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Lower Eyelid Rejuvenation
Lower Eyelid Rejuvenation
Lower Eyelid Rejuvenation
Lower Eyelid Surgery (Lower Blepharoplasty)
Also known as lower eyelid surgery, a blepharoplasty is a cosmetic procedure designed to improve the appearance of the eyelids by addressing excess skin, fat, or both. Blepharoplasty may be performed on the upper eyelids, the lower eyelids, or as a combined procedure, depending on a patient’s anatomy and specific areas of concern. When upper eyelid heaviness, hooding, or drooping skin is the primary issue, patients may benefit from a procedure focused on that region; for more information, please refer to our upper blepharoplasty page.
A lower blepharoplasty specifically targets the area beneath the eyes, a region that commonly shows early and noticeable signs of aging. Because the skin and supporting structures of the lower eyelids are thin and delicate, even subtle changes can significantly affect appearance. Over time, the tissues that support the lower eyelid may weaken, allowing underlying fat to shift forward and create visible under-eye bags or persistent puffiness.
Why the Lower Eyelids Change Over Time
Aging of the lower eyelids is influenced by a combination of structural, environmental, and genetic factors. As collagen and elastin production slows, the skin beneath the eyes becomes thinner and less resilient. This can lead to fine lines, crepey texture, and a loss of firmness. At the same time, the muscle and connective tissues that support the eyelid gradually weaken, contributing to laxity and changes in contour.
Fat pads that normally sit smoothly beneath the eye may begin to bulge forward as support structures relax. This bulging often appears as under-eye bags or puffiness that persists regardless of sleep, hydration, or lifestyle habits. In some patients, the opposite occurs, with volume loss or hollowing beneath the eyes that creates shadows and a sunken appearance.
Genetics play a significant role in how and when these changes appear. Some individuals develop under-eye bags or hollowing at a relatively young age due to inherited facial anatomy rather than aging alone. In these cases, non-surgical treatments may offer limited improvement because the underlying issue is structural rather than superficial.
The Purpose of Lower Blepharoplasty
The primary goal of lower blepharoplasty is to restore a smoother, more balanced transition between the lower eyelid and the upper cheek. Rather than dramatically changing the eyes, the procedure is designed to soften under-eye fullness, reduce excess skin, and minimize shadowing so the eyes appear more rested and refreshed.
When performed thoughtfully, lower eyelid surgery enhances facial harmony and preserves natural expression. The intent is not to make the eyes look tight, hollow, or overcorrected, but to address the specific anatomical factors contributing to a tired or aged appearance.
How Lower Eyelid Surgery Is Performed
Lower blepharoplasty is a highly individualized procedure because under-eye concerns vary widely between patients. Surgical planning begins with a detailed evaluation of skin quality, eyelid tone, fat distribution, cheek support, and overall facial balance.
Depending on the patient’s anatomy and goals, the procedure may involve removing excess fat, repositioning fat to smooth the transition between the eyelid and cheek, tightening loose skin, or a combination of these techniques. In many cases, fat repositioning is preferred over removal to avoid a hollowed or sunken appearance and to maintain a youthful contour.
Incisions are carefully placed to minimize visible scarring. In some cases, the incision is made just beneath the lower lash line, while in others it may be placed inside the lower eyelid. The approach is selected based on the amount of skin laxity present and the surgical goals of the procedure.
Lower Blepharoplasty as a Standalone or Combined Procedure
Lower eyelid surgery may be performed on its own or in combination with other facial procedures, depending on the factors contributing to a patient’s concerns. Some individuals benefit from combining lower blepharoplasty with upper eyelid surgery when changes are present in both areas.
In other cases, lower eyelid concerns are influenced by brow position or midface volume. When appropriate, lower blepharoplasty may be paired with procedures such as a brow lift to achieve a more balanced and comprehensive rejuvenation.
During consultation, your surgeon will discuss whether a standalone approach or a combined treatment plan is most appropriate based on your anatomy and goals.
Who Is a Candidate for Lower Eyelid Surgery?
Candidates for lower blepharoplasty include men and women who are bothered by under-eye bags, puffiness, loose skin, or shadowing that does not improve with non-surgical treatments. Ideal candidates are generally in good overall health and have realistic expectations about the outcomes of surgery.
Lower eyelid surgery may be appropriate for younger patients with genetic under-eye bags as well as older individuals experiencing age-related changes. A thorough consultation is essential to determine whether surgical correction is the most effective option or whether non-surgical treatments may be sufficient.
Recovery and Healing After Lower Blepharoplasty
Recovery following lower eyelid surgery varies from patient to patient. Most individuals experience temporary swelling and bruising during the first one to two weeks after surgery. Mild tightness, dryness, or sensitivity around the eyes is also common during early healing.
Patients are typically advised to avoid strenuous activity during the initial recovery period and to follow postoperative instructions carefully. Many people feel comfortable returning to desk work and light daily activities within approximately 10 to 14 days, although healing continues beyond this timeframe.
Swelling gradually resolves over several weeks, and final results become more apparent as the tissues settle. Your care team will provide detailed guidance on incision care, activity restrictions, and follow-up visits to support proper healing.
Results and Long-Term Outlook
Lower blepharoplasty is designed to produce subtle, natural-looking improvement. Patients often report that they look more rested, refreshed, and less fatigued rather than dramatically different.
While the results of lower eyelid surgery are long-lasting for many patients, it is important to understand that the face continues to age naturally over time. Individual results vary, and factors such as skin quality, genetics, sun exposure, and lifestyle habits influence long-term outcomes.
Some patients choose to maintain their results with non-surgical treatments over time, while others find that surgical correction significantly reduces the need for ongoing intervention.
Physician-Guided Care at Monarch
Lower eyelid surgery at Monarch Plastic Surgery & Skin Renewal Center is performed under the care of board-certified plastic surgeons Dr. Carmen Kavali and Dr. Teri N. Moak. Their approach emphasizes careful evaluation, conservative technique, and outcomes that align with each patient’s facial anatomy.
Patients from Atlanta, Buckhead, and Sandy Springs seek Monarch for physician-led facial rejuvenation focused on safety, balance, and natural-looking results.
Questions & Answers
Lower blepharoplasty is a surgical procedure designed to improve the appearance of the area beneath the eyes by addressing under-eye bags, puffiness, excess skin, or age-related changes in the lower eyelids. The procedure may involve removing or repositioning fat, tightening loose skin, or refining lower eyelid tissues, depending on a patient’s anatomy and goals. Lower blepharoplasty is customized for each individual and can be performed on its own or in combination with other facial procedures to create a more refreshed, natural-looking appearance.
The benefits of lower blepharoplasty are unique to each individual. A lower blepharoplasty can:
- Remove the loose skin and remove extra fat that make the eyes appear heavy or tired
- Reduce under-eye “bags”
- Enhance the overall appearance of the face
- Improve self esteem
- Create a more youthful appearance in the eyes
Does lower blepharoplasty get rid of wrinkles? In some cases, yes.
The ideal candidates for lower lid eye surgery are individuals in good general health who want to improve the appearance of their lower eyelids. You might be a good candidate if:
- You have persistent under-eye bags or puffiness.
- You have excess skin or wrinkles beneath your eyes.
- You feel that your lower eyelids make you look older or more tired than you actually are.
- You have realistic expectations about what the procedure can achieve.
It’s also important that candidates do not smoke or are willing to quit smoking before and after surgery, since smoking can impair healing.
While lower blepharoplasty is suitable for many individuals, there are certain conditions that may make you ineligible for the procedure:
- If you have certain medical conditions, such as heart disease, diabetes, or autoimmune disorders, the risks of surgery may outweigh the benefits.
- Individuals with poor skin elasticity or extremely thin skin may not achieve the desired results without the risk of complications.
- If you have pre-existing eye conditions, such as chronic dry eye or glaucoma, the surgery may pose additional risks.
- Unrealistic expectations regarding the outcomes of surgery can also make you a less-than-ideal candidate.
A lower blepharoplasty also cannot address crow’s feet around the outside of the eyes and correct skin quality or pigmentation issues. This may require other treatments such as chemical peels or laser resurfacing procedures.
The lower blepharoplasty procedure is performed in a surgery center with sedation or general anesthesia. The surgeon makes a small incision, either inside the eyelid or along the natural crease of the lower eyelid, so the scar is barely noticeable after healing. During the procedure, extra skin is removed, and excess fat is either taken out or repositioned to create a smoother, more youthful contour.
Once the surgery is complete, you’ll spend a short time in recovery before going home. Make sure to have someone drive you and stay with you for at least the first night. You’ll receive detailed post-op instructions, including pain management tips, and we’ll schedule a follow-up appointment to check your healing progress.
We are often asked how long eyelid surgery takes to heal. Recovery from lower lid eye surgery is relatively quick, though it varies from person to person. Expect to have swelling and some bruising after your eyelid surgery. There is little discomfort, though, and most people need to take pain medication for only a day or two after the surgery. It also helps to use a cold compress and keep your head elevated.
Most patients are able to return to light activities, including work, within a week. However, strenuous activities, heavy lifting, and exercise should be avoided for two to three weeks. While you’ll see some improvement immediately, it can take several weeks for all the swelling to subside. Full results are typically visible within three to six months. To maintain the results of your procedure, protect the delicate skin around your eyes by using sunscreen and sunglasses, and avoid smoking.
If you are prone to eye infections, we recommend that you see your eye doctor first. Let your surgeon know during your consultation, as well. Individuals who are prone to infections can still be candidates for lower lid eye surgery, but your surgeon may take extra precautions. Antibiotics may be given before and after surgery to lower the risk of infection, and meticulous aftercare is essential.
Having undergone LASIK surgery doesn’t automatically disqualify you from lower blepharoplasty. However, it’s crucial to let your surgeon know about any other eye surgeries you’ve had. Your surgeon will assess your eye health and the integrity of your corneas before proceeding with any further treatments. Those who have undergone or plan to undergo LASIK surgery must wait at least 6 months prior to having the eyelid procedure performed.
The good news is that scarring from lower blepharoplasty is usually minimal. Incisions are typically made either within the natural crease just below the lash line or inside the eyelid. Both of these techniques help conceal scars effectively. With proper care, any scars that do form should fade over time, becoming barely noticeable.
Lower blepharoplasty can be combined with other facial procedures, such as upper blepharoplasty, a brow lift, or a facelift. Many patients choose to combine procedures to achieve more comprehensive facial rejuvenation. This approach also minimizes downtime and allows you to address multiple concerns in a single surgery.
The results of a lower blepharoplasty are often long-lasting. While the natural aging process will continue, most patients enjoy their results for many years. Factors like genetics, lifestyle, and skincare can impact how long the results last, but with proper care, your under-eye area will remain smoother and more youthful.
Please visit our My Consult page to learn more about what happens during your consult.
Please visit our Financing page to learn more on how much a lower blepharoplasty is and what financing options are.