Thinking About Lower Bleph with Pinch? (photo)

I have consulted three surgeons and received three different recommendations with one even saying I did not need anything removed from my lower lids. Can you tell from this photo if I would be a good candidate for some fat repositioning and a pinch?

Doctor Answers 13

Lower Eyelid Improvement

It appears you do have some excess fat of your lower lids.  It is difficult to say if you have excess skin also.  You are certainly a candidate for lower eyelid rejuvenation.  The approach will be different among surgeons.  

Dr. ES

Thinking About Lower Bleph with Pinch?

From you photo, I think you would benefit from a blepharoplasty, but I would hesitate to remove much if any fat as it will hollow out your orbit, you may benefit from fat transfer to the orbital rim and nasojugal fold.  I know you didnt ask about your upper eyelids, but it appears that you have bilateral ptosis and upper eyelid surgery could correct this.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 106 reviews

Correcting lower eyelid puffiness

There is no question that if you want to improve the appearance of your lower eyelids that you would benefit from a lower eyelid blepharoplasty with fat repositioning, muscle tightening and a lateral malar fat pad elevation. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Lower lid bleph

It appears from the picture that you have excess lower eyelid fat. It is difficult to tell whether there is excess skin. If there isn't, then a transconjunctival approach (through the inside of the lower eyelid) to removing the excess fat would be my preferred technique. As far as pinching off skin, it depends on your eyelid tone, if there is redundancy of the orbicularis muscle, and how much redundant skin there is. If it is indicated, then it can be combined with a transconjunctival removal of fat.

Brian D. Kent, MD
Tulsa Plastic Surgeon
5.0 out of 5 stars 7 reviews

Yes you are a candidate

Yes, you should be a good candidate for lower bleph with fat transposition and skin pinch, along with upper lid ptosis surgery.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Lower eyelid blepharoplasty

 The primary goal of lower eyelid  blepharoplasty is to remove puffiness( excess fat)  in the lower lids through a trans-conjunctival  approach. The secondary goal of lower eyelid blepharoplasty is to remove any excess skin that may or may not be present. When excess skin is present a pinch technique  at the lash line is performed and the incision is closed with Histocryl tissue adhesive. Fat repositioning versus fat removal is controversial and both techniques give excellent results.Please see their link below for  our blepharoplasty  photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Look at the whole picture

I believe you have lost volume from your cheeks and that a lot of what you see can be corrected by malar (medial and lateral) fat grafting with little or nothing done to your lower lid. I agree with the surgeon that addresses the upper lid ptosis. Also consider some fat grafts or fillers to the upper lid hollows.

Manuel M. Pena, MD
Naples Plastic Surgeon
3.4 out of 5 stars 5 reviews

Thinking About Lower Bleph with Pinch?

     This will require an exam to help better evaluate.  I would probably not do a skin pinch just from the pictures alone.  Fat removal or transposition or filler to the tear troughs may be indicated as well.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Good candidate for lower blepharoplasty but don't remove too much fat.

With the orbital anatomy seen in the picture one has to be cautious about removing too much fat creating the puffiness of the lower lids. This can make the eyes look extremely gaunt.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Lower lid blepharoplasty

Photos do not show everything because they are often washed out, but solely based upon your photo it does look like you woudl benefit from a lower lid procedure.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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