• Jean-Paul Abboud, M.D., Ph.D.

10 things you need to know before considering cosmetic lower eyelid blepharoplasty

Updated: Jul 7


1. What is cosmetic lower eyelid blepharoplasty and what do you mean by "customized" blepharoplasty?

Blepharoplasty is one of the most commonly performed facial procedure worldwide and the most common procedure Dr. Abboud performs. Cosmetic lower eyelid blepharoplasty (under eye bag surgery) involves the surgical removal and/or repositioning of the fat under the eyes and, if necessary, removal or tightening of any redundant lower eyelid skin. It aims to rejuvenate the area surrounding the eyes and to give an overall more youthful and rested appearance to the face.

Since no two sets of eyes are the same, no two blepharoplasty surgeries should be the same either. Blepharoplasty should be tailored to each patient's aesthetic desires and unique features in order to achieve the best cosmetic results. It requires that the surgeon have a keen artistic understanding of what a beautiful eye looks like, expert knowledge of eyelid architecture and function, and the advanced surgical skills to remove, reposition, and/or tighten the eyelid fat, skin, and musculature. An expert eyelid surgeon (i.e., one with extensive training in oculoplastic surgery), must additionally have the foresight to recognize when to remove and/or reposition fat, and when to combine a lower eyelid blepharoplasty with other procedures, such as a midface or cheek lift, upper eyelid blepharoplasty, or canthoplasty (tightening of the outer corner of the eyelids) to achieve the desired post-operative result.

2. What results should I expect and when will I see them?

While results do vary, you should expect to see an improvement in the under eye bags and a smoother transition between the eyelids and the cheeks after cosmetic lower eyelid blepharoplasty. You should look natural, yet more youthful and more vibrant.

You should notice a difference in your eyelids immediately following your surgery. However, post-surgical swelling and discoloration may initially obscure your final outcome. While many patients return to work 1 to 2 weeks after blepharoplasty, it may take several weeks for your swelling to subside completely. You should be able to see your final results from cosmetic eyelid surgery in about 4 to 6 weeks following your surgery.

3. What does cosmetic lower eyelid surgery entail and what type of anesthesia is used?

Lower eyelid blepharoplasty is most often performed in the operating room, but minor enhancements can be performed in the office. Surgery is typically performed with minimal sedation and local injections of anesthetics.

Before the procedure, Dr. Abboud may mark the bulging fat pads in the lower eyelid that need to be sculpted. After sedation is administered by an anesthesiologist, Dr. Abboud injects local anesthetics, which should make the procedure painless. Based on your pre-operative consultation, he will then proceed with the necessary steps to customize the procedure and to ensure symmetry between both eyes.

4. Are there any alternatives to lower eyelid surgery?

While a lower eyelid blepharoplasty may have a dramatic and long-lasting effect on lower eyelid enhancement, it is not the only option. Dermal fillers such as Belotero®, Juvéderm®, Restylane®, and others can be injected to fill in any hollowness in the lower eyelid, particularly in the tear trough, or to lighten up any dark circles under the eyes. Neurotoxins, such as Botox®, Xeomin®, and Dysport® can also be injected to soften the wrinkles around the eyes, especially the crow's feet (the laugh lines that appear on the outer corner of the eye). Laser skin treatments, alone or in conjunction with blepharoplasty can also soften wrinkles in the lower eyelids. Ask Dr. Abboud about the options available for lower eyelid rejuvenation during your consultation and together you can formulate a treatment plan that is most suitable for your features and your aesthetic desires.

5. Are there any risks to cosmetic eyelid surgery?

Cosmetic eyelid surgery, like any surgery, has risks. Minor side effects associated with blepharoplasty include temporary blurry or double vision, and temporary swelling or bruising. These, however, are part of the normal healing process after surgery and are often temporary as they typically resolve on their own. More serious risks include asymmetry, dry eyes, scarring, or pulling down of the lower eyelids. However, the more qualified and experienced your doctor is in eyelid surgery, the lower that risk. Permanent blindness and double vision are exceedingly uncommon and rarely do they happen in experienced hands. During your consultation, Dr. Abboud will thoroughly go over the risks of the surgery, particularly those pertaining to your procedure.

6. Will I be able to see after surgery?

Following your blepharoplasty, your vision may be temporarily blurry due to minor corneal swelling and the use of eye lubricants that we provide. However, your vision will recover fully in a few days. There will be no patches covering your eyes following surgery.

7. What is the recovery like for cosmetic eyelid surgery?

The recovery process is usually not extensive. There may be some swelling and bruising, but most people do not experience much pain. Application of ice packs and elevating your head can help reduce swelling and speed up recovery. While light activity and refraining from heavy lifting are recommended for 2 weeks following surgery, most patients may be able to return to work only a few days after surgery.

8. Will there be noticeable scars on my eyelids?

As with any surgical procedure, some scarring is to be expected. However, lower eyelid blepharoplasty can be performed either through an incision made on the inside of the eyelid (the pink part), which leaves no visible scars, or through an incision on the outside of the eyelid that is typically hidden underneath your eyelashes. Any resultant scars should be barely noticeable after healing. The approach Dr. Abboud chooses depends on the pre-operative assessment, your desires, and whether or not he will remove any redundant skin. Patients may see some redness around the incisions immediately following surgery, but this typically fades quickly in the weeks and months following surgery.

9. Are results of cosmetic blepharoplasty permanent?

The results of cosmetic blepharoplasty are designed to be long-lasting. Nevertheless, over time, the elasticity of your skin and the quality of your underlying fat and facial muscles will continue to change in response to aging and other environmental factors. Dr. Abboud recommends that patients protect the skin surrounding their eyes with routine moisturizing and sun protection in order to maintain the results of their eyelid surgery as long as possible.

10. Am I a candidate for lower eyelid blepharoplasty?

The most common candidates for lower eyelid blepharoplasty are men or women who notice wrinkles or puffy bags under their eyes, which may cause one to have an aged appearance. Ideal candidates for cosmetic lower eyelid blepharoplasty are non-smokers who are in good physical and mental health and who have realistic expectations about their results.

For more information about cosmetic lower eyelid blepharoplasty, or to schedule a consultation, call us at 858.356.2647


#eyelidsurgery #cosmeticsurgery #lowerblepharoplasty #blepharoplasty #underdyebagsurgery #oculoplastic #oculofacial #plasticsurgery

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