Lower blepharoplasty: how we do it

The natural process of ageing causes multiple age-related changes, which are observed in the anatomy of the eyelids and surrounding structures, including the malar region. Blepharoplasty is a procedure performed widely for tired looking eyes and facial rejuvenation. Lower blepharoplasty (LBP) is usually done with fat transposition rather than fat resection to avoid hollow appearance of malar area. Patients with excess fat and no tear trough deformity can be treated with fat resection alone, where as those with a prominent tear trough deformity requires fat transposition. Transposing the medial and central fat pads instead of excising them can help to fill out the hollowness of the under eye area whereas the lateral fat pads are removed as much as needed through direct excision. In our practice, we generally prefer a transconjunctival approach to lower lid blepharoplasty with fat repositioning.