Cosmetic Face Surgery

Lower Eyelid Surgery (Blepharoplasty)

Lower Eyelid Wrinkles - Lower Eyelid Fat Bags

Lower Eyelid Surgery
Lower Blepharoplasty

Cosmetic lower eyelid surgery, also called a lower eyelid blepharoplasty, is one of the most common cosmetic surgeries performed by Dr. Chang. The most common reasons for lower eyelid surgery include the appearance of lower eyelid fat bags and skin wrinkles from skin excess.  

If you are struggling with vacation size fatty bags under your eyes, it can have a significant effect on your self-confidence. Make-up is not enough to hide them and you may find yourself wearing sunglasses, regardless of the weather. Lower eyelid surgery can fix those bags.

Blepharoplasty is the technical name for surgical eyelid surgery. Cosmetic lower eyelid surgery is one of the most common cosmetic surgeries performed by Dr. Chang. The surgery removes fatty tissue under the eye, along with skin to produce a brighter, fresher look.

There are a number of techniques Dr. Chang uses  depending on what is required.

The subciliary lower eyelid blepharoplasty

The subciliary lower eyelid blepharoplasty is performed by making an inconspicuous incision just below the lower eyelashes. The eyelashes partly hide the eventual scar. In addition, the abundant moisture natural to the the lower eyelid margin helps produce nearly invisible scars.  

Once the incision is created, the skin and eyelid muscles are elevated to expose the excess orbital fat below them. The excess orbital fat is very conservatively removed so as to not produce a hollowed out appearance. The excess skin is then removed. The skin incision is closed with absorbable sutures that may need to be removed in 5-10 days.  

The transconjunctival lower eyelid blepharoplasty

The transconjunctival lower eyelid blepharoplasty is performed by making a very inconspicuous incision “behind” the lower eyelid. This technique is only appropriate for patients with fat bags but very little skin excess. The incision behind the eyelid allows exposure and removal of the fat but does not allow removal of the skin. Some skin tightening can be provided with the skin resurfacing laser.  

General information

Patients are given the choice to have the procedure in the office with local anesthesia and valium or at the surgery center for general anesthesia.  The procedure will take about 1-1.5 hours.  Patients will recover at home and return for a follow-up in a few days.  

Lower eyelid aging is a normal part of aging. For some people genetics, sun exposure, and gravity can cause more severe aging and produce fatty bags and wrinkles. Other cause are:

Weakening and thinning of the barrier that usually holds the lower eyelid fat back

  • There is a normal barrier that holds the fat volume that supports your eye, but this begins to thin with age. Some young patients will have a normally thin barrier. The more the barrier breaks down, the more the fat will push out on the barrier and show as larger fat bags.

Increased fat content behind the lower eyelids

  • The lower eyelid fat usually supports the eye.  Because all fat has the potential to enlarge with weight gain, increases in lower eyelid fat will eventually push out on the lower eyelid barrier and stretch the skin.  This will show even if you lose the fat.  

Loss of the upper cheek fat volume that normally happens with age exposes the lower orbital bone and fat bags

  • There is a normal loss of facial volume with age.  This loss of volume is very obvious in most patients in the upper cheek eyelid junction.  Loss of volume here exposes the lower orbital bone and can be seen as a dark circle. The loss of volume also exposes any other lower eyelid imperfections like the appearance of lower eyelid fat bags.

Someone who wants to:

  • Reduce the visability of wrinkles
  • Remove any skin excess
  • Reduce the appearance of fat bags
  • Reduce the appearance of dark circles

It is important to be healthy, ideally a non-smoker, not overweight and to have a realistic expectation of what can be achieved.

After surgery you should rest at home and let yourself heal. Dr. Chang will send you home with a detailed recovery plan. There are a number of different things to expect:

  • There will be bruising for 2-3 weeks
  • Final results should not be expected for 3-6 months
  • Most patients will return to work in 1-2 weeks with make-up
  • Sutures are removed in 7-10 days if they have not absorbed
  • Avoid strenuous exercise for 2-4 weeks
  • Apply the prescribed opthalmic ointment 3x per day until gone
  • Pain is negligible
  • Scarring will be minimal and hidden in the natural skin folds and creases

As with any surgery, there are associated risks. Only you can decide whether a lower eyelid surgery can achieve your goals and if the recovery and risks are acceptable to you. Complications are rare but can include:

  • Local bleeding or prolonged bruising
  • Ectropion ( pulling down of the eyelid )
  • Milia ( small cysts along the suture line )
  • Residual skin or fat
  • Infection particularly from the absorbable sutures
  • Loss of sensation although rare
  • Widened or thickened scar
  • Asymmetry (unevenness between two sides)
  • Delayed wound healing with skin or tissue necrosis
  • Extra skin at the ends of the incisions
  • Under-correction
  • Over-correction

Unsatisfactory results may require additional procedures. Patients will generally be responsible for any associated facility fees. 

If dark circles are caused by shadowing due to the fatty bags they can be significantly reduced. Dark circles caused by pigmentation will need other procedures such as laser treatment or chemical peels.

Wrinkles will reduce due to the excess skin being removed and tightened but wrinkles around the eyes (crow’s feet) will not be reduced by lower eyelid surgery.

 

The cost of lower eyelid surgery partially depend on the exact technique and whether the procedure is performed under local anesthesia or general anesthesia.  

There are a number of surgical and non-surgical procedures that can be combined with lower eyelid surgery:

  • Canthopexy (lower eyelid)
  • Upper eyelid surgery
  • Forehead lift
  • Mini Facelift
  • Botox and Fillers
  • BBL Laser treatment for pigmentation
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Dr. Phillip Chang Plastic Surgeon in Loudoun VA

Dr. Phillip Chang is a leading plastic surgeon in Loudoun County who specializes in surgical and nonsurgical cosmetic procedures for the breast, body, face, and skin. He is board certified in plastic surgery by the American Board of Plastic Surgery and is the founder of Aesthetica Cosmetic Surgery & Laser Center in Leesburg, VA. Dr. Chang is dedicated to providing high-quality service that concentrates on the unique needs and concerns of his patients. He believes combining attentive care and minimally invasive techniques is the best avenue for achieving beautiful, natural-looking results. Dr. Chang is thrilled to be serving the greater northwest area of Washington, D.C. with top cosmetic care that is dependable and trustworthy.

Interested in learning more about Dr. Chang? Click here.

We are based in Leesburg, VA. Located as part of the Lansdowne medical complex, you have access to our 24-7 state-of-the-art facility as well as access to Lansdowne hospital. We are based directly across the road from INOVA hospital. There is ample parking, elevators to bring you to our third floor offices, and welcoming staff to sign you in.

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All potential patients receive either a phone, virtual, or in-consultation for free.

During the consultation we will discuss your treatment wishes and expectations. This is the time to ask us lots of questions to really understand what is involved, what the costs will be, and what is expected of you. This is also a great time to get to know Dr. Chang.

Aesthetica has received numerous awards from the Loudoun County Chamber of Commerce, New Beauty, Best of Loudoun, Posh 7 Top Picks, and Dr. Chang is internationally known for his lectures and advances in precise surgical technique as demonstrated through his unique mini-facelift procedure.

We have three execeptionally talents cosmetic nurses:

  • Melanie Schwarz, RN, BSN
  • Katy Down, RN, BSN
  • Angela Westbrook, RN, BSN

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