lower blepharoplasty using a conjunctival approach
Lower Eyelid Surgery (Blepharoplasty)
Lower eyelid blepharoplasty is used to remove the fat deposits and loose skin that may form on the lower eyelids with age. Many factors, including heredity and sun damage, accelerate these changes. Younger people also elect to have this procedure done to eliminate puffiness of the eyes from congenital excess fatty tissue.
This procedure is frequently done at the same time as other procedures, such as upper eyelid blepharoplasty, facelift or forehead lift, and can be combined with laser or chemical resurfacing to smooth skin wrinkles. When overhanging of the upper lids interferes with peripheral vision, and both upper and lower eyelids are done at the same time, the procedure may be covered by insurance.
If you're considering lower eyelid blepharoplasty, the following information will provide you with a good introduction to the procedure. For more detailed information about how this procedure may help you, we recommend that you consult a plastic surgeon who is board certified or has completed a residency program that includes instruction in this procedure.
The lower eyelid is gently pulled away from the eyeball using a blunt retractor, while the eyeball is protected with a plastic plate. An electrocautery is used to sweep across the conjunctiva (back layer of the eyelid) along most of its length near its junction with the eyeball. The eyelid fat presents itself through the incision almost immediately. The incision may be enlarged using scissors, and the three fat pockets individually teased out of their capsules and into the surgical field. Most commonly, the fat is then clamped, excised, and cauterized in a piecemeal fashion from each pocket. The surgeon may stop at any time, return the eyelid to its normal position, and asses the operation in progress from the front, thus allowing for excellent precision. At the conclusion of the procedure, the surgeon may choose to close the wound with one or two dissolving sutures, but more commonly no stitches are necessary.