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Lower Blepharoplasty

As we age, the tissues that tend to hold the fat of the eye socket in place weaken, thus allowing for the prolapse of fat into the lower eyelids. The surrounding skin also becomes “crepey” and lax in many cases, and tendons in the outer corner of the eyelid may fall. All of these changes can collectively create the appearance of puffy lower eyelids, potentially with dark circles manifesting around the eye socket. Furthermore, some individuals will lose facial volume underneath the dark circles, accentuating the appearance of fatigue.

When these aesthetic concerns—and any others pertaining to the lower eyelid region—manifest for both women and men, lower blepharoplasty can often be an excellent treatment option.

What Is Lower Blepharoplasty?

Also referred to as lower eyelid surgery, lower blepharoplasty is a cosmetic procedure designed to target and resolve underlying anatomical issues responsible for signs of aging in and around the lower lids, ultimately creating a more youthful and refreshed appearance. With over two decades of experience in eyelid surgery, our skilled oculoplastic surgeon—Dr. Albert Cytryn—can custom-tailor lower blepharoplasty to effectively treat:

  • Under-eye bags
  • Displaced fat pockets
  • Dark circles
  • Excess tissue
  • Wrinkles and crepey skin


In many instances, lower eyelid surgery is combined with treatments such as upper blepharoplasty, midface lift, and/or laser skin resurfacing to achieve a more comprehensive improvement of the eye region.

bna-sample Before
bna-sample After

How Is the Lower Blepharoplasty Procedure Performed?

In a traditional lower blepharoplasty procedure, the fat of the lower eyelid is sculpted away to achieve a more rested appearance. When the aesthetic issue is more related to facial atrophy and hollowing, however, Dr. Cytryn will gear the correction towards moving the fat around into areas of the midface that lack volume—which is a technique called fat transposition. In younger patients, the fat can be removed from the inside of the eyelid, while in older patients the fat is generally removed with an incision made just under the eyelashes so that surrounding skin can be sculpted and the underlying muscles and tendons tightened. When extra skin and wrinkles are present, Dr. Cytryn meticulously removes a small amount of skin while ensuring not to over-excise lower eyelid tissue, which could lead to unsatisfactory aesthetic and functional results.

Lower eyelid surgery is typically performed under light intravenous sedation. When conducted alone, the procedure usually takes an average of about 30–50 minutes to complete. That said, many patients also elect to have their upper eyelids and cheeks/midface addressed at the same time as lower blepharoplasty, which can extend the total treatment time.

I was referred to Dr. Cytryn after I unexpectedly developed (unsightly)unilateral scar tissue following a lower lid blephoroplasty with another surgeon. A second surgery was indicated and from what I understand the procedure was somewhat complex in that a graft was required. Now, almost a year out, I could not be more pleased with the symmetry and overall appearance of my eyes. I was grateful to my initial doctor for referring me to Dr. Cytryn-as someone who ONLY does eyes, he is very capable of more complex work. A surgeon’s surgeon…

Is Lower Blepharoplasty Painful?

Due to Dr. Cytryn’s meticulous surgical technique, the vast majority of lower eyelid surgery patients report experiencing minimal to no discomfort following treatment. During the procedure, Dr. Cytryn takes great care to limit trauma to tissues of the eyelids and surrounding areas, as well as to prevent bleeding before it ever starts—both of which help to significantly diminish the potential for postoperative pain. Furthermore, he provides customized instructions on how to facilitate healing during the recovery process in order to help limit the duration of any possible irritation and/or soreness.

Of course, pain tolerance is unique to every individual, so there may be instances in which analgesic medication is necessary to reduce any discomfort that might occur. That said, Dr. Cytryn’s patients rarely describe any considerable degree of pain after lower blepharoplasty—and most do not even bother with taking medicine.

What Can I Expect During Lower Blepharoplasty Recovery?

Following lower eyelid surgery, you can typically expect some swelling and/or bruising in the treatment area, but these side effects are temporary and should diminish with time. As previously mentioned, any discomfort experienced can usually be controlled with medication if necessary, though a notable degree of pain is uncommon. You will most likely look and feel well enough to return to normal, non-strenuous daily routines within five to ten days; however, Dr. Cytryn generally advises that all intense exercise, physical sports, and other vigorous activities be avoided for several weeks to help ensure proper healing.

Will I Have Visible Scars After Lower Blepharoplasty?

Scarring from lower eyelid surgery will depend on the specific maneuvers performed during the procedure, as well as factors such as genetics, sun exposure, and adherence to postoperative directions. When fat is being removed and/or repositioned for younger patients, Dr. Cytryn is often able to do so from the inside of the eyelids, therefore creating no external scarring. For older individuals—or in the event excess skin and/or wrinkles are present, regardless of age—a small incision placed just below the eyelash is typically required so that skin can be excised and muscles and tendons can be tightened in addition to fat removal and/or repositioning.

Fortunately, even when an external incision is necessary for lower blepharoplasty, it is usually made in a natural crease of the eyelid, and the scar tends to heal extremely well. Once scarring has faded to its final appearance, it is usually virtually indistinguishable from the surrounding skin—particularly when properly cared for during healing and maturation.

How Much Does Lower Blepharoplasty Cost?

The average cost of lower blepharoplasty at our practice ranges from $3,200–$4,000, with exact pricing being determined by the overall complexity of treatment and whether or not complementary procedures are also performed. While this price range can give you a good idea of what to expect, it is important to note that you will need to schedule an in-person consultation with Dr. Cytryn to receive a personalized quote. At this time, he can provide a cost estimate based on the custom plan created after a detailed evaluation of your specific needs and goals.

Additional Frequently Asked Questions

What’s the difference between lower blepharoplasty and a midface lift?

While these two surgeries share similarities, the difference lies in the specific treatment areas. A midface lift surgery is typically performed to contour the middle third of the face, which can take on a hollow effect due to excess skin buildup or weakened facial muscles. Meanwhile, lower blepharoplasty is designed to target drooping skin, bags, or wrinkles below the eyelids. The incisions used in these two procedures are similar in location and size, and many patients choose to undergo both treatments at once for optimal facial rejuvenation.

What procedures are often done along with lower eyelid surgery?

In addition to a midface lift, lower eyelid surgery can be combined with treatments such as upper blepharoplasty, facelift, and/or laser skin resurfacing to achieve a more comprehensive improvement of the eye region.

What increases swelling after lower eyelid surgery?

Moderate swelling is a normal part of the healing process that follows lower blepharoplasty; however, certain habits may further irritate the treatment area. Vigorous exercise should be avoided for several weeks to lower the risk of complications. In addition, smoking tends to decrease blood flow and weaken the immune system, which is why most surgeons recommend that you avoid smoking a few weeks before and after the procedure to minimize the chance of infection. Prematurely wearing contact lenses or eye makeup after surgery can also irritate the skin during the recovery process.

How soon can I wear eye makeup following lower blepharoplasty?

Because the lower eyelid area is usually very tender and vulnerable during recovery, you should avoid wearing eye makeup for approximately two to three weeks following surgery. This is to keep swelling at a minimum and reduce exposure to dirt and bacteria that can be found in cosmetic products.

How long before I can wear contacts after lower eyelid surgery?

Dr. Cytryn generally recommends that patients refrain from wearing contacts for two to three weeks after treatment. Those who normally wear contacts are advised to temporarily switch to glasses to limit touching and pulling of the treatment areas. Wearing glasses allows the wounds to heal properly and helps avoid the risk of infection.

Book Your Consultation

If you would like more information about lower blepharoplasty, or if you wish to find out if this treatment is right for you, please contact us today to schedule a consultation with our experienced oculoplastic surgeon.