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Lower Eyelid Surgery

Lower Eyelid Surgery (Blepharoplasty) in Evans and Augusta, Georgia and Aiken, South Carolina by Dr. Achih H. Chen

Lower eyelid surgery Augusta Evans Georgia–With age, bulges or bags can develop in the lower eyelids. This is commonly accompanied by excess skin. In some individuals, the lower eyelid skin may change in texture to become crepe-like and the eyelid, itself, may even loosen and sag. All of these lead to a fatigued, tired appearance. Dr. Achih H. Chen can reverse these signs of the aging lower eyelid with many different, innovative lower eyelid surgery (blepharoplasty) approaches at our Evans and Augusta, Georgia facial plastic surgery practice, also serving Aiken, South Carolina.

Lower Eyelid Surgery (Lower Blepharoplasty)

The eyes are often the major focus our initial attention when we meet another individual. As it is commonly said, the “eyes are the window to the soul”. Since our eyes are under so much attention, they are often the area that we first notice initial signs of aging.  Puffiness or even bags of the lower eyelids can develop as early as in the 20’s or even earlier. This is most often due to a weak or lax orbital septum—the curtain that holds the fat in place around the lower eyelid. Weakness or laxity of the orbital septum results in a bulge or bag.

Lower Eyelid Bag/Bulge**

**This is a patient of Dr. Achih H. Chen who has given consent to use this photo.

Initially, this can be addressed with fat removal only. Often, this can be accomplished with a lower eyelid surgery (blepharoplasty) that does not involve a skin incision. Instead, the fat is removed from an approach through the inner side of the eyelid. This approach is called a transconjunctival blepharoplasty. With time, excess skin develops to accompany the lower eyelid bulge or bag. In individuals with both excess skin and lower eyelid puffiness or bags, the type of lower eyelid surgery called a transcutaneous lower eyelid surgery (blepharoplasty) works best.

Lower Eyelid Bag/Bulge with Excess Skin**

**This is a patient of Dr. Achih H. Chen who has given consent to use these photos.

This involves a skin incision hidden just below the lash line so that the excess skin may be removed along with the bulging fat. Once healed, the skin incision for the transcutaneous blepharoplasty becomes nearly invisible.

Incision for Transcutaneous Lower Eyelid Surgery** (red line)

*Individual results and recovery may vary.

**This is a patient of Dr. Achih H. Chen who has given consent to use these photos.

In some patients, the lower eyelid bag and the excess skin are also accompanied by changes in the texture of the skin that causes a crepe-like texture. Removal of skin and/or fat alone will not adequately address this skin texture problem. In these individuals, the addition of laser skin resurfacing to lower eyelid surgery will most optimally treat the excess skin, puffiness or bag, and crepe-like texture.*

The aging lower eyelid can present numerous issues, but Dr. Achih H. Chen has many innovative approaches to address these problems. Lower eyelid surgery in Evans and Augusta, Georgia and for patients in the Aiken, South Carolina area can greatly improve your excess upper eyelid skin, opening up your eyes and brightening your appearance.* Please contact Dr. Achih H. Chen for more information or to schedule a consultation at the Georgia Center.

*Individual results and recovery may vary.

Transconjunctival Lower Eyelid Surgery Augusta Evans Georgia

A bulge or a bag may be the first sign of aging in the lower eyelid area. In some individuals, this is not accompanied by excess skin. In these cases, lower eyelid surgery may be approached through the inside of the eyelid. The bulging fat or bag formed by loosening or laxity of the orbital septum, the curtain that holds the fat in place, is treated by removing some of the fat through an incision through the conjunctiva or lining of the inside of the eyelid. This helps smooth the lower eyelid bulge or bag. The incision heals very easily without a visible scar.* With transconjunctival lower eyelid surgery, patients have very little bruising or downtime.* Smoothing of the bulging fat or bag will help restore a more youthful, alert appearance.*

*Individual results and recovery may vary.

Transconjunctival Lower Eyelid Surgery** (Before-left photo, After-right photo)

*Individual results and recovery may vary.

**This is a patient of Dr. Achih H. Chen who has given consent to use these photos.

Transcutaneous Lower Eyelid Surgery

Lower Blepharoplasty Evans Augusta Georgia–In some, excess skin can accompany the lower eyelid bulge or bag that has developed with aging.  In these individuals, the most optimal approach to lower eyelid surgery involves some removal of the excess skin along with the bulging fat that has resulted from looseness or laxity of the orbital septum, the curtain that holds the eyelid fat in place. As this approach involves removing the excess lower eyelid skin, an incision in the skin hidden just below the eyelashes is used. This approach is called the transcutaneous lower eyelid surgery (blepharoplasty). Once the excess skin and fat are removed, Dr. Achih H. Chen closes the incision with very fine, dissolvable sutures. The transcutaneous lower eyelid surgery will address more advanced signs of aging of the lower eyelids than the transconjunctival approach as the excess is removed in addition to the bulging fat. This will smooth the redundant skin and contour the excess fat for a more rested appearance.*

*Individual results and recovery may vary.

Transcutaneous Lower Eyelid Surgery (Before-left photo; After-right photo), photos taken 4 weeks post-op.**Notice how incision line is nearly invisible, even at this early stage of healing*

*Individual results and recovery may vary.

**This is a patient of Dr. Achih H. Chen who has given consent to use these photos.

Lower Eyelid Surgery with Laser Resurfacing

In even more advanced aging of the lower eyelid, skin changes may accompany the excess skin and bulging fat. The skin becomes thin, cobblestone and crepe-like. Removal of skin or fat alone will not address this problem adequately. Instead, for long-term results, the texture of the skin needs to be addressed in addition to the bulging fat and/or excess skin for the best results. Laser skin resurfacing will change the texture and character of the skin, smoothing the cobblestone surface.* Laser resurfacing may be performed in conjunction with lower eyelid surgery to address the combination of excess skin, bulging fat and skin texture changes. Laser skin resurfacing may be completed only around the eyelids or may include the entire face. Dr Achih H. Chen can help you decide if laser resurfacing may give you an even better result to your lower eyelid surgery.

*Individual results and recovery may vary.

Lower Eyelid Surgery with Laser Resurfacing **(Before-right photo; After-left photo), this patient also underwent upper eyelid surgery at the time of other procedures.*

*Individual results and recovery may vary.

**This is a patient of Dr. Achih H. Chen who has given consent to use these photos.

Advanced Lower Eyelid Surgery Technique—Fat Repositioning

As aging occurs, a separation between the cheek fat and the lower eyelid fat may occur. The result is a hollow that forms below the lower eyelid along the orbital rim. This hollow is called the tear trough.

Tear Trough** (red arrow)

**This is a patient of Dr. Achih H. Chen who has given consent to use these photos.

Traditional lower eyelid surgery does not address the hollow or tear trough. Instead, the tear trough is made less noticeable by removing the bulging lower eyelid fat and/or excess skin that lies above the hollow. In individuals with a very prominent tear trough, removing enough fat to make the tear tough less noticeable may often result in a hollowed eyelid appearance. Lower eyelid surgery with fat repositioning avoids this problem. Instead of removing the fat around the lower eyelid, the fat is draped from the eyelid area over the tear trough, filling the hollow. This achieves two goals, filling the hollow of the tear trough and smoothing of the bulging fat or bag. Many patients are happy with the results of traditional lower eyelid surgery, whether they undergo transconjunctival or trancutaneous blepharoplasty; however, those with a prominent hollow beneath their lower eyelids may choose to undergo fat repositioning for more complete rejuvenation. Although rejuvenation of the lower eyelids is a complex issue, Dr. Achih H. Chen can help you make a well informed decision.

Lower Eyelid Surgery with Fat Repositioning **(Before-left photos; After-right photos)

*Individual results may vary.

**This is a patient of Dr. Achih H. Chen who has given consent to use these photos.

Lower Eyelid Surgery Recovery

Lower eyelid surgery (blepharoplasty) is usually performed under intravenous (IV) sedation, but in some cases, may also be performed under local anesthesia. Patients having their lower eyelid surgery performed under IV sedation will need a friend or family member to drive them home, while patients having their blepharoplasty under local anesthesia may drive themselves. Patients can expect some very mild discomfort in the areas around the eyes after surgery.* Many patients are able to go out in public the next day with the aid of sunglasses as a camouflage.* Makeup can be worn 24 hours after the sutures are removed.* Most patients resume normal activities about five to seven days after treatment, and many return to light work activity in as little as one to two days after surgery.*

In patients undergoing laser resurfacing of the lower eyelids, make-up can typically be worn at seven days post-procedure.* This is in contrast to full face laser skin resurfacing, which typically requires 10 days of recovery time before make-up may be worn.*

For patients considering lower eyelid surgery (blepharoplasty) at our Augusta and Evans, Georgia / Aiken, South Carolina-area practice, an even more complete facial rejuvenation can be created with the addition of other procedures such as facelift or mid-face rejuvenation.

*Individual results and recovery may vary.

Contact Us to Arrange for your Lower Eyelid Surgery in the Augusta and Evans, GA and Aiken, SC Region

Lower eyelid surgery can significantly improve the appearance of the area around the lower eyes and make you look more youthful and vibrant.*  Our Facial Plastic Surgeon Dr. Achih H. Chen, serving Augusta and Evans, Georgia; Aiken, South Carolina; and beyond, look forward to discussing your options for rejuvenation of the lower eyelids for a new you! Contact us at the Georgia Center.

*Individual results and recovery may vary.

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