LOWER EYELID BLEPHAROPLASTY NEWPORT BEACH
Orange County’s Best Eyelid Surgery Center
As we age, there are several changes that occur to our facial anatomy. Our lower eyelids are subject to most, if not all of these changes. Puffiness of the lower eyelids can cause our eyes to appear tired, heavy, and uninterested. These attributes are conveyed to whoever is standing across from us, even when they don’t reflect our true emotions.
In addition to puffiness under the eyes that you may see in the mirror, there are several subtle but important changes that may be occurring. This is where Dr. Joseph’s focus and experience in this area are vital. During your consultation, Dr. Joseph will discuss changes in skin, volume, and changes in surrounding structures. Each of these factors can affect the appearance of your eyes and eyelids. He will also analyze and discuss your behaviors, including sleep, diet, and exposures, that may be contributing. Dr. Joseph will customize an approach for your eyes that addresses all of your issues.
The goal of lower eyelid blepharoplasty is to make your eyes appear more rested and vibrant. The art of this surgery is found in the natural results that Dr. Joseph can achieve. The surgery itself customarily addresses undereye bags and puffiness of the lower eyelids caused by visible orbital fat.
Though most surgeons will remove this fat to “get rid of the puffiness,” this is not always the best approach. Dr. Joseph’s experience and focus around the eyes, means he will be able to tailor an approach specific to your concerns, problems, and goals. After surgery, many people will comment on how rested you look and your improved appearance, without knowing that you had anything done.
This is the most common question we hear in our practice. Surprisingly, the answer may be no. If you are trying to improve the appearance of tired, puffy, or heavy eyelids, as described above, there are often a multitude of contributing factors. Surgery may be part of the plan. However, treating volume changes, skin changes, or muscle contraction alone, or in combination, will be a vital part of maximizing your results. During your consultation with Dr. Joseph in his Newport Beach office, you will learn about each type of treatment, and discuss your unique goals. Together you will develop a plan to give you the best results possible.
Surgeons from different specialties may offer this procedure to their patients. As an oculofacial plastic surgeon specializing in eyelid surgery, Dr. Joseph focuses his practice on this area and this type of surgery. This enables Dr. Joseph to tailor the surgery to your specific needs and goals. Dr. Joseph is excited to bring this level of specialized care to Newport Beach.
Any surgery requiring an incision will leave a scar. Unsightly scars occur when the surgeon does not plan, create, or stitch the incision in an ideal fashion. Often times, Dr. Joseph is able to perform the entire surgery through a small, completely hidden incision on the inside surface of the eyelid. This is called a transconjunctival incision blepharoplasty, and is a very specialized approach to lower eyelid surgery.
(Mayo Clinic. (2023). Eyelid Surgery: What to Expect.)
This surgery can be performed with minimal anesthetic. Often a combination of local anesthetic and sedatives delivered intravenously by an anesthesiologist can be used to maximize comfort and relaxation. Dr. Joseph will discuss all of your options with you during your consultation.
The average surgery usually requires between 1.5 to 2.5 hours. However, this time will vary depending on the specific goals that you and Dr. Joseph set forth. Every surgery is unique and to achieve the absolute best result, no surgery is ever rushed.
Recovery varies by individual. The eyes are usually swollen and bruised for 1 to 2 weeks. There can also be some sensitivity and blurriness of the eyes for a few days after surgery. There can be some pain after surgery, but it is usually well controlled with ice compresses and over-the-counter medications.
LOWER EYELID BLEPHAROPLASTY RECOVERY
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Immediately AfterYou can expect some swelling and bruising immediately after surgery. In these cases, applying some ice can be very helpful, and we may prescribe some over-the-counter medication if it is needed. You may experience a dry eye sensation during the first week of surgery. Make sure your eyes are kept dry for at least the first two days.
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1 WeekAround this time, we will ask you to come back into the office so the stitches from your lower eyelids can be removed. You should also be able to start reading, watching tv, and performing small, easy activities around the house for extended periods. Most of your swelling and bruising should improve by the second week.
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2 to 3 WeeksAround this time, you should be able to resume most, if not all, of your routine activities. As lower eyelid surgeries tend to involve a slightly longer recovery period than for upper eyelids, we do not recommend returning to work before two weeks.
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1 Month to 6 WeeksSome minor swelling may persist, which should improve over the next several months. Your lower lid incisions should heal, but this will usually take time, sometimes up to several months. Your doctor may make use of scar cream or steroid injections to help improve your scars.
Will There Be A Scar?
As eyelid surgery involves an incision in the natural crease of your eyelid, scarring is, unfortunately, unavoidable. Fortunately, our office’s qualified microsurgeon can hide the incision to ensure it is all but invisible.Visible scarring is possible when you work with a surgeon who does not plan the incision as well as he should. Fortunately, with our top-quality surgeon, you can always count on getting a professional with years of experience and training on his side.
Lower Blepharoplasty FAQs
Dark undereye circles can have many different causes. Often, people will have multiple factors contributing to their dark circles. If dark circles are caused by fat bulging or hollowing under the eyes, transconjunctival, internal blepharoplasty can significantly improve them. Fat excision, or fat repositioning can help even out the light and shadowing in this area, improving the dark circles. However, if skin quality, vascularity, or pigmentation is part of the cause, complementary treatments such as skin removal, chemical peels or lasers may be recommended as a complement to the surgery.
(American Academy of Ophthalmology. (2022). Understanding Under-Eye Circles.)
There are two main techniques:
Transconjunctival blepharoplasty: This is the preferred, safest, and most sophisticated technique. Fat is repositioned and/or removed through an incision inside the lower eyelid, leaving no visible scar. This allows for improvement of the undereye bag as well as softening of the undereye hollowing or tear trough. Excess or thinning lower eyelid skin can also be addressed during this approach.
Transcutaneous blepharoplasty: The more traditional and somewhat outdated approach. An incision is made just below the lash line, allowing removal of excess skin and muscle as well as fat. This creates a larger surgery with longer healing times. In addition there is a higher risk of scarring to the lower eyelid that can change the eye shape or cause problems with closing of the eyelids.
(Rafaelof, Michael & Joseph, Jeffrey. (2023). Transconjunctival Blepharoplasty. In book: Plastic Surgery of the Lower Eyelids (pp.221-229) 10.1007/978-3-031-36175-3_24)
Laser treatments, like fractional CO2 laser resurfacing, improve surface texture, fine lines, and pigmentation. Another option for skin rejuvenation during lower eyelid blepharoplasty is a lower eyelid chemical peel. Both options work to improve the skin, but in different ways. These treatments are often combined with surgery to optimize the results.
As a cosmetic eyelid surgery specialist, Dr. Joseph can customize your surgical plan to your unique anatomy. As we age in the undereye, we can develop bags and puffiness from eyelid fat that gets bigger with time. If this is your primary problem, a fat removal surgery may be your best fit. A lot of our patients have both bags and hollowing, as we can often develop both as we age. In this case, fat removal alone will not address the hollowing and can leave people looking worse than when they started. Fat repositioning is a sophisticated technique that allows Dr Joseph to address both the bags and hollows creating an ideal and natural result.
Surgery is not the only option to correct a tear trough deformity. However, often this creates the most comprehensive, long-term, natural results. By using a fat repositioning technique, the lower eyelid fat can be moved into the tear trough which smooths the lid-cheek junction, creating a more youthful contour.
ASOPRS. (2023). Tear Trough Correction Techniques.
The cost of cosmetic lower eyelid surgery can vary. Costs can be determined by the experience and expertise of the surgeon, and the complexity of the approach. In addition, costs may include additional complimentary procedures like skin treatments (laser resurfacing, chemical peel, or radio frequency), volume restoration (facial fat grafting, or mid face lift), as well as anesthesia costs. Dr. Joseph plans a custom approach for each patient and so each patient’s costs are dependent on his or her exact needs and goals.
Most patients experience mild to moderate discomfort in the initial days after surgery. The eyes can be sore, gritty, and the areas around the eyes like the eyelids, and cheeks can be uncomfortable. The pain is not severe, however, and can often be easily controlled with oral pain medication.
(Rafaelof, Michael & Joseph, Jeffrey. (2023). Transconjunctival Blepharoplasty. In book: Plastic Surgery of the Lower Eyelids (pp.221-229) 10.1007/978-3-031-36175-3_24)
No, the surgery when approached correctly does not affect vision. Vision may be temporarily blurry or sensitive in the days after surgery due to swelling or ointments used during routine post-operative care,, but it improves relatively quickly.
Results from lower eyelid blepharoplasty can last for many years, but even though the surgery allows for substantial improvement, natural aging continues. The results from under eye bag surgery can last for 10 to 15 years, and sometimes even longer. However continued aging changes such as volume loss, loss of skin quality, and sagging of facial structures may affect the results over time.
Click here to contact Dr. Joseph’s Newport Beach office and schedule your consultation.