No one ever "needs" a lower lid blepharoplasty. It is an elective procedure and only you can determine if your features concern you enough to do something about improving the cosmetic appearance of your eyes and whether it would be worthwhile. Following the advice of anyone who would presume to tell you what to do based on limited photo and more importantly 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
