Eyelid Surgery
Lower Blepharoplasty (Lower Eyelid Surgery)
Refines the lower eyelids by addressing under-eye bags, contour irregularities and excess skin while preserving natural expression.
Lower blepharoplasty refines the lower eyelids by addressing under-eye fullness, contour changes and, where appropriate, excess skin. The procedure is designed to create a smoother transition between the lower eyelid and cheek while maintaining natural eyelid shape and function.
Surgical focus
My approach is considered, curated and grounded in a deep understanding of facial anatomy. Lower blepharoplasty is not simply about removing tissue; it is about restoring under-eye contour while preserving eyelid support, function and natural expression.
Understanding Lower Blepharoplasty Surgery
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.
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.
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.
Recovery and Aftercare
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.
What Are the Risks of Blepharoplasty Surgery?
All surgery carries risk. Possible complications include:
- 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).
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.
WHAT TO EXPECT
From Consultation to Recovery
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
