Name of the Procedure:

Blepharoplasty, lower eyelid; with extensive herniated fat pad
Common name(s): Lower eyelid surgery, Lower blepharoplasty

Summary

Lower blepharoplasty is a surgical procedure to remove or reposition excess fat and skin from the lower eyelids. This helps to correct puffy bags under the eyes, giving a more youthful and rested appearance.

Purpose

This procedure addresses the presence of puffy bags under the eyes caused by herniated fat pads. The goals are to improve the appearance of the lower eyelids, reduce puffiness, and create a smoother, more youthful contour around the eyes.

Indications

• Presence of puffy bags under the lower eyelids
• Noticeable herniated fat pads
• Excess skin causing wrinkles or sagging under the eyes
• Vision impairment due to excessive skin folds (less common)

Preparation

• Avoid medications that can increase bleeding risk, such as aspirin or anti-inflammatory drugs, for at least a week before the procedure.
• Fasting may be required if general anesthesia is used.
• Arrange for someone to drive you home after the procedure.
• Pre-procedure diagnostic tests may include a physical examination and a review of medical history.

Procedure Description

1. The patient is prepped and anesthesia is administered (local anesthesia with sedation or general anesthesia).
2. An incision is made along the lower eyelid, just below the lash line or on the inside of the lower eyelid.
3. Excess skin, muscle, and herniated fat pads are removed or repositioned as needed.
4. The incisions are closed with fine sutures.
5. A sterile bandage may be applied.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is usually performed in an outpatient surgical center or hospital.

Personnel

• Surgeon (often a plastic or oculoplastic surgeon)
• Anesthesiologist
• Nursing staff

Risks and Complications

• Common risks: swelling, bruising, discoloration, temporary blurred vision.
• Rare complications: infection, bleeding, dry eyes, eyelid malposition, and scarring.
• Proper management involves following post-operative care instructions and promptly reporting any concerning symptoms.

Benefits

• Improved appearance of the lower eyelids.
• Reduction in puffiness and swelling.
• Achieving a more youthful and rested look.
• Benefits may be realized a few weeks to a couple of months post-procedure.

Recovery

• Post-procedure care includes cold compresses to reduce swelling and ointments to keep the incision area moist.
• Avoid strenuous activities and bending over for at least 1-2 weeks.
• Sutures (if any) are typically removed within 5-7 days.
• Full recovery can be expected in 2 to 3 weeks, though minor swelling may persist for a bit longer.
• Follow-up appointments will be scheduled to monitor healing.

Alternatives

• Non-surgical options: Dermal fillers, laser skin resurfacing, or chemical peels.
• Pros: Less invasive with shorter recovery times.
• Cons: Temporary results and possibly less dramatic improvement.

Patient Experience

During the procedure, patients are under sedation or anesthesia and should feel no pain. Post-procedure, patients can expect some discomfort, swelling, and bruising. Pain is typically managed with prescribed pain relievers and cool compresses. Most patients are able to return to normal activities within two weeks, with specific after-care measures to aid in healing and comfort.