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Eyes & Brows Last Updated: May 22, 2010

Lower Eyelid Blepharoplasty (Internal)

Quick Facts

Lowe Eyelid Blepharoplasty (Internal)

Category:
Rejuvenate
Surgery/Treatment:
1.5 - 2 Hours
Description:
Facial Plastic Surgeon Dr. Buonassisi may use this "scarless" blepharoplasty for younger patients who do not have much lower lid laxity but have dark circles and bulging fat under the eyes.
Recovery Time:
Time Off Work: 1 Week
Back To Light Activities: Next Day
Back To Vigorous Activities: 2 Weeks

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The board certified experts of 8 West Cosmetic Surgery offer specialized cosmetic surgery for the face and the body. Learn More.

About the Procedure

Lower eyelid blepharoplasty (or eyelid lift) is a cosmetic surgery procedure in which extra skin and fat are carefully removed from the lower eyelids in order to create a more youthful, 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. Because the scars are inside the lower eyelid where they cannot be seen, this procedure is often called scarless blepharoplasty. The EXTERNAL approach involves an incision that is made just below the lower lash line. The incision fades with time to become virtually imperceptible. Every year, thousands of men and women safely undergo blepharoplasty in Vancouver, British Columbia. Is the external or internal approach best for you? The most appropriate approach for your lower eyelid blepharoplasty depends on the specific lower eyelid features that you have, and the degree of sagginess of the lower eyelid bag. Dr. Buonassisi will assess your eyelid features during your surgical consult, clearly explain the pros and cons of each procedure, and recommend which approach is best for you.

Benefits of Lower Eyelid Blepharoplasty

The eyes are one of the first parts of the face to show the signs of aging. This is due to a number of factors including, genetics, sun exposure and the natural aging process. As we age, we begin to notice changes that contribute to an overall tired look. Upper and lower eyelids begin to sag and loose their firm texture. At the same time, fat deposits begin to bulge forward as the eyelid structures become lax. Lower eyelid laxity and puffiness contribute to an overall tired and aged look. Patients are typically very satisfied with the results of their blepharoplasty surgery and appreciate that it requires minimal downtime. Following blepharoplasty surgery, your eyes will appear more youthful, rested and less puffy. The lower eyelid area will be more flat and smooth, and the lid skin will be tighter as it was when you were younger. More about The Science of Aging can found in this website’s Knowledge Base.

How the Procedure 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.  The small scar is inside the eyelid where it cannot be seen. Lower eyelid blepharoplasty surgery typically takes from 1 – 1.5 hours, and patients can return home the same day.

Benefits of the Surgery

  • Tightening of the lower eyelid skin
  • Reduction in the bulging lower eyelid fat
  • A more rested and youthful looking eye appearance

Are You a Good Candidate

Lower eyelid blepharoplasty in Vancouver is most commonly performed on people aged 30 years of age and older, while some patients have the surgery in their late twenties if their eyelid skin has aged quickly. This is possible if there is a history of heavy sun exposure, or eyelid puffiness runs in the family. Some patients have inherited eyelid features, such as fat deposits, which are not necessarily a result of the aging process, but are more so a family trait. Lower eyelid blepharoplasty can be ideal for these young patients, who may be candidates for the internal approach.

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)

General Health

You may be a candidate for blepharoplasty if you are in general, in good health:

  • You have normal blood pressure
  • You are not taking blood thinners, or your physician could safely recommend that you discontinue them for 2 weeks
  • You do not have significant dry eye syndrome
  • Your eye health is otherwise normal

Ideal Candidates for Cosmetic Surgery

Not everyone is a candidate for cosmetic surgery. Ideal candidates for cosmetic surgery demonstrate the following characteristics:

  1. Internally motivated to have cosmetic surgery
  2. Have realistic expectations
  3. Comprehend the potential risks and complication
  4. Motivated to follow pre and post operative instructions
  5. Can comfortably afford the cost of cosmetic surgery

Patients who display these characteristics are more likely to have a positive experience of cosmetic surgery.

Recovery

Most patients describe the recovery period from blepharoplasty surgery to be quite easy. There is typically no discomfort, aside from some slight itching where the sutures are placed. Swelling and bruising is at its worst on day three following surgery, and usually subsides two weeks following surgery. The following information will give you a sense for what kinds of activities are safe during the recovery period.

Time Off Work

  • Most people who work in the public eye take one week off work
  • One week after surgery, some people have perceptible swelling and bruising, which can last for another week or so – these signs are easily covered with makeup or glasses
  • People who work from home are typically feeling good and are able to be back at their desks two days after surgery

Back to Normal Activities

  • You can resume normal activities, such as light household work and taking a gentle stroll, the day after surgery
  • You can resume light fitness activities, such as jogging or yoga, one week after surgery
  • You can resume vigorous fitness activities, such heavy weight training or high impact cardio, two weeks after surgery
  • You should avoid bending over and lifting heavy objects for two weeks after surgery

Restaurant Ready

  • Once your sutures are removed seven days following surgery, you will typically feel “restaurant ready”, meaning that you would feel comfortable meeting up with friends – however, you will still have some evidence of swelling and light bruising, which can be camouflaged with makeup

Complete Recovery

  • Most people are feeling quite comfortable being out in public without much evidence of swelling or bruising two weeks after surgery – makeup or glasses can be used to camouflage these signs
  • The incisions, which are carefully hidden in the natural eyelid crease, fade over time, often becoming imperceptible within 3 months of surgery

Risks & Complications

All surgeries have associated risks. Dr. Buonassisi will review the risks and benefits of the surgery in detail during your surgical consult. In general, complications of eyelid surgery, while not expected, include:

  • Risk of infection
  • Risk of bleeding
  • Risk of poor wound healing
  • Risk of eyelid asymmetry
  • Risk of patient dissatisfaction with cosmetic result

Combination Eye Procedures

Blepharoplasty is often combined with other facial rejuvenation surgeries. Many patients opt to have their eyelids and other facial features, such as jowls and neck, treated at the same time in order to save having to take time off work and recover from more than one surgery. Lower eyelid blepharoplasty is often performed with upper eyelid blepharoplasty, for patients who are dissatisfied with their upper and lower eyelid appearance and would like to have surgery just one. Blepharoplasty is often combined with non-surgical treatments to smooth away lines and add youthful looking volume to the face.

Alternative Eye Procedures

Sometimes large bags under the eyes are stretched out pockets of skin that tend to retain fluid. In this case Dr. Buonassisi may recommend Malar Bag Excision. If your lower eye area is characterized by lower eyelid puffiness and a hallow upper cheek area, you may be a candidate for lower eyelid blepharoplasty with cheeklift.  Blepharoplasty surgery does not treat wrinkles around the eyes – if this is a concern, Dr. Buonassisi may recommend BOTOX® treatments for the Crow’s Feet area, or the area between the eye brows.

What Eyelid Procedure is Right for You?

While the information on this site is extensive, it is not designed the replace the skill and expertise of a board certified facial plastic surgeon. Use the information to help you explore the possibilities and educate yourself about the typical recovery period of cosmetic surgery. While this site provides general information about cosmetic surgery as it related to the average person, it cannot be used as a tool for people to decide which surgery is best for them. Only a thorough consultation with a board certified facial plastic surgeon can provide the specific information they require to make an informed decision about surgery. To find out which surgery is most appropriate for you, please Request a Consult.

Next Steps

Ready to Discuss Your Needs with Board Certified Facial Plastic Surgeon Dr. Thomas Buonassisi? Schedule a Consult

If you are ready to book a consult, please Request a Consult. If you would like to learn more about what to expect during a surgical consult, please go here.

Not Sure You Are a Candidate? Use our Virtual Consult Form

Not everybody is a candidate for cosmetic surgery. To save time, we have launched a Virtual Consultation tool. Upload your photos, provide some information about what you would like to change, and we will provide a complementary evaluation. Find out more about the Virtual Consultation here.

© Copyright 2010 8-West Cosmetic Surgery

This web site is primarily intended for Canadian residents. The information provided is for educational purposes only and should not replace a formal consultation with a Board-Certified Facial Plastic or Plastic Surgeon. Dr. Buonassisi is a Board-Certified Facial Plastic Surgeon who specializes in Vancouver rhinoplasty, face lift, blepharoplasty, double eyelid surgery. Dr. Watts is a Board Certified Plastic Surgeon who specializes in Vancouver breast implants, breast lift, breast reduction and tummy tuck.