What is Lower Blepharoplasty?
Lower blepharoplasty is a surgery that seeks to cosmetically improve the lower eyelid. It corrects the fatty bags and creases of the lower eyelids, as well as laxity, folds, and wrinkles, improving the aesthetics of the lower eyelid. Surgery for eyelid bags must be highly individualized, as there are different techniques, and the most appropriate one must be selected based on each patient’s characteristics.
Lower transconjunctival blepharoplasty
The best method for treating bags and dark circles is the transconjunctival approach. There is no doubt today that the best approach for treating bags of fat is the transconjunctival approach. The fundamental advantage of this approach is that we can treat bags of fat without having to manipulate the orbicularis oculi muscle , which supports the eyelid.
When blepharoplasty is performed externally, however, we must open the orbicularis oculi muscle, which increases the risk of potential complications resulting from the weakening of this muscle, such as eyelid retraction or ectropion. In other words, the transconjunctival approach allows access to the fat pads without having to touch important eyelid structures.
A second and obvious advantage is the absence of scarring and external stitches. If the patient needs to treat skin laxity, we can make an additional incision just below the eyelashes, but it will be very superficial and will not affect the orbicularis oculi muscle.
Our patients say
Preguntas frecuentes sobre la Blefaroplastia inferior
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This will depend on the degree and type of laxity. When there is significant laxity, skin can be safely removed from the lower eyelid. For this, we typically use the “pinch” technique , which is minimally invasive and leaves invisible scars very close to the lash line.
In cases of lesser laxity, it’s sufficient to treat the skin with a chemical peel at the time of surgery. This renews and tightens the skin without the need for incisions.
It is important to remember that expression lines cannot be completely eliminated , and large amounts of skin should not be removed, as this will cause the eyelid to retract.
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In most cases, we redistribute fat above the orbital grooves . This has several advantages. On the one hand, it prevents an excessively sunken appearance, but it also improves the grooves and the eyelid-cheek transition. Furthermore, the result is more stable over time , since the natural progression of aging often causes grooves to become more visible due to the sagging of the cheekbones, and covering the grooves with fat from the bags slows down this process.
Some patients have little fat and are not good candidates for this technique, while others have very pronounced bags and require fat removal. An individualized examination will determine which technique is best for each case.
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We often perform canthopexy during lower blepharoplasty. Not necessarily to alter the shape of the eyelid, but to reinforce eyelid support in patients undergoing this surgery who present with tendon laxity.
Some patients request a narrowed gaze or correction of a drooping eyelid, and this can be achieved through canthopexy.
However, one must have realistic expectations regarding this procedure. Canthopexy achieves moderate effects, not major stretches or alterations to the patient’s natural shape.
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When the patient has prominent grooves or significant volume loss in the orbital grooves and cheeks, they may be a candidate for volume replacement using micro-lipofilling techniques, which improves the grooves and eyelid support.
The use of Nanofat, on the other hand, would be indicated to improve skin quality in cases of significant deterioration or pigmentation.
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This is a very common question users ask before undergoing lower blepharoplasty. Will under-eye bag surgery be very expensive? It all depends on the type of surgery, although it can generally range from €2,000 to €4,000.
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This operation, which people refer to as lifting dark circles under their eyes, is called lower blepharoplasty or lower eyelid blepharoplasty. This procedure removes excess fat under the eyes through an incision in the crease or inside the eyelid. The skin is then reattached with a few stitches. Therefore, we can say that it is a very simple operation with easy recovery.
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The results of lower blepharoplasty are usually seen two weeks after surgery. The surgeon will evaluate the final results starting at six weeks, although this will depend on each patient, as neither the skin type nor the degree of intervention is the same for each patient. You can view the before and after results of blepharoplasty .
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Before your procedure, you will have an initial visit with Dr. Nieto, during which you will discuss your anatomy, possible options, and your goals. This visit lasts between 30 and 45 minutes. Before the visit, we will ask you to complete a brief questionnaire about your health, eye problems, and previous surgeries. It is important for us to know about any pre-existing medical conditions, as well as any drug allergies and the patient’s current medications.
During the same visit, we’ll perform a comprehensive eye exam to ensure your eye health. Dr. Nieto is an expert ophthalmologist trained at the best hospitals in the country and abroad, so your eye health is in good hands. It’s especially important to detect dry eye (poor tear production), as in these cases we tend to perform more conservative surgeries to avoid exacerbating the problem.
Having undergone laser eye surgery, cataract surgery, glaucoma surgery, or retinal surgery is not an impediment to undergoing this surgery, but it is important that these problems be controlled and stabilized prior to surgery. Prior to lower blepharoplasty, you must undergo a general blood test with coagulation and an electrocardiogram, which you must bring with you on the day of the procedure to give to the anesthesiologist.
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You must arrive at the clinic accompanied and approximately 30 minutes before your surgery, bringing the necessary documentation as instructed, as well as any preoperative tests.
Once in the operating room, the nursing team will ensure you are comfortable and relaxed. The anesthesiologist will then introduce himself, check your vital signs, and give the go-ahead for the procedure. We perform this surgery under local anesthesia and sedation.
The drugs used for sedation today are eliminated very quickly from the body, so recovery is rapid and without a hangover. The surgery is always performed on an outpatient basis, without hospitalization. The surgery typically lasts about 45 minutes, but if it’s performed in conjunction with a lower blepharoplasty or brow lift, it can last up to two hours. In any case, thanks to sedation and anesthesia, it’s a painless procedure.
After surgery, you will remain under observation for about an hour while we apply cold and anti-inflammatory drugs to slow the initial inflammation.
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The postoperative period after lower blepharoplasty is painless, so much so that the vast majority of patients do not require any painkillers. However, there may be some tightness at the corners of the eyes when a canthopexy or canthoplasty is performed. Bruising and swelling appear to a greater or lesser extent in all patients, and most of this resolves within the first week. Recovery is not complete after a week, but most patients have no problem resuming their social activities at this point.
During the first few days, it is important to avoid vigorous physical exertion to avoid possible bleeding and shorten the recovery period. We recommend frequent application of ice during the first 2-3 days and antibiotic-anti-inflammatory eye drops if a transconjunctival approach was used. If there are stitches, we will also apply an antibiotic ointment twice a day. Lubricating the eye with artificial tears eye drops is also recommended.
The first check-up takes place one week after the procedure. Before the initial check-up, Dr. Nieto will contact you personally by phone to discuss your progress. You will always have direct contact with him if you have any problems or questions.
Recovery after lower blepharoplasty is usually complete one month after the procedure, when we conduct the second postoperative visit. Occasionally, full recovery may take a little longer. The results of lower blepharoplasty are long-lasting; it is very rare for us to perform this surgery a second time on the same patient.
It is true that over the years, eyelid laxity may appear, but fatty bags do not usually reappear.
