Lower Eyelid Surgery by Dr. Prasad

Lower eyelid surgery is performed to address puffy bags under the eyes, loose skin and sagging tissue supporting the lower eyelids. Very often people seek lower eyelid plastic surgery because their lower lids look droopy, heavy, and tired-looking due to one or several of these problems.

Before

lower eyelid surgery before

After

lower eyelid surgery after

This 43-year old African-American male was frustrated with bags under his eyes that were constantly present, regardless of amount of sleep or lack of stress.He underwent lower eyelid surgery (bilateral lower eyelid transconjunctival blepharoplasty) which left him no external scars. Dark skin has the tendency for keloid (raised) scars and hyperpigmentation from scarring, so transconjunctival blepharoplasty is the best method, but it is a more specialized technique not practiced by most general plastic surgeons. He was very happy with the results as it appears he never had the under eye bags to begin with.


What’s Causing Your Lower Eyelids to Look Puffy?

Eye Bags

Eye bags are caused by a variety of factors. Some are genetic; some are caused by lack of sleep or not getting enough exercise; some are caused by water retention and diets high in salt; and some are caused by sinus infections or allergies. There are a number of non-surgical ways you can remedy this, but unfortunately, as we grow older, eye bags will mostly likely become a permanent fixture on our faces. This is due to fat prolapse—when the fat that surround our eyes begin to sag as well, giving way to unsightly eye bags.

To improve the appearance of the bags under the eyes, the fat may be removed, sculpted and reduced through one of two approaches: (1) external (transcutaneous) and (2) internal (transconjunctival). In the transcutaneous approach, an incision is made directly below the eyelashes to access the fat by lifting up the skin and going through the orbicularis oculi muscle to get to the fat pads.

Depending on a person’s age and ethnicity, the preferred method that Oculoplastic surgeon Dr. Amiya Prasad uses for lower eyelid surgery is the internal (transconjunctival) approach, also known as transconjunctival blepharoplasty. Through the internal approach, there are no outside scars, and the shape of the eye is typically more well-preserved.

Loose Skin

Many people are concerned that after the bags are removed from under the eyes, there will be loose skin, which will end up giving their eyes a saggy, wrinkly look. However, depending on the support of the lower eyelids, loose skin can be removed at the same time. This can easily be done, for example, when the fat pockets are removed during transconjunctival lower eyelid surgery. Whether the approach is from an internal or external source, loose skin may still be addressed and removed.

Poor Eyelid Support

When eyelids have a poor support frame, they tend to look heavier and more tired. The support structures of the eyelid can be shaped in a way that can create a brighter appearance to the eyes. Often times, some surgeons will oversimplify their approach to lower eyelid surgery, thus leading to more unrecognized problems concerning lower eyelid support. Ocuplastic surgeon Dr. Amiya Prasad stresses that properly supporting the lower eyelids through lower eyelid surgery requires several different specialized techniques, and should not be oversimplified by any surgeon.

Before

lower eyelid surgery before

After

lower eyelid surgery after

This 63-year old business man had undergone bypass surgery about two years prior to coming to Dr. Prasad. He felt that he was grateful to be alive and wanted to continue doing the work he loved but was having difficulty communicating because his eyes made him look tired. He had loose skin in the upper and lower eyelids, which needed to be addressed. Dr. Prasad performed lower eyelid surgery [bilateral upper and lower eyelid blepharoplasty (transcutaneous)resulting in his eyes looking less tired.


Before

lower eyelid surgery before

After

lower eyelid surgery after

This 28-year old woman, who traveled from the Dominican Republic, complained that she was tired of looking tired. She had tried lotions and potions from all over the world, even spending as much as $400 for a vial of “serum”. Dr. Prasad explained that her puffiness was due to fat around her eyes that had pushed forward. She successfully underwent lower eyelid surgery (bilateral lower eyelid transconjunctival blepharoplasty) at the office operating facility under local anethesia. She returned home feeling her eyes were brighter and more attractive.


Before

lower eyelid surgery before

After

lower eyelid surgery after

This 26-year old female came in with her mother frustrated with always looking tired. She noticed that applying makeup to cover the bags under the eyes only made the bags look more obvious. She felt that she liked the shape of her eyes and did not want to change the shape with surgery. Dr. Prasad performed lower eyelid surgery (bilateral lower eyelid transconjunctival blepharoplasty), giving her eyes a more energetic appearance, while retaining the shape she desired.


Before

lower eyelid surgery before

After

lower eyelid surgery after

This 30-year old male body builder was constantly being asked if he had enough sleep or if he had been drinking alcohol the night before. He tried several over-the-counter under eye creams with no improvement. Dr. Prasad performed a lower eyelid surgery (transconjunctival lower eyelid blepharoplasty). He appreciated that there were no external scars, so no one would know that he had surgery.

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