Lower Blepharoplasty Sydney

Lower Blepharoplasty (Lower Eyelid Surgery)

Lower blepharoplasty, or lower eyelid surgery, focuses on correcting issues like excess skin, under-eye bags and tear trough deformities. The procedure can reduce the appearance of tired or puffy eyes by removing or repositioning fat that has pushed forward, tightening lax skin, and restoring support beneath the eye. Often the surgery is combined with fat grafting to fill in hollows.

Under-eye fullness and hollowing usually occur together. Fat within the lower lid becomes more prominent as the tissue holding it weakens, while volume is lost along the tear trough, creating a shadow. Deciding which of these is driving your appearance determines whether fat is removed, moved into the groove, or added.

Dr Maryam Seyedabadi, Specialist Plastic Surgeon, MBBS FRACS, performs lower blepharoplasty in Sydney and assesses lower lid tone, cheek support and skin quality first, since a lax lid needs additional support at the time of surgery. Pigmentation causing dark circles is a separate issue and is not corrected by surgery.

Who it may suit

• Persistent bags beneath the eyes that do not change with sleep or fluid intake
• Crepey or loose lower lid skin, with fine creasing that folds when you smile
• A hollow or shadowed groove along the tear trough
• Puffiness that has not improved with non-surgical treatment
• Adults in stable general and eye health, not smoking, who accept that some contour irregularity is possible

What lower blepharoplasty involves

Lower blepharoplasty is usually day surgery under general anaesthetic, or local anaesthetic with sedation, at an accredited facility such as St Luke’s Hospital in Potts Point, East Sydney Private Hospital, Sydney Day Hospital, The Skin Hospital in Darlinghurst or Double Bay Day Hospital.

1. Lower lid tone, lid position and the pattern of fullness and hollowing are checked and marked.
2. Access is gained either from inside the lid, which leaves no external scar and suits fat alone, or through an incision just below the lash line when skin also needs treating.
3. Fat is removed or repositioned into the tear trough, and fat grafting is used where hollowing needs filling.
4. Where lid tone is lax, a supporting stitch at the outer corner is added to hold lid position during healing.
5. Any excess skin is trimmed conservatively and the incision closed with fine sutures.

Recovery

Lower lid recovery is generally slower than upper lid recovery because swelling settles gradually in this area. The timeframes below are typical rather than fixed.

• Bruising can extend onto the cheek and usually fades over roughly two to three weeks
• Oedema often takes six weeks or longer to settle, and residual firmness after fat grafting can persist for months
• Sutures, when used externally, are generally removed at about five to seven days
• Many patients return to desk work within one to two weeks, and to exercise after two to four weeks once cleared
• Sleeping with your head raised and using cold compresses in the first days helps limit swelling

Risks and considerations

Risks include prolonged oedema, bruising, bleeding and haematoma, infection, dry or gritty eyes, watering, chemosis or swelling of the eye surface, altered sensation, and reaction to anaesthetic. Lower lid position can change after surgery, producing scleral show, lid retraction, rounding of the outer corner or, uncommonly, ectropion, which may require further surgery. Rare and serious complications include bleeding behind the eye and loss of vision.

Grafted fat does not survive predictably, so volume can settle unevenly or reduce, and a top-up or contour adjustment is sometimes needed. Removing too much fat can deepen hollowing, which is harder to correct than fullness, so removal is deliberately conservative.

Your consultation with Dr Maryam

A referral from a registered medical practitioner is required before your consultation, and a GP referral is preferred so your medical history, medications and any eye conditions can be reviewed. Dr Maryam examines lid tone and position, takes preoperative photographs, and explains which elements of your under-eye appearance surgery can address.

The risks, possible complications and alternatives are discussed before you decide, including fat grafting alone, non-surgical options, or no treatment. A cooling-off period of at least seven days applies between consultation and booking surgery. Patients under 18 have a cooling-off period of at least three months and also require assessment by an appropriate registered health practitioner. Enquiries can be made on 1300 067 668.