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Internal Lower Eyelid Blepharoplasty

Internal Lower Eyelid Blepharoplasty
By , Articles in Surgery

Internal Lower Eyelid Blepharoplasty

The external or transconjunctival approach to lower eyelid blepharoplasty (or eyelid lift) is a cosmetic surgery procedure in which bulges of fat are carefully removed from the lower eyelids in order to create a more rested eye appearance. The term INTERNAL refers to the way Dr. Buonassisi accesses the underlying eyelid structures. The internal approach to lower eyelid blepharoplasty involves a fine incision made inside the skin of the lower eyelid (this is called a transconjunctival incision).

Because the scars are inside the lower eyelid where they cannot be seen, this procedure is often called scarless blepharoplasty. This approach is appropriate for younger patients (typically under the age of 40) who have buldging lower lid fat, but do not have skin laxity. Patients with skin laxity are generally candidates for the external approach.

This video explains the internal approach to lower eyelid blepharoplasty.

Benefits of Lower Eyelid Blepharoplasty

The internal or transconjunctival approach is best suited for younger patients who have noticeable puffy lower eyelids but do not have loose skin that needs to be removed. Often these herniated bulges of fat are hereditary and can be bothersome for even patients are young are 20.

How the Lower Eyelid Surgery Is Performed

Facial Plastic Surgeon Dr. Thomas Buonassisi makes a very small incision inside the lower eyelid where it cannot be seen.  The tissues are gently separated to expose the lower eyelid fat that often bulges forward.  The fat is carefully removed in order to reduce the puffiness of the lower eyelid.  The incision is then closed and allowed to heal.  Often stitches are not required. Lower eyelid blepharoplasty surgery typically takes from 1 – 1.5 hours, and patients can return home the same day.

Physical features

You may be a candidate for blepharoplasty if you have any of the following physical features:

  • Puffy lower eyelid bags that are caused by bulging fat pockets
  • Your puffiness is not due to allergies
  • You don’t have lax lower eyelid skin (if you do, you are a candidate for the external lower eyelid blepharoplasty approach)


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