Lower Eyelids

Lower Eyelid Plastic Surgery by Dr. Prasad

Blepharoplasty (eyelift surgery) of the lower eyelids is performed to address puffy bags under the eyes, loose skin and sagging tissue supporting the lower eyelids. Very often people seek lower eyelid plastic surgery because their lower lids look droopy and tired due to one or several of these problems.

This 37 year old African-American male was frustrated with people teasing him for having bags under his eyes. He stated that no matter how much sleep he had, he still could not get rid of the bags. He was planning to get married within a year and wanted to look good for his wedding pictures. He underwent bilateral lower eyelid transconjunctival blepharoplasty which left him no external scars. He was very happy with the results.

Causes of Tired-Looking Lower Eyelids

• Bags - Bags under the eyes are often misinterpreted as bags from fatigue or allergy. The bags that are seen under the eyes, that remain despite sleep and appropriate allergy treatment, are due to fat prolapse. The eye sits in a space called the orbit. The fat that prolapses is referred to as orbital fat. To improve the appearance of the bags under the eyes, the fat may be removed, sculpted and reduced through one of two approaches.  The two most common approaches are external (transcutaneous) and internal (transconjunctival). Traditionally, bags have been approached by a majority of practitioners through an external incision. Depending on a person's age and ethnicity, the preferred method that Dr. Prasad uses is the internal approach, also known as transconjunctival blepharoplasty. Through the internal approach, there are no outside scars, and the shape of the eye is typically more well-preserved. In the transcutaneous approach, an incision is made directly below the eyelashes to access the fat by lifting up the skin and going through the orbicularis oculi muscle to get to the fat pads. 
• Loose Skin - Many people are concerned that after the bags are removed from under the eyes, there will be loose skin. Depending on the support of the lower eyelids, loose skin can be removed at the same time. This can be done when the fat pockets are removed with transconjunctival lower eyelid plastic surgery. Loose skin can also be removed when the approach to the lower eyelids is from the outside completely.
• Eyelid Support - One of the most common reasons people are referred to Dr. Prasad has to do with unrecognized problems with lower eyelid support. Properly supporting the lower eyelids requires several different specialized techniques. In addition, the support structures of the eyelid can be shaped in a way that can create a brighter appearance to the eyes.

This 63 year old business man had undergone bypass surgery about two years prior to coming to Dr. Prasad. He felt that he was grateful to be alive and wanted to continue doing the work he loved but was having difficulty communicating because his eyes made him look tired. He had loose skin in the upper and lower eyelids, which needed to be addressed. Dr. Prasad performed bilateral upper and lower eyelid blepharoplasty (transcutaneous) resulting in his eyes looking less tired.

Enhancing Lower Eyelids: Choosing What is Right for You

Dr. Prasad provides all his patients with an initial consultation. During this consultation, Dr. Prasad will perform a proper evaluation of all the key anatomic issues involved in supporting your lower eyelids and discuss in detail what he recommends as well as well as the results you can expect. When you come for your consultation, be sure to remember to provide all information related to any existing eye conditions, including dry eyes, allergies and eye medications. A customized treatment plan will be developed for you with Dr. Prasad.

This 28 year oldwoman who traveled from the Dominican Republic complained that she was tired of looking tired. She had tried lotions and potions from all over the world, spending as much ast $400 for a vial of "serum". Dr. Prasad explained that her puffiness was due to fat around her eyes that had pushed forward. She succesfully underwent bilateral lower eyelid transconjunctival blepharoplasty at the office operating facility under local anethesia. She returned home feeling her eyes were brighter and more attractive.

This 26 year old female came in with her mother frustrated with always looking tired. She noticed that applying makeup to cover the bags under the eyes only made the bags look more obvious. She felt that she liked the shape of her eyes and did not want to change the shape with surgery. Dr. Prasad performed bilateral lower eyelid transconjunctival blepharoplasty, giving her eyes a more energetic appearance and retaining the shape she desired.

This 30 year old male, body builder, was constantly being asked if he enough sleep or if he had been drinking alcohol the night before. He tried several over-the-counter undereye creams with no improvement. Dr. Prasad performed a transconjunctival lower eyelid blepharoplasty. He appreciated that there were no external scars, so no one would know that he had surgery.