Lower Bleph?

Hello! A technical question to all doctors. I am planning a lower blepharoplasty. I have hollows under the eyes and faint musklatur around the area. What technology is recommended. I do not use fillers. Thanks in advance :)

Doctor Answers 7

Hollows under Eyes

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   Usually the appearance of the hollow is due to herniation of fat in the lower eyelid and loss of fat at the tear trough due to descent or fat atrophy.  A combination of fat removal with fat grafting or transposition may be appropriate depending upon goals and current anatomy.

Lower bleph

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A lower blepharoplasty is performed through a transconjunctival approach where the incisions are placed on the inside of the lower eyelid and any bulging fat is removed.  If there are excess skin wrinkles on the lower lids and the eyelid is in good position, consideration for a small pinch of eyelid skin can also be performed and the incision is closed with a tissue glue known as Histoacryl.

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

Lower Blepharoplasty with Tear Trough Deformity

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During lower eyelid blepharoplasty, reposition of fat and release of the area can give a nice improvement of a noticeable tear trough area. Alternately, fillers such as restylane can be added to the area to improve the appearance.

Lower blepharoplasty and tear troughs

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It seems that you may be describing a tear trough issue which can be created from excess skin or fat and loss of tissue in the area of the lower lid near the groove with the nose and central cheek area. Often times a lower blepharoplasty with fat transposition or movement of fat into that area can effecively eliminate that condition on a long term or permanent basis. Good luck.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Correcting hollowness around the lower eyelid area

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If you have hollowness of the lower eyelids are a and visualization of the bony shape around the eyes then you definitely need  some volume to the area.  Many times we can use the existing peri-orbital fat to fill in the tear trough hollow and elevate the malar fat pad to add volume to the lateral area.  In addition re-suspending the orbicularis muscle also helps to correct the problem.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Lower blepharoplasty and hollowness

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Hollowness in the lower eyelids may be do to a depressed nasojugal groove. Sometimes this area can be undermined during blepharoplasty to release this area.  Sometimes fat can be redraped there as well.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lower blepharoplasty for hollowness with thin muscles

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Of course it is best to choose a fine surgeon rather than pick a procedure you think will best help you, and then find a doctor who does that:  this is what many of the top doctors in RealSelf have repeatedly advised.

That being said, we usually perform a short incision cheek lift, elevating the cheek fatty tissues while preserving a healthy cuff of pretarsal orbicularis to maximize muscle roll postoperatively for your problem.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 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.