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With time, the thin eyelid tissues lose their elasticity and support, resulting in age-related or worsened bags.  The skin stretches and becomes loose and crepey, bunching, especially when smiling, and forming festoons in its worst form. Another age-related change is the loss of volume around the eye socket (called the orbit), the junction between the eyelid, the cheek, and the cheek itself. Each of these anatomic or age-related changes needs to be evaluated and addressed to achieve the best results. 

Customized for You The Procedure Volume Loss Dark Circles & Bags Before & After The Recovery Frequently Asked Questions Your Consultation

Lower Blepharoplasty Customized for You

Dr. Levin has been performing eyelid surgery for over a decade and knows there is no one-size-fits-all plastic surgery. Using the most modern techniques, the surgery is customized to each patient’s individual needs. For a younger patient, it eliminates the bags and addresses hollowness. For those with age-related changes, it corrects puffiness, dark circles, and loose eyelid skin. Incisions are usually inside the eyelid with no visible scars. When skin tightening is necessary, the incision is placed under the eyelashes and is virtually imperceptible.  The ultimate goal of the surgery is to leave the patient looking natural and refreshed, like the bags and dark circles were never there. 

Blepharoplasty Procedure with Dr. Flora Levin

Flora Levin MD

What Is the Lower Blepharoplasty Procedure?

Lower blepharoplasty is a common procedure used for under-eye bags and dark circles treatment. It is usually performed using local anesthesia and light sedation.

To improve the lower eyelid bags, incisions are placed inside the eyelids (transconjunctival approach). This approach minimizes the risk of complications associated with the older approach of going through the skin.  Not all plastic surgeons use this approach, so finding a surgeon specializing in eyelid surgery is important.  The bags, which are actually herniated orbital fat pads, are removed.

When skin laxity is present, it is often addressed with either CO2 laser resurfacing or a tightening procedure. In the latter, the incision is placed just below the lashes, and a conservative amount of skin is removed. This is done without changing the shape or position of the lower eyelid. In patients with pre-existing eyelid laxity, a canthal suspension procedure (canthopexy) is performed to support the eyelid and prevent possible short or long-term complications. It is noteworthy that the normal smile lines will still be present after skin tightening and are amenable to further improvement with neuromodulator (Botox) treatments.

6 Weeks Later With Lower Blepharoplasty With Fat Transfer

6 Weeks After Lower Blepharoplasty with Fat Transfer

Addressing Volume Loss

To address the volume loss, Dr. Levin uses micro-fat transfer with the patient’s own fat. Eyelid rejuvenation cannot be done in isolation without addressing the surrounding areas. This is one of the most important aspects of lower eyelid rejuvenation that is often neglected because the surgeon is only focused on the eyebags. A micro-fat transfer is a highly technical procedure to create a natural feel to the midface without making someone look overfilled. This step, when expertly performed, can make the difference between natural, long-lasting results and looking plastic or hollowed. What type of anesthesia is used?

The surgery can be performed either in our office-based procedure room with light sedation or at the surgery center with deeper anesthesia. Of course, local anesthesia is utilized as well. Although upper eyelid blepharoplasty, when performed alone, is done under just local anesthesia, when it comes to total periocular rejuvenation and lower blepharoplasty, it is easier, and the outcome is much better when these procedures are done with sedation. This reduces the need to inject a lot of local anesthesia, which can distort tissues, affect the procedure's outcome, and result in prolonged healing.

Lower Blepharoplasty Videos

Can a Lower Blepharoplasty Treat My Dark Circles & Bags?

Lower blepharoplasty addresses the presence of dark circles, lower eyelid bags, sagging eyelid skin, and the overall tired appearance. A youthful lower eyelid is vertically short with a smooth transition between the eyelid and the cheek. With age, tethering of facial ligaments, volume loss in the cheek area, and protrusion of eyelid fat (bags) create an elongated lower eyelid appearance, with visible lines separating the eyelid and the cheek.

Bulging and hollowing create shadows that appear as dark circles. Thin eyelid skin does little to camouflage prominent blood vessels or the underlying muscle. While upper blepharoplasty primarily addresses the excess skin, lower eyelid surgery is more multifaceted.

Depending on the patient’s individual needs, it may involve removal and/or repositioning of the lower eyelid fat (the bags) through eyelid surgery, removal of the excess eyelid skin, eyelid tightening, or a combination of these.

Before & After Lower Blepharoplasty

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Recovery from a Lower Blepharoplasty Procedure

The procedure may take anywhere from 1 to 2.5 hours, depending on what is being done. After the procedure, you will need a friend or family member to drive you home. Patients are instructed to apply ice for the first 48 hours, rest, and avoid strenuous activity for at least 1 week.

Swelling and bruising are variable and expected in the early postoperative period. You will be given detailed post-operative instructions before the surgery, and they are reviewed after. Healing time varies between patients, with age, general health, and medications affecting the individual healing time.

6 Weeks After Lower Blepharoplasty with Fat Transfer 

6 Weeks After Lower Blepharoplasty with Fat Transfer

Lower Belpharoplasty FAQ's

How soon after eyelid surgery will I see my results?

How long will my results from lower eyelid surgery last?

How long does the procedure last?

Can I get cosmetic eyelid surgery if I have had PRK or LASIK surgery?

Who is an ideal candidate for lower blepharoplasty?

Can I combine lower eyelid surgery with other procedures?

What is the cost for a lower blepharoplasty with Dr. Levin?

How soon after eyelid surgery will I see my results?

20% of healing takes place in the first 2 weeks, 60% to 70% during the first 1-2 months and the last 10-20% after that. . Healing times are highly variable. Younger patients tend to heal more quickly, with swelling resolving after just a couple of weeks. Older patients, who may need surgical skin tightening as part of their surgery, may take longer. Most patients will see the best and final results at 3 to 6 months after surgery.

How long will my results from lower eyelid surgery last?

The changes achieved during the surgery mean that your eyes will always look younger. Yes, the aging process will continue but will restart from a younger point after the procedure.. You will enjoy the changes in your eyes for many years.

How long does the procedure last?

Due to the multifaceted nature of the lower blepharoplasty eyelid surgery, the procedure may take anywhere from 45 minutes to 1.5 hours and the recovery time from 1-3 weeks. As with upper blepharoplasty, selecting a surgeon with an intricate understanding of the eyelid and facial aging process, knowledge of the anatomy and experience, guiding the selection of the best procedure for each individual patient, will result in the best possible outcome.

Can I get cosmetic eyelid surgery if I have had PRK or LASIK surgery?

LASIK and PRK surgeries address the shape of the cornea and in no way affect the eyelids. Patients who have had either of these vision correction procedures can have blepharoplasty. Dr. Levin wants her patients to wait at least six months after having LASIK/PRK before having this procedure, to be sure the cornea has fully healed.

Who is an ideal candidate for lower blepharoplasty?

Men and women with lower eyelid bags, dark circles and/or crepey eyelid skin are potential candidates for lower blepharoplasty. Dr. Levin treats patients of all ages who are bothered by their lower eyelid appearance. As with any cosmetic procedure, good candidates are healthy people with good lifestyles and realistic expectations.

Can I combine lower eyelid surgery with other procedures?

Of course, many of Dr. Levin’s patients have both lower and upper eyelid surgery performed during a single session. Other patients seek to combine blepharoplasty with a brow lift or full-face laser resurfacing to create a more rejuvenated look. It is best to wait with non-surgical treatments such as BOTOX and dermal fillers until a few weeks after surgery once the swelling resolves. This will ensure the most predictable and long-lasting results.

What is the cost for a lower blepharoplasty with Dr. Levin?

The cost of a lower blepharoplasty starts at $12,000. This is the surgical fee and does not include the anesthesia or facility fees. Come in for a consultation so you can be given a quote tailored to your specific needs.

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Meet Dr. Flora Levin

Dr. Flora Levin is a board-certified oculofacial plastic surgeon serving Connecticut's Fairfield, Westchester, and Westport areas. She is an expert in eye rejuvenation and has helped thousands of patients look more youthful through her surgeries. Selecting a surgeon with an intricate understanding of the eyelid and facial aging process, knowledge of anatomy, and experience, guiding the selection of the best procedure for each patient, will result in the best possible outcome. Contact us to schedule your consultation to find out your under-eye bag treatment options.

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Our Patient Reviews

4.8 Stars 489 Reviews
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Dr. Levin is an excellent doctor. I received Botox injections and fillers under my eyes, cheeks and temples. She was very thorough and took her time explaining and answering all my questions. The wrinkles were smoothed and my entire face looks much more youthful and rested. I would absolutely without hesitation recommend Dr. Levin to all my friends. The results are amazing.

Yvette – Bridgeport, CT

I had surgery with Dr. Levin for droopy eyelids. From the first to the last appointment I felt as if I was her only patient. She spent as much time with me as needed, answered all my questions and alleviated all my concerns. The surgery went very well, and I’m very happy with the results. Everything you would want from a doctor! Highly recommend.

JD – New Canaan, CT

Saw doctor Flora Levin for a Botox consultation. She took her time explaining everything to me, and was very thorough. I scheduled the procedure, and was very happy with the results! She followed up within a week after the procedure to check, and make sure i got the results that i expected. Would highly recommend!

RD – Westport, CT

6 Weeks After Lower Blepharoplasty with Fat Transfer 

Flora Levin MD

6 Weeks After Lower Blepharoplasty with Fat Transfer 

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