Lower eyelid surgery is a great procedure for patients to improve the appearance of the “eyelid bags” under their eyes. Often, patients feel that these eye bags under their eyes gives them a tired appearance. Excess eyelid skin is removed during the procedure, as well as fat, and the underlying tissue can be tightened and re-positioned to improve the overall appearance. 

Good candidates for this procedure:

  • Patients with excess skin and fine, ‘crepe paper’ type lower eyelid wrinkles

  • Patients with bags and dark circles under the eyes

What to expect: Consultation

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 All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for lower eyelid surgery.

Dr. Hsu will first ask you about your specific goals for the lower eyelid surgery. He will examine the lower eyelid area with your eyes open and closed.  He will also ask about your general health history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits.

Dr. Hsu will then give you his assessment on whether you would be a good candidate for the procedure, and if so, how the surgical plan should be individualized for your anatomy. Since each patient's anatomy and surgical goals are different, you and Dr. Hsu will work together to reach optimal aesthetic results. 

Surgery Details:

On the day of surgery, arrive early to fill out paperwork, meet the anesthesiologist, and be prepared for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last minute questions you may have.

Lower blepharoplasty procedures are performed under general anesthesia for a duration of approximately two to three hours.  Dr. Hsu will create a small incision underneath the lower eyelashes, ensuring that the ensuing scar is well hidden. He will then open up the skin in that area to remove the excess fat. Much like the upper blepharoplasty, Dr. Hsu will tighten any laxity of muscle and remove excess skin as needed. If upper and lower blepharoplasties are done in conjunction, the procedure will last approximately two to three hours.

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Recovery & Post-operative:

After the surgery, use a cold compress or hand towel in 20 minute intervals on the surgical area for the first 48 hours to help minimize swelling.  You must keep your head elevated during the recovery period, making sure to sleep on two pillows at night. For most patients, by two weeks after surgery, bruising and swelling has subsided enough for makeup and concealer to cover any remaining bruising.

Dr. Hsu will usually remove stitches during your first week follow up appointment. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner. The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to gradually return to full exercise and activity.

During the recovery period, we recommend walking within the house several times per day to speed healing and minimize the possibility of developing blood clots. If you have any issues after surgery, Dr. Hsu is available 24 hours for any immediate concerns. For an extended period of time after surgery, Dr. Hsu will see you to make sure you are healing well. Follow up appointments are scheduled one week, two weeks, and several months to a year afterward.

Dr. Hsu's view on Lower Eyelid Surgery.

Both upper eyelid surgery and lower eyelid surgery are two of my favorite procedures for patients.  These usually give excellent results with immediately visible benefits for patients.  The eyes and their surrounding skin are some of the first areas of the face to experience changes with aging, so early rejuvenation of these areas can make a dramatic difference.

In the lower eyelids, I will vary my approach based on the individual patient.  In some patients, it is purely an excess skin problem causing lower eyelid skin wrinkling.  In others, there is some muscle weakness that can be addressed with tightening.  In others, there is an issue of excess fat causing a bulging “eye bag” appearance. The approach to each patient needs to be individualized based on what specifically is causing the suboptimal appearance.