Lower Blepharoplasty
IN SYDNEY
Lower Blepharoplasty (Lower Eyelid Surgery)
Refines lower-lid contour and the lid–cheek junction with conservative, tissue-respecting techniques.
My approach is considered, curated, and grounded in a deep understanding of facial anatomy. Planning focuses on skin quality, orbital fat prominence (“bags”), the tear-trough/lid–cheek junction, lid tone/laxity, ocular surface health (dry-eye tendencies), and midface support. Wherever possible, I prioritise fat-preserving techniques and precise lateral canthal support to protect eyelid shape and function.
What is a Lower Blepharoplasty?
Lower blepharoplasty addresses pseudoherniated fat and skin excess/texture that cast shadows or create a tired appearance. Through internal (transconjunctival) or external (subciliary/skin-muscle) access, fat is recontoured or transposed into the tear trough to smooth the transition to the cheek. When skin is mildly redundant, a skin-pinch excision or staged resurfacing (laser or chemical peel) is used to refine texture - avoiding unnecessary muscle excision..
Where Lower Blepharoplasty fits among other options
Lower Blepharoplasty uses a range of techniques, each tailored to the degree and pattern of ageing. The choice of technique depends on anatomical findings, the desired outcome, and your tolerance for downtime and scarring. Below are four commonly performed approaches - each with its own advantages.
Transconjunctival (internal) fat-preserving blepharoplasty
Ideal when skin quality is good to moderate; allows fat reduction/redistribution without an external scar.
Can be paired with a skin-pinch or resurfacing if needed.
Subciliary (external) approach
Considered when meaningful skin excision is required and lid tone is adequate.
Dissection is conservative to protect orbicularis and support.
Lateral canthal support
Canthopexy (soft-tissue suspension) or canthoplasty (reconstruction) when snap-back is weak, laxity is present, or anatomy requires extra stability.
Adjacents/alternatives
Laser/chemical peel for texture/crepe skin.
Micro/nanofat for hollowness.
Midface support in selected cases if descent contributes significantly.
COMBINE YOUR BLEPHAROPLASTY
Refine & Rejuvenate
Skin quality: Laser or chemical peel (often staged 6–12 weeks) to improve fine lines and crepe changes.
Volume: Micro/nanofat to soften the tear trough or lateral hollowing when indicated.
Canthal support: Canthopexy/canthoplasty for stability in lax lids or negative-vector anatomy.
Upper-lid/brow procedures: Planned same-session or staged for balance across the periocular region.
Rhinoplasty/facelift: Usually staged to simplify recovery patterns.)
WHY CONSIDER A LOWER BLEPHAROPLASTY?
Who Is the Ideal Candidate?
Prominent lower-lid bags/shadowing with or without a tear-trough.
Mild-moderate skin redundancy/texture change.
Adequate lid tone (or willingness to add canthal support).
Good ocular surface health and realistic goals.
When another approach may be better:
Marked lid laxity/ectropion tendency without planned canthal support.
Severe dry-eye or ocular-surface disease until stabilised.
Predominantly skin texture concerns - consider resurfacing first/alone.
Complex anatomy (e.g., significant negative-vector or midface descent) may benefit from additional support procedures.
WHAT TO EXPECT
From Consultation to Recovery - Blepharoplasty Surgery
Undergoing facelift surgery is a detailed and personalised process. From your first consultation to your final review, every stage is carefully planned to support your comfort, safety, and optimal healing.
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Your Initial Consultation
Eyelid exam including snap-back/distraction tests, scleral show, canthal position, and ocular surface review.
Photography and planning; transconjunctival vs subciliary access; need for canthopexy/canthoplasty; role of resurfacing or skin-pinch.
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Preoperative Planning
Medication/supplement review, smoking cessation, lubrication plan if dry-eye-prone.
If combining procedures, confirm same-session vs staged sequencing.
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Surgery Day
Setting: Accredited day surgery or private hospital.
Anaesthesia: Local with sedation or general (case-dependent).
Duration: ~60–120 minutes (scope-dependent).
Technique: Transconjunctival access for fat contouring/transposition (no external scar). Skin-pinch for mild excess; subciliary approach only when meaningful skin removal is required. Lateral canthopexy/canthoplasty added when eyelid support is indicated. No routine orbicularis muscle excision.
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Week 1 Post-Op
Cold compress 48 hours; head elevation; lubricating drops/ointment as directed.
Bruising/swelling peaks 48–72 h, settles over 7–10 days.
Suture removal (if external) usually day 5–7.
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Week 2–3 Post-Op
Back to desk work/social settings ~7–14 days (camouflage as needed).
Resume gentle skincare once closed; avoid contact lenses until comfortable/cleared.
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6 Weeks+ Post-Op
Progressive refinement as residual swelling resolves; staged resurfacing commonly at 6–12 weeks if planned.
YOUR RECOVERY
Postoperative Care & Follow-up
Wound care: Clean/dry; ointment as directed.
Eye care: Regular lubrication; avoid rubbing; sleep head-elevated.
Activity: Walk daily; avoid strenuous exercise 1–2 weeks; no heavy lifting or inverted positions initially.
Scar care: If subciliary, start silicone therapy once closed; strict sun protection.
Follow-up: Early review; suture removal if needed; then 4–6 weeks and as advised..
SURGICAL RISKS
What Are the Risks of Blepharoplasty Surgery?
Bruising/haematoma, infection (uncommon).
Dry eye or irritation; chemosis (conjunctival swelling).
Asymmetry, contour irregularity, hollowing or persistent fullness.
Eyelid malposition (retraction, ectropion, scleral show) - mitigated with conservative skin handling and canthal support when indicated.
Temporary numbness, milia, pigment change after resurfacing.
Very rare diplopia (muscle injury) or vision-threatening bleeding - emergency protocols are in place.
Anaesthetic risks (if sedation/general used).
Why Choose Dr Karagiannis for your Blepharoplasty?
1. Expertise & Experience
Multiple facial aesthetic fellowships across Europe and Australia with focused periocular training.
2. Anatomy-first Planning
Preference for fat-preserving, transconjunctival techniques and targeted canthal support to protect eyelid position.
3. Combined Approach
Integrated planning with resurfacing and volume restoration, sequenced to streamline recovery.
4. Continuity of Care
Clear, guideline-compliant counselling and continuity of care in accredited facilities.
Blepharoplasty FAQS
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Transconjunctival access leaves no external scar. A subciliary incision is used only when skin removal is required.
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I favour fat preservation/redistribution to smooth the tear trough and avoid hollowing; selective reduction is used when appropriate.
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Most patients feel presentable in 7–14 days; refinement continues for several weeks.
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Surgery addresses structure and bulges; laser/chemical peel can be added (often staged) for texture.
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If lid laxity or anatomy suggests risk of malposition, lateral support improves stability and eyelid shape.
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Cosmetic lower blepharoplasty is generally not eligible. Functional indications are assessed individually and discussed in advance.
Request a Consultation
We’ll assess lid tone, fat distribution, skin quality, and ocular surface health to confirm whether transconjunctival fat-preserving blepharoplasty, skin-pinch/subciliary access, and/or canthal support best suits you.