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Lower Blepharoplasty

North Carolina Eyelid SurgeryOver time, the delicate skin around the eyes can become thin and loose, causing puffiness, dark circles, and sagging tissue under the eyes that can make a person look older or fatigued. Whether due to genetics, sun exposure, weight gain, or age, it is possible to correct puffy or wrinkling lower eyelids and achieve a more youthful, natural-looking appearance with a surgical procedure known as lower blepharoplasty.

What is the Ideal Aesthetic of the Lower Eyelid?

The eyes are the most important facial feature as they communicate a majority of our non-verbal communication.  The shape of the eye and the surrounding facial features will show our emotions including joy, sadness or fatigue.  There is a shape and structure of the lower eyelid that will create an eye shape that appears open and awake.  That shape is a smooth area that seamlessly transitions from the lower eyelashes to the cheek area.  Over time, this transition can be interrupted by a depression, fullness, or wrinkles creating shadows or circle underneath the eye.

Fat Repositioning & Lower Blepharoplasty

Dr Kulbersh

What Are the Changes that Happen to the Lower Eyelid with Aging?

Over time, we lose the smooth transition from the eyelashes to the cheek.  This occurs because:

  1. Sun exposure damages the lower eyelid skin
  2. Fat herniated from behind the eye to create bags
  3. Loss of volume in the cheek
  4. Sagging of cheek tissue

These changes can create wrinkles, bags or dark circles underneath the eye that will create a sad or tired appearance of the eye.

What is Lower Eyelid Blepharoplasty at Carolina Facial Plastics?

Lower blepharoplasty is a lower eyelid surgery used to create a smoother transition from the lower eyelid to the cheek.  There are many technical variations of that Dr. Kulbersh uses during a lower blepharoplasty to customize the procedure.  The following are the steps taken for each concern:

  1. Excess or wrinkled skin of the lower eyelid – The excess skin or wrinkled skin can be treated by a few modalities.  The excess skin can be removed by making a small incision underneath the eyelashes.  If there is poor quality of skin causing the wrinkles, a chemical peel or laser resurfacing treatment of the skin will be used.
  2. Excess puffiness or bags under the eyes – The lower eyelid puffiness is mainly caused by excess fat that herniates from behind the eye.  This fat is commonly repositioned into the cheek area during the procedure. A small incision will be made either under the eyelashes or inside the lower eyelid, so that the scar is well hidden.  There are instances where the fat will need to be sculpted or removed.  Since the face will lose volume overtime, I do not advise that patients have aggressive fat removal of the lower lids.  This was common practice in the past and result in the hallow appearance of the many years after the surgery.  This is avoided by reposition the fat or conservative removal of fat in the area.
  3. Loose or sagging eyelid – If the eyelid is sagging or loose it may need to be tightened with a canthopexy procedure.  A canthopexy tightens the lower eyelid.
  4. Loss of Volume in the Cheek – If a deflated cheek is contributing to the circles underneath the eye, cheek volume can be added by a facial fat transfer, facial fillers, or a cheek implant.

What Conditions Can a Lower Eyelid Plastic Surgery?

Before and After eye bag removalBlepharoplasty plastic surgery is an ideal option for those who want to significantly reduce the appearance of bags, puffiness, loose skin or hollowness under the eyes. The procedure is minimally invasive and when performed by a skilled surgeon, can achieve a smooth, supple, and youthful look. By eliminating excess skin or fat under the eyes, not only does a lower blepharoplasty rejuvenate the entire face, but it can help correct the proper contour and function of the eyelids.

What is the Recovery from a Lower Blepharoplasty?

The recovery from a lower blepharoplasty will take about 1 to 2 weeks depending on the individual.  During the first week, the patient will experience swelling and bruising.  This will peak 48 hours after the surgery.  Vision will be a little hazy as the patient will be placing drops and ointment in the eye.  There is minimal pain associated with a lower blepharoplasty, but patients will have narcotic pain medications available.  Stitches placed below the eyelids are dissolvable.  For fat reposition lower blepharoplasty, the stitches will be removed 1 week after surgery.

For the best treatment and recovery from a lower blepharoplasty procedure, Dr. Kulbersh invites you to schedule your surgery at Fairview Surgical Suites, an exclusive, single-room operating theater dedicated to facial aesthetic surgery, and Fairview Recovery Retreat, a recovery center where you can relax in a stress-free environment surrounded by aftercare professionals. Both facilities are designed to maximize your results and ensure a speedy recovery with the highest level of care.

When can a Patient go back to Work after a Lower Blepharoplasty?

Patients typically resume work from home in a few days and go back into the office 1 week after the surgery.

When can a Patient resume exercise after a Lower Blepharoplasty?

Patients can resume exercise 2 weeks after their surgery.

When can Contacts be worn after a Lower Blepharoplasty?

Contacts can be worn 2 weeks after surgery.

How Long with a Lower Blepharoplasty Last?

A lower blepharoplasty will last forever.  The under eye area will always look better than if a patient never had surgery.  With that being said, all patients will continue to age and see changes in the under eye area.  Generally speaking, a lower blepharoplasty will last 10-20 years.

To learn more about lower eyelid surgery, visit

Schedule a Lower Blepharoplasty Consultation

At Carolina Facial Plastics in Charlotte, Dr. Jonathan Kulbersh specializes in only facial plastic surgery, including rejuvenating upper and lower eyelid surgery.  He had trained with the best in Beverly Hills and did additional training in oculoplastic surgery (eye plastic surgery). To learn more about lower blepharoplasty and whether it is a procedure for your specific needs and goals, please contact us and schedule a consultation today by calling (704) 842-3644.

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