Lower Lid Blepharoplasty
There are 3 fat pads in the lower orbit: medial, central, and lateral fat pad. They are located behind a thin fibrous layer called the orbital septum. With age, the septum thins and allows the fat to protrude. Lower lid blepharoplasty removes these fat pads through a hidden transconjunctival incision on the posterior part of the eyelid. The fat does not return after it is removed. The eyelid skin is thin and can appear crepey after the fat pads are removed (or in some cases repositioned), from stretching, which is why CO2 or Erbium laser resurfacing is recommended at the same time to tighten the skin and smooth out wrinkles. Laser skin resurfacing not only improves the wrinkle pattern but also promotes new collagen formation, which decreases the appearance of dark circles.
The goal of this procedure is to not only unpack the bags but also give the face a more rested look while maintaining the unique shape of the eyelid.
This is usually performed under local anesthesia, although it can also be done under general anesthesia per patient request. It usually takes about an hour to perform. This can be done in conjunction with upper lid blepharoplasty or upper lid ptosis procedure as well and peri-ocular or full face and neck laser skin resurfacing.
This varies per patient, but about 80% of swelling decreases by month 1, and the residual 20% can take several months to resolve. There are no stitches to remove from the lower lid and patients are usually seen at the following intervals postoperatively: 1 week, 1 month, 3 months. Some patients may benefit from lower eyelid filler around week 4-6 post procedures to improve hollowness from bony reabsorption that occurs with age. No bandages are placed after the procedure, but detailed instructions will be given about ice and head positioning to decrease swelling after the procedure.
As with any surgical procedure, there are certain risks associated with a lower blepharoplasty procedure, which Dr. Rosh will review at your consultation.
This advanced eyelid procedure improves the appearance of under-eye bags and puffiness by removing or repositioning fat through a hidden incision inside the lower eyelid (transconjunctival approach). A laser is used for precision, minimizing bleeding, bruising, and downtime.
- No visible scars and no sutures – The incision is inside the eyelid, leaving no external marks. The wound generally self seals in about 1 week.
- Reduced swelling & bruising – Laser technology minimizes trauma to surrounding tissues.
- Faster healing – Compared to traditional techniques, recovery is typically quicker.
- Natural-looking results – Preserves eyelid shape and avoids a hollowed appearance.
Dr. Rosh usually includes lower lid C02 resurfacing as part of the procedure to improve texture changes at the same time as surgery.
Ideal candidates:
- Have under-eye bags, puffiness, or fat pockets without excess skin
- Want a scar-free, minimally invasive solution
- Have good skin elasticity
- Are in overall good health and have realistic expectations
The procedure typically takes 45 to 90 minutes, depending on individual needs.
No. It is performed under IV anesthesia with sedation in the office, ensuring comfort during the procedure. Some mild discomfort or tightness may be felt during the healing process.
- Swelling & bruising: Usually subsides within 7 to 10 days
- Return to work: Most patients resume normal activities within 5 to 7 days
- Final results: Gradual improvement over several weeks to months
No. The transconjunctival approach places the incision inside the lower eyelid, making it completely hidden.
Results are long-lasting, often for 10-15 years or more, depending on factors such as aging, skin care, and lifestyle habits.
While rare, possible risks include:
- Temporary swelling, dryness, or irritation
- Mild asymmetry
Temporary blurry vision due to swelling
Dr. Rosh uses precise laser technology to minimize risks and enhance safety.
Yes, this procedure is often combined with:
- Skin resurfacing (laser or chemical peel) to improve fine lines and skin texture
- Filler or fat transfer to enhance volume and smooth hollow areas
Upper eyelid blepharoplasty for full eye rejuvenation
Since it is a cosmetic procedure, it is typically not covered by insurance. However, financing options may be available.
To learn if this procedure is right for you, schedule a consultation with Dr. Rosh by 813 303 0123.
Schedule your individual
treatment plan today!
