Would I be a possible candidate for a lower blepharoplasty with fat repositioning? Have dark under eye circles. (photos)

Question

For as long as I can remember I have had dark under eye circles. As you can see in the photos I included, they are almost purple on my tear trough. My eyes constantly look tired and I have become very self conscious about them. I rarely will leave the house without makeup. I have tried tear trough filler with no noticeable change. Would a lower blepharoplasty help this? I feel as though the fat needs to be repositioned in order to lift the skin.

Jonathan Kulbersh, MD · Answer

Hello, and thank you for your question. Lower blepharoplasty is an ideal plastic surgery option for those who want to significantly reduce the appearance of bags, puffiness, loose skin, or hollowness under the eyes. The procedure is minimally invasive and when performed by a skilled surgeon, can achieve a smooth, supple, and youthful look. However, there are other options to consider as well. Fillers (performed by a skilled provider), lasers, Profound RF (RF microneedling), and other procedures that help collagen production can be very effective in refreshing the skin around the eyes. Furthermore, fat grafting may also help treat sunken areas beneath the eyes. To determine the best treatment or combination of treatments for you, I recommend schedule an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can do a proper evaluation, customize the best treatment plan, and ensure the best possible outcome.

C. Blake Perry, MD · Answer

Yes you would be a candidate for lower lid blepharoplasty. An incision is made on the backside of the eyelid (transconjunctival approach) and the fat is repositioned over the orbital rim to make a smooth transition from the lower lid to cheek. Additional CO2 laser is performed on the lower lid skin to improve texture and thickness. No lower lid surgery will completely eliminate the "discoloration" as some of this is due to the vascular nature of the underlying orbicularis muscle.

William Portuese, MD · Answer

A trans conjunctival approach lower blepharoplasty can accomplish removal of the fat bags in the lower lids. In our practice, we no longer do fat repositioning. The Incision is located completely on The inside of the lower lid. This will have no beneficial effect on the color of the skin itself.

Darryl J. Blinski, MD · Answer

Thanks for posing your photos. I recommend a transconjunctival lower blepharoplasty with minimal fat re positioning. Then after 2 months healing modified phenol lower lid peel for de colorization of skin. Fees in $10,000 ranges in toto.

Robert T. Buchanan, MD (retired) · Answer

The problem when you had tear trough filler is that whoever did the filler did it improperly. You are a perfect candidate for properly done filler, not blepharoplasty. Make sure you see a true expert when you try again.

Would I be a possible candidate for a lower blepharoplasty with fat repositioning? Have dark under eye circles. (photos)

Answers (5)

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