WHAT IS LOWER BLEPHAROPLASTY?
I look tired! I have bags! My eyelids are puffy! People tell me I look tired but I am actually not tired! Where did these bags come from??
Lower blepharoplasty is the rejuvenation of the lower eyelids. Common complaints of lower eyelid aging include “bagginess” or “puffiness” of the lower eyelids, loose skin, lower eyelid laxity, dark circles and wrinkles. Improvement of these changes involves a combination of procedures which should result in a natural-looking lower eyelid, without the stigmata of surgery.
HOW IS A LOWER BLEPHAROPLASTY PERFORMED?
Lower blepharoplasty is a generic term that encompasses many different approaches, with lasers, surgery, peels, etc.
Men, women, young, middle-aged, older: all these variables result in many different changes which can lead to changes in the lower eyelids. Therefore, there is no one surgical technique that is used to reverse these aging changes. Indeed, procedures are designed to address, among other things, changes seen with age, changes in different sexes, the degree of laxity, the degree of puffiness, fluid collection, pigmentation, bulges and grooves, wrinkles, scleral show etc!
Lower blepharoplasty is therefor an amalgam of several different procedures, used in combination to give the ideal result.
Even though we have come a long way since the first ever photographically recorded case of lower eyelid blepharoplasty (performed in France), we have to admire the overall result, albeit with some residual problems. In plastic surgery, with advances in our knowledge of anatomy, physiology, eye function, etc, we can now design bespoke procedures for each person.
THE FIRST LOWER BLEPHAROPLASTY IN HISTORY : THE FRENCH WERE FIRST!
“Real Self Review
"The most beautiful upper and lower blepharoplasty by Dr. Bhupendra Patel: thank you!
- Bhupendra C.K. Patel, MD, Salt Lake City, UT
Beautiful upper and lower eyelid blepharoplasty: I couldn’t afford to also get my brows lifted but Dr. Bhupendra Patel MD operated upon my upper and lower eyelids and transferred some fat into my frown lines and even my brows look better! People now take a double take when I tell them I am 75 years old! My eyes look like those of someone much younger! I wish I could have Dr. Patel perform a facelift on me but maybe next!! Right now, I am very happy with my upper and lower blepharoplasty results. I look very good and feel happy and confident. Happy, happy, happy.
Overall rating *****
AM I A CANDIDATE FOR LOWER BLEPHAROPLASTY?
Cosmetic lower blepharoplasty is performed when the patient is bothered by the appearance of the lower eyelids. Dr. Patel will examine you to ensure that the procedure may be performed safely. We see many patients for second, third and fourth opinions because of complications after blepharoplasty: we endeavor to ensure that our patients do not get any untoward results. Not all patients are suitable candidates for lower blepharoplasty.
You are a candidate for a lower blepharoplasty by itself or with an associated mid-face procedure (Hammock Lift TM), if:
- your anatomical and physiological changes can be safely reversed
- if you do not have other associated illnesses that can affect the outcome
- if you understand the details of what can be achieved (and what cannot be achieved with a lower blepharoplasty)
- you understand that there will be bruising and swelling which can vary from person to person
- you accept that the aim is to leave you looking natural without a tight or pulled look
- you understand that as we age, some variable puffiness occurs, especially when one is tired or first thing in the morning: this is normal physiological fluid movement which cannot be prevented
In men, the lower blepharoplasty must improve the bags and the deep grooves, as well as lighten dar circles and firm up lax eyelids: requires careful attention to detail
In ladies, it is important not to pull the lower lids downwards with a lower eyelid blepharoplasty as dryness of the eyes is more common in ladies
“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…” D. Rock 63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT
HOW WILL I BE ASSESSED?
Without making it too complicated, it is important that the surgeon assesses all the factors that may affect the outcome of lower eyelid blepharoplasty and chosen techniques. Dr. Patel has designed a number of modifications to lower eyelid blepharoplasty (including the “Hammock Lift”) which give patients the very best results. It is my belief that cosmetic lower blepharoplasty is the most difficult and exacting of all cosmetic procedures. Therefore, particular analysis is required and specific procedures are designed.
A BRIEF SUMMARY OF THE STRUCTURES WE STUDY WHEN ASSESSING A PATIENT FOR A LOWER BLEPHAROPLASTY
WHAT OTHER PROCEDURES MAY BE PERFORMED WITH LOWER BLEPHAROPLASTY?
In the presence of a deep groove and ptosis of the cheek, it is unwise to perform just a lower blepharoplasty: your results will be ho-hum! In such instances, a midface elevation with fat transfer combined with a lower blepharoplasty gives the best result. If this applies to your anatomy, it is important to identify the factors before undergoing surgery!
A technique designed by Dr. Patel, called the “Hammock Lift” takes into account the aging of the lower eyelids, the midfacial tissues, and the lower facial tissues and without performing a facelift, results far superior to just lower blepharoplasty.
We designed the “Hammock Lift” to improve the top two-thirds of the face: the brows, the upper eyelids, the lower eyelids and cheeks. This only leaves the lower facelift and necklift to be performed later to give a total facial rejuvenation. The Hammock lift gives amazing three-dimensional results with proportionate improvement of the face…
This lady, for example, wanted to look less tired with an endoscopic brow lift and upper and lower blepharoplasty, which worked very well.
The beauty of the “Hammock Lift” is that a total three-dimensional improvement is seen in the top two-thirds of the face with a more youthful and vibrant face. The tired and aged look is gone. The results are such that most people cannot see any scars and the face just looks youthful
“My Hammock Lift is exactly what I needed, but did not know!! Dr. Patel explained to me how the Hammock Lift improves the upper two-thirds of the face, including brows, upper lids, forehead, lower lids and cheeks. I also got an improvement along my jawline which I am thrilled with as I plan on having a lower face and necklift later but this already gets me a great improvement. I have sent my two sisters to him! Brilliant surgeon. Cannot speak highly enough about him and his team. ” J. Stevenson “Top marks”– Park City, UT
WHAT KIND OF RESULTS CAN I EXPECT AFTER A LOWER BLEPHAROPLASTY?
Most patients will request a lower blepharoplasty because they “look tired”. To that end, beautifully performed lower blepharoplasty will remove that emotion when looking in a mirror! It is important to perform the surgery with subtlety abut accuracy: this way, the typical “operated look” of lower eyelid retraction, ectropion in more severe cases, and show of the white of the eye inferiorly can be prevented.
LOWER BLEPHAROPLASTY CAN BE PERFORMED IN MEN AND IN WOMEN
Although lower blepharoplasty may be performed in men as well as in women, the surgical techniques are different. In many men, we also lift the cheeks to fill in the nasojugal and malar grooves (grooves below the bags). In ladies we will frequently use fat grafts to recreate the beautiful cheeks of youth and also use fractional lasers to improve the texture of the skin.
It is important to create beauty in women and handsome eyes and eyelids in men with the use of appropriate techniques.
“I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm.” D. Gull Highly recommended for eye lift surgery – Salt Lake City, UT
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Most lower blepharoplasties are performed in an outpatient operating theatre for the sake of sterility and your comfort.
In most cases, dissolving sutures are used which break up after about seven to fourteen days. They become itchy as they begin to dissolve and it is fine to gently scratch the incision line.. The prescribed ointment will also help with the itching, as will oral Benadryl (over-the-counter). There may be sutures on the outer corner of the eye, on the inner aspect of the lower eyelid and on the lower eyelids just below the eyelashes.
We use a number of tools, including lasers to give our patients the best possible results. Laser resurfacing, when performed in combination with a lower blepharoplasty gives a nice improvement in the skin texture, wrinkles and colour.
Most patients need to sleep with two to three pillows for the first two or three nights. This helps reduce the swelling more quickly. You may be up-and-about the very day of the surgery, albeit with some degree of blurry vision because of the healing eyelids. Gentle exercise (brisk walk on a treadmill or gentle cycling) may be resumed within two days. More vigorous exercise like skiing, tennis, etc may be resumed after 10 days. Driving may be difficult for the first two to three days because of blurry vision. Most patients return to work within a week.
Most lower blepharoplasty procedures take 45 to 60 minutes operating time.
Everyone gets bruising and swelling after lower blepharoplasty! Care is taken during surgery to reduce the degree of bruising our patients get. We will also show you how to apply ice to the eyelids after surgery to reduce the swelling and bruising. The worst of the bruising and swelling is over within a week. However, some residual bruising and swelling can take another few days to disappear. Also, the use of the laser leaves the skin rather pink for the first week, after which the pinkness fades slowly. I always remind patients that “it takes us 20, 30, 40 years to age, so a few weeks of proper healing is not surprising.”
Cosmetic surgical procedures are never covered by insurance.
There will be a sensation of tightness on the outer corner of the lower eyelids for the first couple of weeks. Numbness and a little stiffness of the lower eyelids is also to be expected. Because healing lower eyelids make the eye produce thicker tears, there will be some blurriness of vision. Only moderate pain is experienced by our patients. Most of my patients tell me they just need Tylenol or extra-strength Tylenol after surgery. And even that, just for the first one to two days.
- Bruising, swelling and blurry vision are not risks: they occur in every patient.
- Some degree of asymmetry is inevitable as this is always the case prior to surgery as well.
- Some degree of bleeding and oozing of blood-stained fluid for the first few days is also normal.
- Rarely, the dissolving sutures may break sooner if you sleep on your face or you sustain trauma: if this happens, putting in further sutures may be done in our clinic.
- In the first few days, everyone will experience some degree of dryness and blurry vision. You will also feel that your lids look a little tight on the outer corner where you will also feel some of the deeper sutures if you put your finger there: this is of no concern. The tightness and the bumps under the skin settle over a few weeks.
- More serious complications which are very rare include excessive bleeding, hemorrhage and loss of vision.
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CONTACT DR. PATEL
Do you have questions or need more answers?
Dr. BCK Patel MD, FRCS
Salt Lake City, Utah 84106, USA
(801) 413-3599 (phone/text)
Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
Saint George, UT 84790, USA