Adrian Richards, Leading Plastic & Cosmetic Surgeon at Aurora Clinics provides valuable information on having Low Eyelid Surgery and who is suitable for treatment. For more information please contact one of the Aurora Patient Advisors on 01844 214362.

Eyelid Surgery – Lower Blepharoplasty – Who is Suitable for Treatment

Hello. My name’s Adrian Richards. I’m a plastic and cosmetic surgeon, and today I’m going to be talking a little bit about lower blepharoplasty. A blepharoplasty is an operation on the eyelids. Lower blepharoplasty is an operation on the lower eyelid. Upper blepharoplasty is an operation on the upper eyelid.

Basically, who would benefit from a lower blepharoplasty? There are really two things to assess. The first is do you have excess skin on the lower eyelids? The second thing is, do you have puffiness of the lower eyelids? The excess skin of the lower eyelids is characterised by fine wrinkles on the lower eyelids. This caused by just laxity of the skin that comes with time.

Puffiness of the eyelids is quite different. That’s caused by movement forwards of the fat tissue that surrounds the eyeball. The eyeball is held within the eye socket, and it’s protected from some sort of a movement via the fat pads, the fatty pad layer. With time, the wall that holds the fatty layer back weakens. You can imagine the gravity sort of pushing the fat forward, and almost like a small bulge or a hernia appears on the lower eyelids. It’s these fat pads which are moved forward which gives you the bulging. The important thing to differentiate between this is because a different technique is used for each of them.

If you have skin excess, if you lift your eyelid up and out, like that and the skin tightens and you like that appearance, you really need a standard lower blepharoplasty in which a cut is made along the crow’s feet from the corner of the eye and down just under the eyelashes. Then the skin is released from inside. The fat pads can be addressed at that time, either reduced or more recently what we’re tending to do is move the fat pads. Not just remove them, because that could leave quite a hollow looking eye, but actually to release them and make them blend nicely into the cheek, because a youthful sort of eyelid cheek junction is very, very smooth. We tend to do more fat preservation surgery on the lower eyelid, whereas ten years ago, it was more fat removal.

If you’ve got a combination of loose skin and puffiness, you probably need to be considering lower blepharoplasty with an incision, an external incision. If it’s just puffiness we’re looking at without too much excess skin, we can use a technique called a transconjunctival blepharoplasty. All that basically means is instead of being on the outside; the cut is actually inside the eyelid, lower eyelid, where it’s hidden. In that technique, a small incision can be made and the fat directly removed from inside the eyelid. The advantage of that is the fat’s removed, the puffiness is reduced without any external scarring, which is obviously a great advantage.

That’s a good technique. It will address the puffiness but it won’t reduce the skin. It won’t really tighten up the skin. If the skin excess is relatively mild, the technique we can use is the transconjunctival blepharoplasty to remove the puffiness and either a skin peel or a laser treatment just to tighten up the skin a little bit. That’s only really good for people who’ve got moderate fat excess with slight skin excess. If you’ve got more skin excess, you really need to be thinking about more traditional skin removing blepharoplasty.

So that’s an introduction to blepharoplasty. I’m going to be talking a little bit in another video about the actual procedure, recovery, and complications. Thank you for listening to that. If you would like further information and to arrange a complimentary consultation with one of our surgeons, please do so by either visiting the website, which is Aurora-Clinics.co.uk, or possibly give us a ring in the office directly on 01844 214362. Thanks very much for listening. We hope to hear from you soon.