Lower Blepharoplasty

Blefaroplastica Roma dr. Pierfranco Simone

Lower eyelid rejuvenation

Lower blepharoplasty is a procedure which seeks to reduce fat pads (fat hernias) from underneath the eyelids (a cause of eyelid protrusion) and to remove excess skin from lower eyelids if necessary.

If the condition is mainly characterised by protruding fat pads only (with no excess skin) – as is typical in younger patients – it is possible to remove the fat from the inside of the eyelid. There are no incisions on the outer surface of the eyelid (transconjunctival lower blepharoplasty) and consequently no scars. If there is excess skin, skin excision must be performed along the eyelid margin. However, the resulting scar is virtually invisible.

In order to achieve a natural result, it is crucial that excess tissue is removed only, avoiding over-correction. This can lead to a sunken or skeletonised appearance which is more pronounced after complete swelling resorption.

In the majority of cases, it is possible to use the fat in the hernias as a filler. In fact, it can be redraped to correct tear troughs. The redistribution effectively reduces bulges and fills grooves below the eyelids simultaneously.

Transcutaneous lower blepharoplasty usually necessitates the temporary suspension of the lateral lower eyelid, with deep dissolvable sutures (canthopexy). This procedure provides support to the lower eyelid, maintaining its natural (not rounded) shape. This technique yields stable results, preventing excess downward tension.

Lower blepharoplasty is usually performed under local anaesthesia, with sedation (anaesthesia is limited to the operation locality and a tranquilliser is administered). In this case, the patient is discharged in a matter of hours after surgery.

In selected cases, or when in combination with other procedures, lower blepharoplasty is performed under general anaesthesia (the patient is asleep), followed by a one-night stay in hospital.

Careful administration of pain-killers during and after the surgery ensures that post-operative pain and discomfort are kept to a minimum.