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Is lower blepharoplasty without muscle removal sufficient? (Photos)

Ciao1115Jan 21, 2026

I’m 23 and have one congenital eye bag on my left eye, had it since birth. The other has a normal eye bag that I wouldn’t have had altered if it weren’t for the other. I previously got botox treatments in the bad eye because I do have bunching up. The botox did help when smiling, however the bag is still there when I don’t smile, much worse on the left. My surgeon wants to address the orbicularis muscle and remove some of the hypertrophic tissue, but the complications really scare me and I was wondering if only removing the fat could be an option as it’d significantly reduce the volume underneath the skin. Besides that, yes, I do agree that I have some hypertrophy, but I also think that some of the roll that forms when I smile is the fat that gets pushed up as you can observe the bag I have with a relaxed face just move slightly higher and change shape when I smile, but the mass seems the same to me. Long story short: would it be enough to just work on fat to avoid unnecessary complications? Or is removing muscle tissue inevitable? The results don‘t have to be perfect, I just don’t want to look so extremely asymmetrical and as though I’d never gotten a night of sleep ever. Thank you for any input!

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