It’s always exciting to watch the evolution of a cosmetic surgery result from consultation, to immediate postop recovery, through to the result. Patients understand that it takes time for swelling and bruising to subside related to all plastic surgery procedures. I’m also amazed at how fantastic the removal of lower bags can improve the appearance of the face. It’s amazing how fat pockets of the lower eyelids – or lower eyelid bags – can age the face.
The incision for this procedure is along the lower eyelid eyelash line and is usually extended 1cm or so laterally to facilitate the best results. I advise patients during the consultation process that the primary indication for a lower eyelid blepharoplasty is to remove the fat pockets. It is generally not a skin operation.
This operation cannot and should not be an attempt to tighten the lower lid skin to a great degree. A “pinch” surgery – using special forceps to estimate how much of the skin can safely be taken off. This is sometimes indicated. However, it is essential to keep in mind that lower eyelid surgery is not primarily a skin operation. It is primarily a fat-removal operation.
Eyelid Fillers
This is the biggest benefit of this operation. As with all cosmetic procedures, it is essential that an experienced surgeon perform this operation. Once the bag removal surgery is complete and heals. This may take a few weeks or months. The patient can then be evaluated for any other additional nonsurgical procedures that may improve their appearance. These may include PRF, EzGEL, with or without radiofrequency, lasers, peels or fillers. A smooth lower eyelid without bags can be lovely.
Also, in my technique, I will trim some of the muscle that causes crow’s feet. This further adds to the benefit of this operation. Botox used properly can reduce the crow’s feet even further.
THOMAS TREVISANI, MD
BOARD-CERTIFIED PLASTIC SURGEON
MEMBER OF THE AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
