Changes occur to the lower eyelids that are somewhat different than those which can occur to the upper eyelids. Often times the primary concern of the patient is the amount or size of the “bags” which appear in the lower lids. In some individuals this is a genetic predisposition and occurs quite early in life. Unfortunately, these patients appear fatigued and older than they may actually feel or be. These patients are best treated with a transconjunctival approach to the lower eyelids in which an incision is created entirely inside the eyelid and remains invisible. Through this incision the lower lid fat, which is responsible for the bulging, can be repositioned and excised to give a smooth youthful appearance.

Older patients who seek rejuvenation of the lower lid generally have a combination of excess lower lid skin, bulging lower eyelid fat, and even laxity of the ligaments which supports the lower eyelid from the bone. In these situations an incision is usually required in the skin just beneath the lower eyelashes and extends into one of the creases around your eyes. Excess skin, lower eyelid bags, and fat are all removed and repositioned in this manner.

It is important to realize that surgery of the eyelids adequately removes excess skin and deep wrinkles about the eye, but will not remove the fine wrinkling of the skin and the “crows feet” which surrounds the eyes. These areas will show improvement but other surgical and non-surgical modalities are available which specifically address these issues. A detailed preoperative discussion and facial analysis in our office will determine which modality is most suitable for your particular situation.