Am I a good candidate for lower eye lid surgery? (Photo)

I am 44 years old and have hereditary undereye puffiness. I feel in the last few years with age it has gotten worse. I am so frightened of this type of surgery but I am unhappy enough to consider it

Doctor Answers 8

What can be done for my lower lids.

You can have a great result with the right operation. Your cheek bones under your eyes are positioned back and don't provide adequat support for your lower lids. Your lower lids seem to be too lax and need tightening. You don't want the fat simply removed as it will create a hollow appearance. You obviously need to be examined carefully to give you a firm plan of treatment, but looking at your pictures I would say that you need a fat transfer to the tear through, support of your lower lids with a canthopexy and very conservative skin excision. You would also benefit from cheek augmentation with fat or fillers. I must say that you should not take these recommendations or any other recommendation seriously unless you have been examined carefully. 

You look like a great candidate!

It certainly looks like fat removal is the most direct approach, and my oppinnion is that a transconjunctival approach would be best (through the inside of the eyelid).  There are some other things that may be considered as well (fat repositioning) and there may be a nonsurgical option too (filler injection along the orbital rim).  However, surgery would be more permanent and better address the problem.  Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Lower eyelid surgery can make a beautiful difference for you!

You will definitely benefit from lower eyelid surgery.  The results can be beautiful and long lasting.  I would recommend removing some of the fat pockets in the lower eyelids.  Since your photos don't show your cheeks, I can't tell for sure but it looks like you may benefit from fat injection to the area just below your lower eyelids.  This can create a very natural and attractive rejuvenation of your lower eyelids.  It will remove the tired look and brighten your whole face.  We perform lower eyelid surgery routinely in our state-of-the-art certified surgical suite.  You would be able to go home the same day.  We are located in Wayne, NJ and would be happy to discuss this with you in person.  Take care.
Dr. Parham Ganchi - NJ Plastic Surgeon

Parham Ganchi, PhD, MD
Wayne Plastic Surgeon
4.8 out of 5 stars 144 reviews

Lower eye lid surgery for puffy eyes

 The photographs demonstrate herniated fat pads in the lower lids.  In our practice, we place the incision for fat pad removal on the inside of the eye lids also known as a trans--conjunctival approach. This rejuvenates the eyelids to get rid of the tired and puffy look. The procedure is performed under a brief general anesthetic as an outpatient surgical procedure

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Lower eyelid puffiness

Hi, I have added a link that might be helpful...

Hi Lori2188.  Behind the lower eyelid skin and muscle (that contracts with squinting) is fat and when the fat pushes forward, it creates the "bags". Depending upon your examination, removing the excess or repositioning the fat, with removal of any excess skin, and possibly tightening the lower lid may be recommended.  Non surgical skin tightening alone will not address the bulging fat. Of course, if you have allergic swelling in the skin, surgery will not address that.  I encourage you to have an office consultation with a board certified Plastic Surgeon who can address your concerns about the procedure and outcomes.  Good luck!

Lower lid surgery

You have a large amount of prolapsed fat.  A fat repositioning bleph would move this fat inferiorly into your tear trough, and smooth out the lid/cheek junction  You will probably need a pinch of skin excised as well.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

I think you would benefit from eyelid surgery, absolutely.

The truth is that you have a very complicated lower eyelid.  There is no substitute for an actual personal consultation.  However based on your photo, a transconjunctival arcus marginalis release surgery is probably the best for you.  Do your homework carefully and find a surgeon who makes sense to you.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

You can have a great result...

You appear to be a good candidate for lower eyelid surgery. The puffiness can be reduced by removing some of the fat under the eye. Then the skin can undergo laser resurfacing to tighten the skin and remove wrinkles. Finally, some fat can be placed in the crease under the puffy bag in order to create nice, smooth appearance from the eyelid to the cheek. The surgery is usually short and very safe. The recovery is usually painless, with some swelling for about a week. Be sure to see an eyelid specialist for consultation.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 187 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.