Lower blepharoplasty

The procedure

Lower eyelid rejuvenation is performed whilst you are asleep either as an isolated procedure or in combination with other facial rejuvenation procedures. 

male blephs 1 frontal

male blephs 1 oblique

Patient of Mr Pacifico only 6-weeks following upper and lower blepaharoplasty. Note the improvement to the lines and bags under the eyes. More importantly, his eyes are much brighter and his overall appearance is fresher and less tired.

What does it involve?

An incision is made just below the eyelashes of the lower eyelid, to ensure that the resultant scar is very well camouflaged. The bulging fat behind the muscles of the lower eyelids is either pushed back and small internal stitches used to stop it bulging back again, or sometimes a small amount of the fat is removed and repositioned to camouflage the eyelid bags.

Once the fat has been addressed, a small amount of excess skin is removed to tighten up the lower lid. Mr Pacifico often performs a canthopexy at the same time - this is a procedure that tightens the lower lid and raises it slightly to give a more youthful appearance and supports the healing eyelid.

What are the benefits?

Lower eyelid surgery improves the tired and aged appearance that you feel you may have. It provides a freshness to the eyes and gives your whole face a brighter look.

How long does the surgery take?

Depending upon the complexity of the surgery in your individual situation, the surgery takes will take 1-2 hours.

What is the recovery period?

You will have some swelling and bruising afterwards, which will fade after around 2-weeks following surgery. The scars themselves heal quickly. The stitches are removed at 5-7 days. Mr Pacifico often puts a temporary (for 2-days or so) dissolvable stitch in to prevent your eyes from opening too much and to ensure they are well-lubricated with tears. Your eyes may feel dry and gritty initially, but this usually resolves after a short time. Therefore lubricating drops and ointment is always prescribed to keep the eye moist. Some people find they need to use this for over 1-month following surgery.

How long before daily activities may be resumed?

Rest is advised initially, and it is recommended that you sleep with 2 or 3 pillows so your head is elevated - this will help the swelling resolve. Most people are ready to go out and return to work after 10-14 days. Strenuous activity should be avoided for at least 3-weeks. Contact lenses should be avoided for 4-weeks after surgery, as these will dry the eyes out. Reading, television and computer usage may also dry out the eyes, so should be kept to a minimum. Make-up on the lower lids should be avoided for 3-4 weeks until the sensation in the lids has returned to normal.

What are the success rates?

Lower eyelid surgery has a high success rate. Potential complications are outlined below. Problems with dragging down of the lower lid is one of the most important complications to be aware of, which is why Mr Pacifico often performs a canthopexy and also on occasion uses the temporary stitch described above to support the lid after surgery. You will look your best at 6-12 months after the surgery.

lower blepharoplasty

The above photographs show the improvement in the appearance of the bags of the lower eyelids following a lower blepharoplasty by Mr Pacifico

What are the possible complications?

The most important complication to be aware of is bleeding post-operatively. Small amounts of bleeding may be stopped with pressure on the eyelid. Rarely you may need to return to the operating theatre. The most serious, but fortunately extremely rare, complication relates to bleeding that occurs behind the eyeball. This is a surgical emergency, which would require medicine and an urgent return to the operating theatre - if not attended to as an emergency, it may rarely lead to blindness (the risk of this complication has fortunately been estimated to be as rare as 1 in 40,000).

Scars can occasionally take time to settle down and may benefit from regular massage post-operatively, something Mr Pacifico will discuss with you at your post-operative visit. Infection occurs infrequently, as do small whiteheads around the scar, which may be treated in the outpatient clinic.  Inflammation of the eye can occasionally occur, which may need treatment with drops or ointments. Rarely, a muscle that moves the eyeball may be bruised or damaged leading to double vision (this rare complication usually only causes temporary symptoms).