With age, many people develop “puffy” or bulging lower eyelids. This is most commonly due to normal fat in the eye socket that has shifted forward. With age, the tissues holding the fat in place become weaker, resulting in fat protruding through the lower eyelid. In some patients, injections of filler can help improve the appearance of the lower eyelids. For others, lower blepharoplasty is a better option. The surgery is done in the outpatient setting and is customized to an individual patient’s needs and desired cosmetic outcome.
Most commonly, an incision is made on the inside surface of the lower eyelid. Through this incision, the fat is accessed and partially excised. In some patients, rather than excising the fat, it is used to fill hollow areas in the tear trough below the lower eyelid. In some patients, the lower eyelid may also need to be tightened through a small incision near the outer corner of the eyelid to provide appropriate support or improve contour. A minimally invasive mid face lift can be performed through this same incision if needed. If there is excess skin on the lower eyelid, a small ellipse of skin beneath the eyelashes can also be excised. Dr. Riske and Dr. Mettu will develop a customized approach to address your specific needs.