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Common Questions About Lower Eyelid Blepharoplasty

I see patients every day in my office that are concerned with bags and wrinkles on their lower eyelids. The different surgical approach to the lower lids can be confusing to patients so here are some commonly asked questions.

Common Questions About Lower Eyelid Blepharoplasty

Q: What is the difference between the “trans-conjuctival” approach and the “sub-cillary” approach in lower eyelid cosmetic surgery?

A: In the “trans-conjuctival” approach the incision is made on the inside of the eyelid, so that there is no scar and no stitches. This is an excellent choice for younger patients who only have eyelid bags without excess skin and sagging muscle. The advantages of this approach is that the incision is made on the inside of the eyelid, so the recovery is much faster. The disadvantage is that sagging skin can not be corrected with this approach. I will often combine a trans-conjiunctival blepharoplasty with a laser resurfacing to the lower eyelids. The laser helps to improve the quality of the skin and removes some fine lines and wrinkles.

In the “sub-cillary” approach an incision is made just below the eyelashes. This allows a more aggressive solution for patients who have sagging skin, excess rolls of muscle, or skin and muscle that is hanging.

Q: Are the results of lower eyelid surgery permanent?

A: While your lower lids will continue to age with the rest of your face, the bags that are removed typically do not come back. I have been in practice for 21 years performing lower lid blepharoplasty and I have seen my patient’s results “age” over the years. It is very uncommon to repeat a lower lid blepharoplasty once it is done.

Q: What is the recovery time for the the “trans-conjuctival” approach and the “sub-cillary” approach in lower eyelid cosmetic surgery

A: In the trans-conjuctival approach recovery is remarkably quick. Most patients are back at work within 4-5 days, sometimes sooner.  With the sub-cillary approach patients have stitches for a week, and then usually some residual swelling for another few days after the sutures are removed. So I tell patients it is about a 10 day recovery when we approach the eyelids with a sub-cillary incision.

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