Would I benefit from a blepharoplasty procedure? I have been very concerned about the lower lid. (Photo)

Im 46 years old and don't wear any make up. I have been very concerned about the lower lid. I don't know who else to ask so I thought I would try this website. Since I have no way of covering up my eyes i wear glasses all the time. I'm your professional opinion would I really need this procedure? I would like to know before I spend money. Thanks

Doctor Answers 16

Less is more..

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Blepharoplasty with lower eyelid skin tightening would probably yield good results. Often a mild laser skin resurfacing on the dark circles can improve the skin color, give a youthful glow and tighten the skin. This can be performed in conjunction with the blepharoplasty. I would make sure the surgeon is cautious and does not over correct or the results will look worse than doing nothing at all. All the best!

The importance of lower eyelid support structures during under eye surgery, & addressing skin & volume in the eyelid-cheek area

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Lower eyelid blepharoplasty addresses puffiness, eyelid position and excess skin. If you have puffiness under your eyes, which it appears you do, then addressing the lower eyelid area with a blepharoplasty makes sense.

At 46-years-old, you probably noticed that there’s been some volume loss under your eyes. In my practice, most patients are confused between a filler versus surgical procedures to address this area.
A few years ago, I wrote a book, “The Fine Art of Looking Younger” where I explained the issues of facial aging. Facial aging has two essential principles: first is volume loss where we lose bone, muscle and fat as we get older; second is laxity. For example, the lower eyelid tendon becomes looser and the orbicularis muscle gets a little more lax. Overall, there’s a support issue that may be part of the whole lower eyelid rejuvenation process for you.

When I do an evaluation for lower eyelid blepharoplasty, I look at the tone of the lower eyelid. I do a snap test by pulling the eyelid down and see how well it comes back up. In addition, I think it is important to address the fat pockets as well as lifting or tightening the lateral canthal tendon. Looking from different perspectives, we also have to asses if there’s a relative prominence of the eye to deal with any type of support structure in the lower eyelid.

I also wrote an article many years ago called “Ethnic Considerations in Eyelid Surgery” to cater patients who were not Caucasians and were embracing and exploring cosmetic surgery procedures. Unfortunately, traditional cosmetic procedures like an external incision lower eyelid blepharoplasty where the lower eyelid is opened up, and fat and skin removed was problematic for patients of African origin. It resulted in the eyelid being pulled down. Someone with dark skin color has to be mindful of the techniques applied to lower eyelid blepharoplasty. At the same time, addressing volume loss can be the second part of the equation. By adding volume in the cheek area with fillers, cheek implants, or through face lifting, it can have a tremendous impact in the context of how the eyes look.

The last part of this equation is skin quality. People often mistake lower eyelid surgery as a way to reduce wrinkles and dark circles. To address the skin quality issue in our practice, we routinely use platelet-rich plasma for lower eyelid rejuvenation. We draw your own blood, then spin it to concentrate the platelets and growth factors necessary for healing. We place it under the skin of the eyelids and see a qualitative improvement in the skin, which includes improvements in wrinkles and skin color. There is an overall healthier glow to the skin.

I think you should meet with cosmetic surgeons who have a lot of experience with different skin types. Once you find someone who resonates with you, you can move on with the procedures. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Periorbital rejuvenation.

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Looking at your picture, I see several interesting things:

First both lower lids are with laxity, excess skin and a bit droopy, with significant hollowness of the nasojugal area (deep tear trough hollow), depression which occurs at the infero-medial aspect of the lower lid.
Your face have a substantial deflation and descent of the mid face malar fat (cheeks), and in your lower eyelids there is too an infra-orbital flattening (volumen deficit) which is caused by descent of the mid face malar fat and periorbital tissues.

You need to have a full blepharoplasty on both upper and lower eyelids. For lower periorbital rejuvenation you need to have an orbicularis oculi muscle lifting, this procedure elevate the lower lid, correct muscle weakness, the periorbital hollows, and the tear troughs; creating a smooth plane then soften the orbital line or the transition from your eyelid to your cheek.

With this procedure you can achieve a more rested look. After surgery your lower eyelid is just smooth with no bags, no wrinkles and black circles; the scar is in the lower lash line, heal well and it’s invisible.

Best wishes,

 Orlando Figueroa Cerpa M.D.

Tijuana, Mexico Plastic Surgeon

Orlando Figueroa Cerpa, MD
Mexico Plastic Surgeon

Lower eyelid bleph

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Thank you for your pictures.  I would recommend a lower eyelid bleph to remove your excess skin and fat.  This would give you give you a more rested appearance

Would I benefit from a blepharoplasty procedure? I have been very concerned about the lower lid.

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Whether you "need" a cosmetic operation or not is a decision you can only make! Best to seek IN PERSON examinations and opinions. I might recommend upper and lower lid blepharoplasty with canthalpexy. 

Would I benefit from a blepharoplasty procedure? I have been very concerned about the lower lid

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Based on your photos, you would benefit from both a upper and lower blepharoplasty.  You have a fold of skin on your upper eyelids, as well as fat pockets and too much skin on your lower lids.  Consult with a board certified plastic surgeon for an in person evaluation to discuss your options.  Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Lower lid blepharoplasty

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  A lower blepharoplasty will help rejuvenate the lower lids, however the dark discoloration in the skin will not be changed with the surgical procedure. The primary goal of lower eyelid surgery is to remove excess puffiness created by 3  fat pads on the lower lids and to remove some excess skin. The amount of skin removed is determined at rest, not with animation. For many examples, please see the  link below

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

Lower eyelid bleph

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You look like you would benefit from a lower eyelid surgery.  Tough to tell from these pictures what I might recommend, and you certainly want to get a couple of opinions.  From these pictures it looks like you have some skin laxity and some volume deficit.  So you may need a fat transfer and some skin removed.  See an oculoplastic surgeon who can help you decide what would be the best option for you.   

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Would I benefit from a blepharoplasty procedure?

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If you are concerned with the appearance of your lower eyelids, you schedule a consultation with a plastic surgeon to discuss the procedure. Make sure to choose a double board certified plastic surgeon that is experienced with eyelid surgery.

Jeremy A. Benedetti, MD
Saint Petersburg Plastic Surgeon

Would I benefit from a blepharoplasty procedure? I have been very concerned about the lower lid. (Photo)

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Yes your lower eyelids show changes that can be improved with Blephroplasty   It is important to find a surgeon who is board certified and who performs a lot of eyelid surgery. Best to you

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.