About:

Lower eyelid surgery — known as lower lid blepharoplasty — is a procedure to improve the sagging, baggy, or wrinkles of the undereye area.

Sometimes a person will get this procedure with others, such as a facelift, brow lift, or upper eyelid lift.

Safety:

The procedure may be performed under local or general anesthesia.

Side effects include bruising, bleeding, and soreness. Most people take 10 to 14 days to recover before returning to work.

Convenience:

The procedure lasts one to three hours.

You must apply cold compresses routinely for the first two days after surgery. Innovations in techniques mean a surgeon doesn’t usually bandage your eyes.

Cost:

The average cost for the surgical procedure is $3,026. This doesn’t include anesthesia, medications, and operating room facility costs.

Efficacy:

Effectiveness of lower eyelid surgery depends upon your skin quality and how you care for your skin after your procedure.

Eye bag surgery, also called blepharoplasty of the lower eyelid, is a cosmetic procedure that helps correct lose skin, excess fat, and wrinkles of the lower eye area.

As you age, your skin naturally loses elasticity and fat padding. This can make the lower eyelid appear puffy, wrinkled, and baggy. Lower eyelid surgery can make the undereye smoother, creating a more youthful look.

According to the American Society of Plastic Surgeons, the average cost of eyelid surgery is $3,026. This price can vary by region, experience of the surgeon, and other factors. This is the cost for the surgery itself and doesn’t include costs for operating room facilities and anesthesia which will vary depending on your location and needs.

Because the procedure is usually elective, your insurance likely won’t cover the costs.

The costs will increase if you have both upper and lower eyelid surgery. Your surgeon can provide an estimation of costs prior to surgery.

Lower eyelid surgery works by removing excess skin and fat and sewing the skin under the eye back together, giving the undereye area a tighter appearance.

There are delicate structures around the undereye, including eye muscles and the eyeball itself. The surgery requires a delicate, precise approach to smooth the undereye area and make it appear less puffy.

Several surgical approaches exist for lower eyelid surgery. The approach usually depends on your goals for your undereye area and your anatomy.

Prior to the procedure, a surgeon will mark your eyelids. This will help the surgeon know where to make incisions. They’ll usually have you sit up so they can see your eye bags better.

The procedure may be performed under general or local anesthesia. General anesthesia is when a patient is completely asleep and unaware of what is happening during the procedure. Local anesthesia allows a patient to be awake, but the eye area has been numbed so they don’t feel what the surgeon is doing.

If you’re having multiple procedures, a doctor will likely recommend general anesthesia. If you’re having just lower eyelid surgery, a doctor may recommend local anesthesia. A benefit of this is that a doctor can test eye muscle movements to reduce the risks for this side effect.

While the incision sites may vary, a doctor will make cuts into the lower eyelid. Your doctor will then remove excess skin and fat and suture or sew the skin back together to create a smoother, lifted appearance.

Your doctor may also recommend fat grafting or injecting fat to hollow areas under the eyes to give them a fuller appearance.

Lower eyelid surgery may be used to treat the following cosmetic concerns:

It’s important you speak honestly with your surgeon about what bothers you about your undereye area and what types of results you can expect.

A surgeon should discuss the risks and side effects associated with surgery.

Potential risks

  • bleeding
  • cysts where the skin was sewn together
  • double vision
  • drooping upper eyelid
  • excessive muscle removal
  • necrosis, or death, of fat tissue under the eye
  • infection
  • numbness
  • skin discoloration
  • vision loss
  • wounds that won’t heal well
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It’s possible that a person can also have side effects from medications during surgery. Always tell your doctor about any allergies you have as well as medications and supplements you take. This will help to reduce the risks of drug reactions.

Lower eyelid surgery is usually an outpatient procedure, unless you’re having other procedures performed too.

Your doctor will give you instructions for care following surgery. This usually includes applying cold compresses for about 48 hours after surgery to help reduce swelling.

Your doctor will also prescribe ointments and eye drops, to help prevent infections. You can expect some bruising, dry eyes, swelling, and overall discomfort in the days after your surgery.

You’ll usually be asked to limit strenuous exercise for at least one week. You should also wear darkly tinted sunglasses to protect your eyes as the skin heals. If your surgeon placed sutures the body doesn’t absorb, the doctor will usually remove them about five to seven days after surgery.

Most people find the swelling and bruising has decreased significantly after about 10 to 14 days, and they feel more comfortable in public.

You should always call your doctor if you have symptoms that may mean you have postsurgery problems.

See your doctor immediately for

  • bleeding
  • fever
  • skin that feels hot to the touch
  • pain that worsens instead of getting better over time
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It’s important to remember that you’ll continue to age after the procedure. This means that it’s possible the skin can start to appear sagging or wrinkled again at a later time. Your results will depend on:

  • your skin’s quality
  • your age
  • how well you take care of your skin after the procedure

Once you feel ready, schedule your procedure. Your doctor will give you instructions for before surgery. These may include refraining from eating or drinking after midnight the day before your surgery.

A doctor may also make suggest eye drops or other medications you may take before surgery.

You should bring someone to drive you home from surgery, and prepare your home with what you may need as you recover. Examples of items you may need include:

  • cloths and ice packs for cold compresses
  • sunglasses to protect your eyes
  • any eye prescriptions your doctor may want you to use following surgery

You can also ask your doctor if there are any other special preparations you should use before your procedure.

If eyelid skin sagging is mild to moderate, you can discuss other treatments with your doctor. Options include laser skin resurfacing and dermal fillers.

Laser skin resurfacing

Laser skin resurfacing involves using lasers, such as the CO2 or Erbium Yag lasers. Exposing the skin to the lasers can cause the skin to tighten. Not everyone can receive laser skin treatments. Those with especially dark skin tones may want to avoid laser treatments as the laser can create discoloration in highly pigmented skin.

Dermal fillers

Another alternative treatment is dermal fillers. While dermal fillers aren’t FDA-approved for undereye issues, some plastic surgeons may use them to improve the look of the undereye area.

Most fillers used under the eye contain hyaluronic acid and are injected to give the area underneath the eyes a fuller, smoother appearance. The body will ultimately absorb fillers, making them a temporary solution for treating undereye volume loss.

It’s possible that a person’s skin may not respond to laser treatments or fillers. If the lower eyelid remains a cosmetic concern, a doctor may recommend lower eyelid surgery.

To find a plastic surgeon in your area that provides lower eyelid surgery, you may wish to visit the websites of various plastic surgery boards and searching for area surgeons. Examples include the American Society of Plastic Surgeons and the American Board of Cosmetic Surgery.

You can contact a potential surgeon and ask for a consultation appointment. At this appointment, you’ll meet with the surgeon and can ask questions about the procedure and if you’re a candidate.

Questions for your doctor

  • How many of these procedures have you performed?
  • Can you show me before and after pictures of procedures you’ve performed?
  • What kind of results can I realistically expect?
  • Are there other treatments or procedures that may be better for my undereye area?
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You aren’t obligated to undergo the procedure if you don’t feel confident in the surgeon. Some people may speak to several surgeons before determining the best fit for them.

Lower eyelid surgery can give a more youthful and tighter appearance to the skin under the eyes. Following your doctor’s instructions in the recovery period is vital to achieving and maintaining your results.