best to use transconjunctival approach with eye fat bags repositioning, not removal. See an expert.

Zoran Potparic, MD · Answer

based on this photo you seem to be good candidate for transconjuctival lower blepharoplasty. Addition of micro-fat and nano-fat grafts to cheeks and periorbital area would further improve result. Good luck.

Is 38 too young for lower bleph (fat removal)? (Photo)

Answers (10)

Answer: Young for lower bleph

Answer: Young for lower bleph

Answer: Lower blepharoplasty for under eye fat bags

Answer: Lower blepharoplasty for under eye fat bags

Answer: Lower blepharoplasty with fat/nano grafting

Answer: Lower blepharoplasty with fat/nano grafting

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Is 38 too young for lower bleph (fat removal)? (Photo)

Answers (10)

Answer: Young for lower bleph

Answer: Young for lower bleph

Answer: Lower blepharoplasty for under eye fat bags

Answer: Lower blepharoplasty for under eye fat bags

Answer: Lower blepharoplasty with fat/nano grafting

Answer: Lower blepharoplasty with fat/nano grafting

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.