It's aging me and I always look tired. Would a lower bleph be enough to fix this? (Photo)

Question

Wondering if a lower bleph would correct this problem? I have a slight bulge the indent right underneath it and it really bugs me and ages me and makes me look always tired!

Serdar Ozates, MD · Answer

If the photograph is representative and the lighting and angle are not misleading, the lower eyelid fat bulging does not appear to be very prominent. The contour irregularity you are describing may be more related to the transition between the lower eyelid and the cheek, with a slight hollow underneath the bulge.
In this situation, a lower blepharoplasty may not necessarily be the best or most appropriate solution. Depending on the findings during an examination, the contour could potentially be improved with a small amount of fat grafting or, in selected cases, a carefully placed dermal filler to soften the indentation.
The ideal approach depends on the anatomy of the lower eyelid, the amount of fat herniation, skin quality, and the depth of the hollow. An in-person assessment would be necessary to determine which option would give you the most natural and balanced result.

Mehmet Ozdemir, MD · Answer

We have reviewed your photo. You may be a suitable candidate for lower blepharoplasty to improve the under-eye contour. An in-person consultation is recommended.

Julian De Silva, MD · Answer

Hi, thank you for your question. What you describe, a slight bulge with an indent directly underneath, is one of the most common patterns I see in oculoplastic practice, and it is usually a two-part problem. The bulge is typically orbital fat sitting forward. The indent below it is the tear trough, where the ligament tethers the skin and volume falls away. The tired look comes from the shadow between the two, not from either alone. That matters for your question. A lower blepharoplasty that simply removes the fat can soften the bulge yet leave, or even deepen, the hollow, so the answer is often fat repositioning, moving the bulging fat down into the trough rather than discarding it. In some younger patients with good skin, careful filler to the trough alone can be enough. Which applies to you depends on lid tone, skin quality and how much true excess there is, which needs an in-person examination. Ask specifically about repositioning rather than removal when you consult. It is a question that quickly shows you how a surgeon thinks.

Mats Hagstrom, MD (license on probation) · Answer

This is a complex anatomic area, and the problem is fairly difficult to treat.
Options include lower eyelid blepharoplasty, fat grafting, midface implant, a mid facelift or using fillers.
Fillers is probably your best option but finding a provider who has sufficient skill and experience might be difficult.Best,Mats Hagstrom MD

It's aging me and I always look tired. Would a lower bleph be enough to fix this? (Photo)

Answers (4)

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