Lower Eyelid Surgery: Eliminate Under-Eye Bags and Restore Freshness

Lower eyelid surgery (lower blepharoplasty) addresses the most common complaint in periorbital aging — puffy bags, dark shadows, and loose skin beneath the eyes. These changes can make a person look permanently tired or older than their years, regardless of how well-rested they actually are. Lower blepharoplasty delivers a refreshed, revitalized eye appearance that dramatically improves the overall facial expression.

Causes of Under-Eye Bags

Under-eye puffiness is caused by the forward herniation of orbital fat through a weakened lower eyelid septum. Genetics play a major role — some patients develop prominent lower eyelid bags in their 20s or 30s. Aging, fluid retention, and skin laxity all contribute to worsening of the appearance over time.

Surgical Options

• Transconjunctival lower blepharoplasty: The incision is made inside the lower eyelid, leaving no external scar. Ideal for patients with fat excess but good skin tone
• External (subciliary) lower blepharoplasty: An incision is made just below the lash line, allowing removal of excess skin and repositioning of fat. Preferred when significant skin laxity is present
• Fat repositioning: Rather than removing the fat, it is repositioned to fill the tear trough hollow, creating a smoother transition between the lower lid and cheek

Recovery

Swelling and bruising beneath the eyes are expected for 7–14 days. Cold compresses and head elevation help reduce swelling. Most patients return to work within 10–14 days. Final lower eyelid results are visible within 4–6 weeks and typically last 5–10 years or longer.