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    Lower Eyelid Surgery (Lower Blepharoplasty)

    Lower Eyelid Surgery (Lower Blepharoplasty)

    Lower Eyelid Surgery


    More than one hundred thousand people undergo lower eyelid surgery each year in order to improve their appearance and look more rested. The surgery is intended to help people that have “puffy” lower eyelid bags and/or “dark circles” underneath their eyes which can lead to a “tired” appearance.  You may have had the experience of a friend or colleague asking you if you are “tired” when you are truly well-rested. When people keep hearing this question even though they are not tired it is usually due to the presence of droopy lower eyelids, dark circles underneath their eyes and/or bothersome under-eyelid bags. These signs of aging can make you appear older than you are and look more tired than you feel. Believe it or not, these effects of aging can often be seen as early as in the mid-thirties in some patients! Cosmetic lower eyelid surgery, known technically as a lower blepharoplasty, involves removal of the lower eyelids “bags” along with tightening of excess loose skin in order to restore a refreshed and more youthful appearance to the lower eyes.

    Aging of the lower eyes can lead to the development of lower eyelids “bags” and a “tired” appearance. During your consultation, Dr Motykie will evaluate your eyes, forehead, eyelid muscles and skin in order to customize your surgery to your particular needs and concerns. Topics that will be discussed will include whether or not both your upper and lower eyes need to be treated, whether lower eyelid bags need to be corrected, whether loose skin needs to be removed and whether or not an additional procedure will help you to achieve your goal such as laser skin resurfacing or brow surgery. This initial evaluation is critical because, unlike some other centers that only perform one type of lower eyelid rejuvenation, Dr Motykie utilizes a variety of modern, time proven techniques that our custom tailored to your own unique anatomy and individual goals.

    CONSULTATION

    During your consultation it will be determined which type of lower blepharoplasty technique will best meet your needs and desires from surgery. If it is determined that lower eyelid bags and loose skin are both a problem, Dr Motykie will most likely suggest a transcutaneous approach to your surgery which will allows for removal of the excess lower eyelid skin in addition to correction of the lower eyelid bags. In this approach, Dr Motykie is meticulous about hiding your incisions within the natural creases of the eyes in order to maximally conceal them. This means the incisions will typically fall just below the lashes of the lower eyelids. In some cases, the incisions may extend into the natural laugh lines at the corners of the eyes or into the crow’s feet. If during your consultation it is determined that your only problem is “bags” beneath the lower eyelids (without any loose skin), a transconjuctival blepharoplasty can most likely be performed which does not involve the removal of any skin below the eyelid. In this approach, an incision is made inside the lower eyelid which avoids any visible scarring on the outside of the lower eyelid. If there is fine wrinkling of the lower eyelid skin, a chemical peel or laser resurfacing often offers a safer solution than surgical excision of skin which can lead to lower eyelid retraction and a visible scar on the outside of the lower eyelid. Lastly, sometimes, the problem is not actually bulging fat pockets, but rather hollowing and loss of fat volume below the eyelids. In this case, adding some of your own fat to this area through facial fat grafting can do wonders in creating a more youthful and rested lower eyelid appearance. In fact, Dr Motykie will include facial fat grafting in the majority of his lower eyelid surgeries in order to enhance the final long-term results and youthful appearance of the lower eyelids.

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    PRE-OPERATIVE PERIOD

    DAY OF SURGERY

    LONG TERM RESULTS

    Lower eyelid surgery, can effectively rejuvenate puffy, sagging or tired-looking eyes by removing excess fat, skin and/or muscle from the lower eyelids. All patients vary in their ability and speed to recovery after surgery but most commonly you can expect the final result from surgery to be evident at six months after surgery. Long term after the surgery, you should look younger and “more-rested” not strange or “over-done.” As you heal further your friends, family and colleagues will most likely stop asking you if you are tired and begin to ask you what your secret is to looking so rested and “healthy.” The final result should look very natural and simply make you appear more rested and youthful.

    ALTERNATIVE PROCEDURES

    Although “bags” underneath the eyes and loose skin can be improved with a lower eyelid surgery, fine wrinkles under the eyes are very difficult to correct surgically. However, crêpe skin and wrinkles of the lower eyelid skin can be improved dramatically with chemical peels or laser treatments before, during or after the surgery. Injectable artificial fillers have also been touted to improve aging lower eyes without the need for surgery. In experienced hands, I think the artificial fillers offer a valid temporary solution for camouflaging hollowness underneath the lower eyes but these type of injections simply cannot correct lower eyelid bags or remove loose, wrinkled skin.

    REVISION LOWER EYELID SURGERY

    If a lower eyelid surgery has been unsuccessful elsewhere due to retraction of the lower eyelid skin or hollowing underneath the eyes due to over aggressive removal of lower eyelid fat pockets, a revision lower eyelid surgery may be able to restore a normal appearance and a rested, natural look when performed by an experienced surgeon. A lower eyelid “sling” or reconstructive lower eyelid surgery can be performed by Dr Motykie to repair and improve the appearance of the lower eyelids if the eyelid shape has been altered unfavorably by prior surgery. If too much fat has been removed by a prior surgery elsewhere, Dr Motykie can most likely repair the resulting sunken look with facial fat grafting underneath the eyes.

    COMBINED PROCEDURES

    In the majority of patients undergoing lower eyelid surgery, there are other areas of the face and neck that may also benefit from rejuvenation surgery such as the upper eyes, brow, face and/or neck. It is very common to combine upper eyelid and lower eyelid surgery at the same time since both the upper and lower eyes typically age at a similar rate. Facial fat grafting is invaluable to perform in combination with lower blepharoplasty surgery because it can correct a “sunken” look underneath the eyes by replacing lost facial fat volume as well as enhance cheek bones and camouflage dark circles under the eyes. A lower Blepharoplasty can also be combined with a browlift or BOTOX® treatments to raise the eyebrows and reduce the appearance of wrinkles or crow’s feet above and around the eyes. Although wrinkles of the lower eyelid skin can be difficult to completely correct surgically, they can be dramatically improved with chemical peels and/or laser resurfacing. Lastly, a facelift can be performed with lower eyelid surgery in order to achieve balanced facial rejuvenation in patients that have developed jowls or loose skin in the neck in addition to aging of the lower eyelids.

    For your own personal and confidential consultation, contact Dr. Motykie’s office today. Dr Motykie will answer all of your questions and together you can determine which procedure best fits your desires and needs. Remember, it is impossible for a surgeon to tell you the best approach for you without first listening to your desires and concerns and then performing an examination of your eyes and surrounding tissue. Out of town patients may send photographs in order to have a online consultation performed by Dr Motykie.

    To find out more about eyelid surgery please contact us at 310-246-2355