Lower eyelid blepharoplasty (or eyelid lift) is a term to describe a cosmetic surgery procedure in which extra skin and fat are carefully removed from the lower eyelids in order to create a more youthful eye appearance. The term EXTERNAL refers to the way facial plastic surgeon Dr. Buonassisi accesses the underlying eyelid structures using a fine incision made just below the lower lash line (called a subciliary incision). The incision fades with time to become virtually imperceptible. The external approach is appropriate for patients who have lower lid skin laxity, pronounced bags and general puffiness. Generally speaking, patients over the age of 40 have started to develop the kind of skin laxity that would make the external approach the better one for them.
The internal approach involves an incision which is made in the inside (or conjunctiva) of the lower eyelid, meaning that there are no scars on the outside of the eye. This approach is typically appropriate for patients under the age of 40 who have litte skin laxity or lose bags, but are bothered by a puffy pocket of herniated fat.
It is important to have your lids and other eyelid features assessed carefully by Dr. Buonassisi during a consultation.
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.
Following lower eyelid 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.
Facial Plastic Surgeon Dr. Thomas Buonassisi is an expert cosmetic blepharoplasty surgeon. He creates a small incision just below the lower lash line where it can be hidden from view. The skin and underlying muscle is gently elevated to expose the fat that often bulges forward from the lower eye. Once the fat is removed and reshaped the excess skin is trimmed and the underlying muscle is suspended upward and outward to support the tissues for long-term tightening of the lower lid. The skin is closed with very fine stitches that either dissolve on their own or are removed one week after surgery. Lower eyelid blepharoplasty surgery typically takes from 1 – 1.5 hours, and patients can return home the same day.
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.
Most patients take 2 – 3 weeks off work or social activities to allow for bruising and swelling to resolve. This procedure does certainly take longer to recover from than an upper eyelid blepharoplasty or a transconjunctival approach to lower eyelid surgery. It is common for patients to experience substantial swelling that lasts around 2 weeks, or more in some patients. One of the reasons patients experience swelling is because of what is called a canthopexy. To prevent a complication called an ectropian (when the lower lid margin becomes lax following lower eyelid surgery) Dr. Buonassisi uses a canthopexy technique – which involves securing the outside edge of the lower eyelids in an intentionally high position. This helps to prevent lower eyelid margin sag in the long run, but does result in an overly tight appearance to the lower lids that can last about a month. For this reason, we h2ly encourage patients to plan carefully and allow plenty of time for their final results to appear.
It is important that patients considering lower eyelid surgery have a thorough consultation with Dr. Buonassisi in order to become informed about the medica and cosmetic risks of surgery. The medical risks include the extremely rare chance of bleeding and infection. The cosmetic risks vary from patient to patient depending on their age, skin quality and other facial features – but can include slight asymmetry poor wound healing or poor scar formation. Patients are typically very happy with the result of their surgery and the way their incisions heal.