Learn about Lower Blepharoplasty: Who is Suitable for Treatment

Hello! My name's Adrian Richards, I'm a plastic and cosmetic surgeon and today I'm going to be talking a little bit about lower blepharoplasty. So a blepharoplasty is an operation on the eyelids and a lower blepharoplasty is an operation on the lower eyelid, upper blepharoplasty is an operation on the upper eyelid. So basically, who would benefit from a lower blepharoplasty? Well, there's really two things to assess. The first is do you have excess skin on the eyelids and the second thing is do you have puffiness of the lower eyelids. The excess skin of the lower eyelids, it can be characterized by fine wrinkles on the lower eyelids and this is caused by just laxity of the skin that comes with time. Puffiness of the eyelids is quite different. That's caused by movement forwards of the fat tissue that surrounds the eyeball. So the eyeball is held within the eye socket and it's protected from sort of a movement via the fat pads or a fatty pad layer. With time, the wall holds this fatty layer back weakens. So you can imagine that gravity is sort of pushing this fat forward and almost have a small bulge or a hernia appears on the lower eyelids. It's these fat pads which are moved forwards which gives you the bulging. The important thing is to differentiate between this because a different technique is used for each of them. So if you have skin excess, so if you lift your eyelid up and out like that and the skin tightens and you like that appearance, you really need a standard lower blepharoplasty, in which a cut is made along the crows feet from the corner of the eye and down just under the eyelashes. Then the skin is released from inside, the fat pads can be addressed at that time, either reduced or more recently, what we're tending to do is move the fat pads so not just remove them because that can leave quite a hollow looking eye but actually to release them and make them blend nicely into the cheek. A youthful eyelid cheek junction is very, very smooth and so we tend to do more fat preservation surgery on the lower eyelid whereas ten years ago, it was more fat removal. So if you've got the combination of loose skin and puffiness, you probably need to be considering a lower blepharoplasty with an external incision. If it's just puffiness we're looking at without too much excess skin, we can use a technique called a transconjunctival blepharoplasty. All that basically means is instead of being on the outside, the cut is actually inside the lower eyelid where it's hidden and in that technique, a small incision can be made and the fat directly removed from inside the eyelid. The advantage of that is that fat is removed; puffiness is reduced without any external scarring which is obviously a great advantage. That's a good technique, it will address the puffiness but it won't reduce the skin so it won't really tighten up the skin. If the skin excess is relatively mild, the technique we can use is the transconjunctival blepharoplasty to remove the puffiness and either a skin peel or a laser treatment, just to tighten up the skin a little bit. That's only really good for people who've got moderate fat excess with slight skin excess. If you've got more skin excess, you really need to be thinking about more traditional skin removing blepharoplasty. So that's your introduction to blepharoplasty. I'm going to be talking a little bit in another video about the actual procedure, recovery and complications. So thank you for listening to that. If you would like further information and to arrange a complimentary consultation with one of our surgeons, please do so by either visiting the website which is aurora-clinics.co.uk or possibly give us a ring in the office directly on 01844 214362. Thanks very much for listening, we hope to hear from you soon!