What Is Lower Eyelid Surgery, and Why Choose Our St. Louis Practice?

West County Plastic Surgeons performs lower-lid blepharoplasty (eyelid surgery) for St. Louis patients, removing excess skin, muscle and fat deposits that can create bags, puffiness, dark circles, wrinkles or an overall tired appearance. This procedure can also tighten and reposition the eyelid or create a smooth, well-contoured transition between the bottom eyelid and the midface. During the procedure, a small incision is created along the lower eyelids, either inside each lid or outside along the lash line, to provide access to the area below each eye. From there, your surgeon will remove and reposition fat deposits, bulging muscle tissue or excess skin to refresh and rejuvenate your eyes. This procedure is often combined with fat grafting or fat transfer to the lower eyelid as well.

At the Washington University School of Medicine, our board-certified plastic surgeons Dr. Terry Myckatyn and Dr. Marissa Tenenbaum stay abreast of cutting-edge techniques and technologies in plastic surgery so that they can deliver the very best medical care to their patients. They have successfully performed thousands of blepharoplasty procedures, and they are proud of the number of satisfied patients they have treated. They understand that a positive outcome from this procedure can help you look as young and well rested on the outside as you feel on the inside.

To speak with one of our plastic surgeons about lower-lid blepharoplasty surgery, contact our St. Louis office by phoning (314) 996-8800, requesting your consultation online, or emailing us today.

Click here to view a video on eyelid surgery.

Dr. Terry Myckatyn, MD and Dr. Marissa Tenenbaum, MD

Dr. Terry Myckatyn and
Dr. Marissa Tenenbaum:

Trusted. Experienced. Committed.

What Are My Options for Lower-Lid Blepharoplasty?

There are two forms of lower-lid blepharoplasty: A transconjunctival blepharoplasty removes fat deposits from the bottom eyelid through a well-hidden incision on the inner surface of the bottom eyelids. To tighten or remove excess eyelid skin, the transconjunctival blepharoplasty can be combined with laser tightening of the bottom eyelid or a second incision through which excess skin is removed.

A subciliary blepharoplasty removes excess skin, muscle, and protruding fat through a well-hidden incision just below the bottom lash line to create a well-contoured transition between the eyelid and cheek. It can also be combined with fat grafting or fat transfer to the hollowing in the lower eyelid or cheek area.

Lower-Lid Blepharoplasty: What You Should Know

Anesthesia: This procedure is performed with the patient under general anesthesia.

Length of procedure: 60 to 90 minutes.

Estimated recovery time: Patients may return to work after 1-2 weeks, but should avoid vigorous activities for 3 weeks. Visible bruising or swelling should resolve within 1-2 weeks. To learn how to prepare for this procedure and what to expect afterwards, click here to download our patient instructions.

Side effects: Common side effects include bruising, swelling, a well-hidden scar, and possibly some eye irritation. Downward traction of the eyelid may occur in some cases, but usually resolves in days to weeks. Click here to download a detailed consent form from the American Society of Plastic Surgeons, listing the risks and benefits of lower-lid blepharoplasty surgery.

Before-and-after photos of eyelid lifts and brow lifts (forehead lifts): Click here 

Procedures That Complement Lower-Eyelid Surgery

Lower-lid blepharoplasty alone can dramatically improve a person’s facial appearance. However, in certain patients, optimal results are achieved when lower eyelid surgery is combined with the following procedures:

Before & After

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  • Canthopexy or canthoplasty. Lower-lid blepharoplasty can occasionally result in loosening of the eyelid, which causes the lower eyelashes to be out of position and increases exposure of the sclera, or white part of the eyeball. A canthopexy procedure reconstructs and tightens the outer part of that eyelid, or canthus, to improve its position. A canthoplasty procedure reconstructs and tightens the outer part of the lower eyelid to improve its position. Both are commonly performed with a subciliary lower-lid blepharoplasty or other reconstructive procedures to secure the position of the lower lid.
  • Midface lift. The midface, which includes the part of the face below the eyes and above the mouth, can be rejuvenated by extending either the transconjunctival or subciliary lower-lid blepharoplasty procedure.
  • Fat grafting or repositioning. Your own fat, sometimes referred to as autologous fat, can be used to fill deep creases, add volume, or create attractive contours in the midface. Bulges of fat directly below the eye can be repositioned to smooth midface contours, or fat can be harvested from other areas of the body, including thighs or abdomen, and then transferred to the midface to fill creases and improve contours. Alternatively, some injectable hyaluronic acid fillers such as JUVEDERM® can be used in place of autologous fat for this purpose.

If you’re ready to speak to a board-certified plastic surgeon about rejuvenating the area around your eyes, contact our St. Louis office by phoning (314) 996-8800, requesting your consultation online, or emailing us today.

If you have questions or would like to book a consultation with one of the surgeons at West County Plastic Surgery, please call (314) 996-8800.

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