Lower Lid Blepharoplasty

Lower lid fat bags, also known as under-eye bags, refer to the bulging or puffiness that occurs beneath the lower eyelids. These are made of fat, not fluid. These fat bags are a common cosmetic concern that can make individuals appear tired, older, or perpetually fatigued. Lower lid fat bags can develop due to various factors, including genetics, aging, fluid retention, and weakening of the supporting structures around the eyes. They are caused by protrusion or herniation of the orbital fat pads, which are responsible for cushioning and protecting the eyeballs. When these fat pads become more prominent or displaced, they create a noticeable bulge or bag-like appearance under the eyes.

How Are These Bags Addressed?

Lower lid blepharoplasty surgery is a cosmetic procedure aimed at rejuvenating the lower eyelids and improving the appearance of under-eye bags, wrinkles, and excess skin. The surgery involves making precise incisions either inside the lower eyelid (transconjunctival approach), and through these incisions, the surgeon accesses the underlying herniated fat. Excess fat is carefully removed or repositioned to reduce the appearance of under-eye bags, while any loose or sagging skin is trimmed or tightened with CO2 LASER. Additionally, if necessary, the surgeon may perform a canthopexy or canthoplasty procedure to reinforce the outer corner of the eye and provide additional support. The incisions are then closed with sutures, resulting in a smoother, more youthful lower eyelid contour. As expert oculoplastic specialists, your surgeon will individually tailor your care with whichever technique or combination of techniques he feels would suit you best.

What Is a Festoon?

A festoon refers to a specific type of swelling or bag-like protrusion that occurs over the cheek area, below the under-eye bags. It is characterized by a distinct, puffy appearance that is different from lower lid herniated fat. While lower lid herniated fat refers to the bulging of fat pads beneath the lower eyelids, festoons involve a combination of fluid retention and skin laxity. Correcting festoons typically requires a multi-faceted approach, but these are often difficult to correct, often requiring more than one procedure. Treatment options may include lower lid blepharoplasty to address the underlying fat pads and excess skin, along with techniques such as laser resurfacing therapy, excess skin removal, mini-midface lifting, or direct excision of the festoon to tighten the skin and reduce fluid accumulation.

Importantly, unlike fat prolapse which can be a normal process of aging, festoons can be worsened by medical conditions. Addressing any underlying causes, such as allergies or sinus issues, excess salt intake or any other medical cause, can help minimize the appearance of festoons. The specific correction approach will vary depending on the severity of the festoons and individual patient factors, so consultation with an experienced oculoplastic surgeon like Dr. Chen or Dr. Pharo is crucial to determine the most appropriate treatment plan.

How long should surgery take?

1-2 hours

Anesthesia use?

Local with sedation or general

Recovery time?

2-3 weeks

Insurance covered?

Not covered

FAQs

  • No. These bags are the fat actually prolapsing forward and the only thing that can adequately address them is surgery.

  • Like all surgery, there are risks with lower lid blepharoplasty. Some of the most pertinent risks include persistent fat that may need additional surgery to remove, hemorrhage behind the eye that may need to be drained, prolonged swelling around the eye, double vision, poor wound healing, and risks associated with anesthesia. Your surgeon will discuss the risks of the surgery in detail with you at your pre-operative appointment.

  • Recovery from lower lid blepharoplasty may involve temporary swelling, bruising, and mild discomfort, but the results can yield a refreshed and rejuvenated appearance, with a reduction in under-eye bags and improved overall eye aesthetics.

    You should expect 2-3 weeks of recovery time.