If you do indeed need a lower blepharoplasty where fat needs to be removed or repositioned in the lower eyelid, we will perform a transconjunctival lower blepharoplasty. This technique involves a hidden incision on the back side of the eyelid (the conjunctiva) and then removing and/or repositioning the fat. This approach provides a natural, non-surgical look after surgery which preserves the structure and function of the Orbicularis muscles in the lower eyelid.
Some patients have excess skin in the lower eyelid and will need a “pinch” skin excision. This can be performed alone or in conjunction with transconjunctival lower blepharoplasty. The “pinch” excision is done on the skin, close to the eyelashes, so you will see the incision until it fades away. The fat is removed or repositioned through the hidden incision inside of the lid. This front and back technique also preserves the Orbicularis Oculi muscle and insures preservation of the lower eyelid contour and position.
If your eyelids are also lax, you may need a lateral canthopexy or canthoplasty to tighten the lower lid at the same time as your lower blepharoplasty. A canthopexy is a hidden stitch which is placed near the outer corner of the lower eyelid. This stitch stabilizes the lower lid and keeps the eyelid in position while healing. It dissolves in four to eight weeks. A canthoplasty is a bigger tightening of the lower eyelid.
Some patients may require mid-face elevation to rejuvenate the lower eyelid-cheek complex. In this procedure the eyelids and cheeks are repositioned upward to smooth the contours and elevate the structures of the mid-face. This is most useful in patients with malar bags or festoons.
After a through consultation and evaluation, we can discuss which procedures can help you reach your cosmetic goals.