Lower Blepharoplasty with Negative Vector Orbit? (photo)

You clearly have a negative vector eye and this puts you at significantly greater risk for lower eyelid malposition with any type of skin removal.  The correct approach for your eye is to do a transconjunctival removal of the fat with an autologous fat transfer to the midface.  There is no risk of lid malposition with this procedure.  The second best approach is fillers. 

A lower transconjunctival blepharoplasty without the addition of volume will leave you with hollow looking eyes.

A negative vector is when the cheek bone is relatively back to the projection of the eyeball or the front of the cornea. This means that the eye is forward while the cheekbone is back.

Being a specialist in oculofacial plastic surgery who does a lot of revisional surgery, I have learned that it is important to balance everything. This is because the position of the lower eyelid is very dependent on multiple factors like the lateral canthal tendon, the position of the lower lid retractor, the tone of the skin and the orbicularis muscle. So if you want to push through with the surgery, you have to find a surgeon who can provide you the level of care you need.

As a board certified facial cosmetic surgeon, I not only look at the eyes but I think of the face as a whole. I try to balance everything to help with facial aging. A common strategy for negative vectors is not only addressing the eyes but addressing the mid-face and cheek area. I would add volume using a filler or something more long-term such as a cheek or submalar implant.  I hope that was helpful, and thank you for your question.