Lower Eyelid Surgery in Miami, FL

Introduction to Lower Eyelid Surgery

At our practice in Miami, lower eyelid surgery is one of our specialties. Double board-certified oculofacial plastic surgeon, Gregory D. Lewen, M.D., offers lower eyelid surgery (also known as a lower blepharoplasty) for men and women in Miami, Aventura, Fort Lauderdale, and the surrounding areas of Florida. Dr. Lewen is one of the few plastic surgeons in the area who specializes in plastic surgery of the eyelids and surrounding areas of the face.

In the paragraphs below, we’ve provided information on lower eyelid surgery. If you’re interested in upper blepharoplasty, revision eyelid surgery, or other forms of eyelid surgery, please check out our articles on those pages. If you have any questions or would like to book a consultation, please contact us today.

What is Lower Eyelid Surgery?

A lower eyelid blepharoplasty, or a “lower eyelid lift,” is a surgery that can dramatically improve and rejuvenate the tired and aged appearance of puffy lower eyelid “bags” and may also reduce the appearance of wrinkling skin underneath the eyes. Most importantly, this surgery will frequently change how the light reflects in the area around your eyes to ultimately add a more youthful, refreshed, and energetic appearance to your face.

What are the Common Reasons to get Lower Eyelid Surgery?

The appearance of eyelid bags in the lower lids is frequently caused by a combination of factors that can contribute to this heavy and tired look. The eyes are normally surrounded by fat that serves to protect the eyes within the bony eye socket. With time, some of the tissues that hold this fat back in the eye socket will weaken and can cause some of the fat to bulge forward. Additional aging changes are simultaneously occurring in the midface and cheek area, where a normal loss of volume over the course of time can cause a loss of fullness and support for the midface and cheek areas. This can cause the midface and cheek area to fall, and this can create the appearance of hollows around the eyelids that exaggerate the appearance of bags that are present here. For some patients, the appearance of lower eyelid bags at a younger age can also be a hereditary condition that is based on the shape of your face.

Who is a Candidate for a Lower Eyelid Surgery?

If you are not happy with the appearance of your lower eyelids, you may be a candidate for lower blepharoplasty. The most common complaints are due to puffiness under the eyes, bags under the eyes, dark circles under the eyes, excess wrinkles, or too much skin under the eyes.

What’s the First Step to Lower Eyelid Surgery?

The first step is to get in touch! Our team will be happy to assist in scheduling a consultation for you to come in and meet with Dr. Lewen one-on-one. Dr. Lewen will answer any questions you may have regarding our Miami lower eyelid surgery during your consultation and will evaluate each case individually to determine the most appropriate and effective treatment to address your concerns while providing you with the most natural-appearing results.

If Dr. Lewen determines that a lower blepharoplasty is a good surgical option for you, he will provide you with an individualized treatment plan that includes this procedure, as well as any other complementary procedures to help give you the refreshed look that you desire.

Dr. Lewen requires all cosmetic eyelid surgery patients to have a full eye exam with dilation completed within 6 months before scheduling surgery. Surgery should be scheduled for a time when you can relax for at least one to two weeks. It is important to avoid any strenuous activity, heavy lifting, or bending down during this time to avoid complications and to promote the best healing situation. It is also important to avoid taking any blood-thinning medications for at least two weeks prior to surgery. Dr. Lewen’s staff will review a list of common medications, supplements, and vitamins that can cause your blood to be thinner.

Please note: If you have been placed on a blood-thinning medication by your doctor for a medical reason, you will have to ask your doctor’s permission before stopping any such medications. This includes aspirin and any other blood thinners.

It’s vital that you’re as open and honest about your surgical goals with Dr. Lewen as possible. Great communication always leads to the best results.

What Should I Expect on the Day of Lower Eyelid Surgery?

This surgery is typically performed in an outpatient surgery center (where you go home the same day) using either IV anesthesia to induce a twilight sleep or light general anesthesia, and then local anesthetic injections are administered to the lower eyelid areas. As with all surgery in an outpatient surgery center, a standard medical clearance is required. This clearance typically includes basic blood work, a history, and physical exam, a recent EKG, and a urine pregnancy test (if you are female and of reproductive age) from your primary care physician or your cardiologist.

The average time for lower eyelid blepharoplasty in Miami is usually about two hours, but this can vary greatly depending on other procedures being performed and your medical history. The approach to lower eyelid surgery is done with either a transconjunctival incision, a transcutaneous incision, or some combination of both. A transconjunctival incision is made through the inside lining of the eyelid and is typically a better approach for removing, sculpting, or manipulating the fat pockets of the lower eyelid. A transcutaneous incision is typically made in the outside corner of the lower eyelid and extends underneath the eyelashes of the lower eyelid where it typically hides nicely over time. This incision does not usually affect the eyelashes. This is usually a more suitable approach for addressing areas of eyelid muscle weakness, tightening the eyelid itself, and/or removing skin to give a more rejuvenated look to the lower eyelid areas. Depending on the individual case, Dr. Lewen may also use a combined approach for patients in order to achieve the best and most natural-appearing results.

The appearance of your cheek and midface areas can also frequently impact the appearance of your lower eyelids. In an ideal rejuvenation of this facial area, the goal is to create a smoother transition overall between the lower eyelid and the cheek. For this reason, Dr. Lewen will often make recommendations for rejuvenating this area of the face in combination with lower blepharoplasty. Such options for rejuvenation may include options such as the injection of facial fillers, fat grafting to the midface/cheek areas, a midface/cheek lift, and/or CO2 laser treatment or Morpheus8 (RF plus microneedling) to the skin or folds in the midface/cheek areas in order to create a smoother appearance and transition. It is important to understand that any recommendations that Dr. Lewen makes for rejuvenation of this facial area are in addition to lower eyelid surgery and may be required in order to obtain the best possible result.

Combining Lower Eyelid Surgery with Laser Resurfacing

Dr. Lewen may also make recommendations regarding laser resurfacing for the lower eyelid skin or puffy skin areas over the cheekbones for some patients. In these cases, the CO2 laser can be used to create a tightening effect for this tissue instead of requiring surgical removal. If CO2 laser skin resurfacing is recommended for you, Dr. Lewen and his staff will review a skin treatment plan, and clear instructions will be given regarding the required use of specific medical-grade skincare products in the pre-and postoperative periods in order to attain the best possible results.