Lower Blepharoplasty Candidate?

I'm nineteen, in good physical health (not gonna lie I do have some low self esteem issues) and I want to know if it looks like I need it also.

Doctor Answers 14

Lower Blepharoplasty

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I would say need is too strong of a word. You have some fat pseudoherniation (bulging) which makes a bit of a hollow just under the fat bulging. At this point you may be candidate for a transconjunctival blepharoplasty. Given your age, I would treat you with fillers like restylane just in the tear trough to help blend that transition zone a make it much less obvious. At some point later on, you may consider the transconjuntival blepharoplasty.

Hope that helps.

Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Too young for Lower Blepharoplasty at 19

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Dear Angie,

No. At age 19 you are way too young to benefit from a Blepharoplasty.

The lower lid depressions (tear trough) can be corrected with Restylane/Juvederm injections.

May I also recommend you go on a good skin care line that will correct your acne and will give you the great skin a young lady your age deserves.

As regards the nose issue you posted on another thread, this picture gives a better idea of the nose. If your nose bothers you (and ONLY you), you can get it narrowed and flatter in a relatively straight forward operation.

Hope this was helpful.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Fillers to the tear troughs

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Aesthetic lower eyelid procedures (blepharoplasty) are best performed on patients with excess skin or bulging fat below their eyes. This is often seen as wrinkly skin or bags beneath the eyes. By tightening the skin and removing the excess fat, the eyes will look refreshed and rejuvenated. Often times, excess skin and fat is not the problem and patients present with hollowing of the upper cheek area. This hollowing can contribute to looking aged and tired. Filling these hollows (tear troughs) with a filler such as belotero or fat can improve the overall aesthetic appearance without surgery. At 19 y.o., you most likely do not need lower lid blepharoplasty. If the hollowing beneath the eyes really bothers you, you may benefit from fillers to the tear trough area to provide additional volume. Consult with a board certified plastic surgeon to determine the best treatment option for you. Good Luck!

Scott Farber, MD
Boca Raton Plastic Surgeon
4.8 out of 5 stars 22 reviews

No evidence that a lower blepharoplasty is needed

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Since you are only 19, there is no evidence of any need to perform a lower blepharoplasty. There are no fat pads present in the three compartments of the lower lids that need to be addressed.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Evaluation of Lower Lids for Blepharoplasty

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It is very uncommon to have to perform lower lid blepharoplasty on 19 year olds. I appreciate the picture but it's hard to due a full analysis. Using what I have I will say that I see moderately pronounced tear trough deformities. These are the depressions that occur between the nose and the lower lids at superior aspect of the nose. From your picture I think that this is occurring because you have some lower lid pseudoherniation. That is, the fat around the eye globe is pushing against the lower lid creating a "bag." Because the the tissues are very adherent to the orbital rim the depression will occur at that site-as in your case.

So shooting off the cuff I would say you might possibly benefit from a lower lid bleph. using a transconjunctival incision (inside the lower lid) and redraping the lower lid fat into the tear trough.

Other options include filling the tear trough with dermal fillers or micro fat grafting.

Arcus release and fat grafting not blepharoplasty is appropriate for you

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A standard blepharoplasty wit fat removal will give you a "hollow eye" appearance. You do not have bags, loose skin and wrinkles so you do not need a standard blepharoplasty.

You are very young and pretty. If the dark circle or depression beneath your lower eyelid really troubles you, then a transconjunctival arcus release and fat grafting will plump the depression and improve the look. (see reference below).

I avoid injecting fillers beneath the lower eyelid. The skin is so thin that permanent discoloration from bleeding can occur and occasionally the color of the filler shows through the skin. In addition lumps are frequent following filler injection benmeath the lower eyelid.

Lower blepharoplasty

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 At 19 I would say you do not need a blepharoplasty. Yes, you do have some hollowing along the orbital rim, but no a blepharoplasty will not improve this for you.  If it really bugs you, you may benefit from a little filler.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Perhps at a later date.

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You look just like a 19 year old lady who is interested in a rhinoplasty!

I would suggest you look into fillers to plump up your "hollow" orbits rather than surgery at this time.



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First of all, no one "needs" cosmetic blepharoplasty. If there is something specific that you want changed, then you should discuss it with your surgeon. I agree that at your age, an invasive procedure may be overkill. However, if your exam does show bulging fat pockets, then you may benefit from removal of this fat. Good luck.

Fillers for the under eye circles are what you need

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Dear Angie

Realself exists because you are looking to get help in a caveat emptor (let the buyer beware) world. If you knock on the doors of enough cosmetic surgeons, someone will do exactly what you are asking for whether it is the right thing or not. In particular, lower eyelid surgery needs to be applied very sparingly. The entire concept behind lower eyelid surgery we now understand is wrong for the majority of patients. Unfortunately many surgeon have a conflict of interest. There you are in their office asking for a lower eyelid surgery. They make money performing surgery. You do the math.

For someone your age and with your issues providing volume to the lower eyelid hollow is most likely all you need. This can be done beautifully using under eye Restylane filler. Yes, the service is not permanent but I have many patients who feel that they get almost of two years of benefit from treatment. Remember that the results of surgery are not permanent either but complications from surgery are permanent. Consider looking on the liquidfacelift.com website for the names of well qualified injectors in your area who do under eye treatment.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.