Lower blepharoplasty: the solution for bright, natural-looking eyes

Understanding lower eyelid blepharoplasty

Lower eyelid blepharoplasty is a surgical procedure designed to improve the appearance of the lower eyelids by removing excess skin, fat or muscle. It is often sought to reduce under-eye bags and smooth wrinkles, giving a younger, more rested look. There are several techniques, each suited to particular needs: transcutaneous, transconjunctival, pinch blepharoplasty and laser resurfacing.

Patients, and especially those who consult Dr Hayot, are often looking for natural results without visible scars, which guides their choice of technique. Transconjunctival blepharoplasty, for example, is particularly valued because it leaves no external scar, as noted in a 2023 study(Transconjunctival Blepharoplasty), which describes its use for cosmetic rejuvenation without a skin incision.

Risks of the traditional transcutaneous technique

The transcutaneous technique involves an incision under the eyelashes to reach the fat pads and the excess skin. Although effective, this method carries a higher risk of complications, including:

• Round eyes: excessive tension after healing can result in a frozen, inexpressive look.
• Nerve damage: the dissection can affect nerve endings, causing tingling, pain or numbness.
• Hollowed appearance: overcorrection, by removing too much fat, can result in an aged, tired look.

These complications underline how important it is to choose the right surgical technique for each patient, in order to minimise risks and maximise the aesthetic result.

A safer alternative: the advantages of the transconjunctival approach

Transconjunctival blepharoplasty is a safer alternative to the transcutaneous technique. The incision is made inside the eyelid, so there is no visible scar. Its advantages include:

• No external scar: particularly valued by patients concerned about appearance.
• Preservation of the natural structure of the eye: by avoiding the orbicularis oculi muscle, the risk of functional complications is minimised.

A 2024 study(Exploring Gentle Transconjunctival Blepharoplasty Techniques) shows that this technique offers faster recovery and less pain, making it ideal for patients with fat pads but no excess skin. According to another study from 2023(Lower Lid Transconjunctival Blepharoplasty), it is particularly indicated for patients with good skin elasticity, and gives the highest patient satisfaction.

Other techniques for particular needs

Besides the transconjunctival approach, other options exist to meet patients’ specific needs:

• Laser resurfacing: for patients with mild skin laxity and fine lines under the eyes, laser resurfacing is a non-invasive option that stimulates collagen production to smooth the skin. A study published in Lasers in Surgery and Medicine(Laser blepharoplasty and laser resurfacing of the periorbital area) demonstrated the benefits of this technique for improving wrinkles and skin texture around the eyes.
• Hyaluronic acid fillers: for non-surgical correction of under-eye hollows, hyaluronic acid fillers can be used. A study published in Aesthetic oculoplastic surgery(Hyaluronic Acid Fillers for Lower Eyelid Rejuvenation) showed that these fillers are effective in correcting retraction and improving periocular volume.

Comparison of the techniques

Here is a comparison of the different lower eyelid blepharoplasty techniques, based on scientific data and on feedback from our patients:

Technique	Description	Risks	Indications	Duration of results
Transconjunctival	Internal incision, removal of fat	Low; concealed scar, no retraction or ectropion reported	Fat pads without excess skin	5-10 years
Laser resurfacing	Collagen stimulation by laser	Risk of slight pigmentation	Superficial wrinkles, thin skin	1-2 years

Dr Bernard Hayot: 30 years of expertise in eyelid and oculoplastic surgery

With more than 30 years’ experience in eye surgery, Dr Bernard Hayot is a recognised expert in blepharoplasty and in other eyelid and oculoplastic procedures around the eyes. His commitment to patient safety and to natural results has made him a respected figure in the field. Dr Hayot is a pioneer of innovative techniques such as transconjunctival blepharoplasty and pinch blepharoplasty, which offer safer and more effective alternatives to traditional methods.

With international experience and advanced training in the United States, Dr Hayot remains at the forefront of surgical innovation. At our practice he offers personalised care, tailoring each treatment plan to the individual needs and goals of each patient. Whether you are considering lower eyelid blepharoplasty or another procedure, you can rely on Dr Hayot’s expertise and dedication to deliver the best possible result.

FAQ: frequently asked questions

What is lower eyelid blepharoplasty?

Lower eyelid blepharoplasty is a surgical procedure designed to improve the appearance of the lower eyelids by removing excess skin, fat and sometimes muscle. It reduces under-eye bags and smooths wrinkles for a younger, more rested look.

Who is a good candidate for lower eyelid blepharoplasty?

Good candidates are people with under-eye bags, excess skin or wrinkles around the eyes that they wish to correct. It is important to have realistic expectations and to be in good general health.

What are the different techniques for lower eyelid blepharoplasty?

• Transcutaneous (external) approach: an incision is made just under the eyelashes to remove skin and fat.
• Transconjunctival approach: an incision is made inside the eyelid to remove the fat, leaving no visible scar.
• Pinch blepharoplasty: A minimal technique for removing a slight excess of skin.
• Laser resurfacing: improves skin texture and reduces wrinkles, often combined with other techniques.

What are the risks of lower eyelid blepharoplasty?

The risks include infection, bleeding, scarring, dry eye, ectropion (an outward-turning eyelid) and, rarely, changes in vision. The transconjunctival approach generally carries fewer risks than the transcutaneous method.

How long does recovery take?

Recovery generally takes 1 to 2 weeks. You may have some swelling, bruising and discomfort, which gradually settle. Most patients can return to work within 5 to 10 days, depending on the technique used.

Will there be visible scars?

With the transconjunctival approach there is no visible scar, because the incision is made inside the eyelid. The transcutaneous approach may leave a scar along the lash line, but it is generally well hidden.

Is the procedure painful?

The surgery is performed under local anaesthesia with sedation, or under general anaesthesia, so you will feel no pain during the procedure. Post-operative pain can be managed with prescribed medication.

How much does lower eyelid blepharoplasty cost?

Costs vary according to the surgeon, the location and the technique used. For a personalised quotation, please contact the practice.

Are the results permanent?

The results are long-lasting, but natural ageing continues. Fat that has been removed generally does not return, but sagging skin may appear over time and may call for further treatment.

Are there non-surgical alternatives?

Yes. Non-surgical options include fillers to add volume under the eyes, laser treatments to improve skin texture and chemical peels to reduce fine lines. These options can be discussed at your consultation.

Conclusion

Lower eyelid blepharoplasty can transform the face, but it is essential to choose a technique that limits the risks while giving a natural result. The traditional transcutaneous method, although effective for some patients, carries a high risk of ectropion and retraction. Alternatives such as the transconjunctival approach are safer and give excellent results, particularly in patients with no excess skin.

If you are considering such a procedure, consulting an expert such as Dr Bernard Hayot is the best way to explore your options and ensure a safe outcome. With his expertise in modern, minimally invasive oculoplastic techniques, he will help you achieve a rejuvenated look that enhances your natural appearance.

Take action: make an appointment with Dr Hayot to discuss your goals and find out which eyelid and oculoplastic options are best for you.