The aesthetic goal of surgery in the region near the eye is to transform a sad or tired older appearance into an open and friendly younger look.
Surgery on eyelids is performed to address excess skin and fatty protrusions in the upper eyelid, and may include a brow-lift at the same sitting.
Surgery on lower eyelids improves the fatty bulging bags that form in that region.

Loss of tone in the lower eyelid may require tightening of the muscle of the lower eyelid.
Fine lines and a crinkled appearance in the skin of the eyelid are best treated with laser skin-resurfacing.
Asymmetry is common with both eyebrows and eyes, and some measure of natural asymmetry may remain after surgery.
The procedure is done under local or general anesthesia.
Surgery on the Lower Eyelid (Lower Blepharoplasty)

1. Treatment of baggy Lower Eyelids with a Trans-conjunctival Approach (hidden incision)

If there is no excess skin, and there is good tone in the lower eyelid, then a hidden incision approach or “trans-conjunctival blepharoplasty” may be the best option.
The incision is closed using dissolvable sutures.
If any excess skin is present, a small “pinch excision” of skin is done along the margin of the eyelash.

Dr. Shaer believes in preserving some fat around the eye to avoid the hollow sunken-eye appearance with aging, so he chooses to reposition the fatty bulges into a smooth layer that softens the bony rim and gives a full, youthful result.

This is the most common approach and latest technique for rejuvenation of the lower eyelid.

2. Treatment of Fatty Bulges of the Lower Eyelid with Re-suspension of the Muscle of the Eyelid.

If the lower eyelid has lost tone, then tightening the muscle of the lower eyelid may help to re-suspend the eyelid (canthopexy).

With this approach, some excess fat is removed, and the muscle of the eyelid is tightened to support the eyelid.
The incision is made just beneath the lower eyelash line to the outer corner of the eye.
Excess skin is trimmed and the wound is closed using a very fine suture.

Post-operative Blepharoplasty Recovery :

• No heavy lifting or strenuous activity for 1-2 weeks after the surgery to minimize the risk of bleeding around the eye;
• Swelling usually diminishes at one week;
• Residual bruising then fades thereafter;
• No pain;
• No visible scars;
• Sutures for hidden incision dissolve on their own, external sutures are removed after 6 days.