Lower Blepharoplasty: a Complete Guide to a Brighter Look

October 10, 2023
lower blepharoplasty

Unfortunately, none of us is getting younger. And as we grow older, it gets harder and harder for our bodies, including our skin, to maintain the shape we once had. Lower blepharoplasty is an effective way of dealing with “puffy eyes,” “eyelid bags,” and several medical conditions. But before you schedule an appointment with a surgeon, it is crucial to explore the fundamental aspects of this medical procedure.

In this article, you will learn about lower blepharoplasty in simple terms, get all the information you need to decide whether the surgery is required, see the outcomes of such operations, and discover valuable insights a renowned plastic surgeon shared in an interview. You’ll get the answers to the most common and essential questions: “does lower blepharoplasty leave scars,” “how much does it cost,” and many others. Stay tuned if you’re interested!

What Is a Lower Blepharoplasty?

The first question you might have is: “How can you improve my appearance with a surgical operation?” Blepharoplasty is a face surgery that removes excess skin and fat from the upper or lower eyelids, making your skin look smoother and your face younger. There are three types of blepharoplasty: lower, upper, and double-eyelid blepharoplasty.

What is a Lower Blepharoplasty?

Lower blepharoplasty is slightly more complicated than upper blepharoplasty, but it is still a surgery with minimal invasiveness. The task of the surgeon includes identifying the unique physical condition of every patient and choosing the suitable surgical technique (we’ll talk about the modern approach to lower blepharoplasty a bit later). But how to know if you need the surgeon’s opinion in the first place?

If you would like to explore the surgical options for the upper eyelids—you can visit our related articles: upper blepharoplasty and double-eyelid blepharoplasty.

How to Know Whether You Need Surgery?

Before going to the doctor’s office, you need to consider several things, including your health concerns, the changes in appearance you want to achieve, and the alternatives to the surgery. Before we proceed with the medical and cosmetic requirements, let’s discuss briefly the typical alternative treatment—placing a filler to smooth the face skin.

In many cases, injecting a filler may be an adequate solution, however, its most significant drawback is that such augmentation is usually not permanent, so you will need to revisit the surgeon after some time (usually 6-12 months). Generally, it is a cosmetic solution, so it doesn’t help with medical conditions. This kind of face contour improvement often involves a material called hyaluronic acid, and Dr. Alejandro Avila has substantial experience in this area. Now, let’s look at the situations where a lower blepharoplasty surgery can work.

How to Know Whether You Need Surgery?

Medical Requirements for Surgery

Experiencing any kind of unpleasant symptom in your lower eyelid area is a good reason to contact a medical specialist. Alongside aging comes the weakening of skin and muscles that prevent fat from bulging out and keep the eyelid at its normal position. An eyelid can turn in (a doctor can call it entropion) or out (ectropion).

Lower eyelid conditions always cause unpleasant symptoms, including irritation, tearing, dryness, loss of peripheral vision, or pain. The good news is that lower blepharoplasty can fix those issues and, in many cases, even be covered by insurance.

Cosmetic Benefits of the Operation

On the other hand, many patients are concerned with their overall look. So-called “puffy eyes” can negatively affect your confidence, and make you look tired or sad. Blepharoplasty can help you with all these issues. The definition of a successful cosmetic blepharoplasty depends on the consensus a patient and a doctor try to reach. Sometimes, a person might look very differently after the operation, and that’s not always a good thing. In the words of Dr. Avila, successful surgery is:

“For me, the natural result means that the patient can recognize himself as a younger self after the surgery. I ensure this outcome by analyzing every facial detail before the operation.”

Lower Blepharoplasty: Before and After

And now, let’s take a look at a couple of examples of how lower blepharoplasty can transform people’s appearance. We’ll also explain what was the thought process behind each operation.


This patient has had a transconjunctival blepharoplasty with fat removal. The picture below was taken just one week after the operation. Such an effective result is possible for patients who have a consistent eyelid tone and minimal skin excess.


In this case, the patient decided to get a blepharoplasty (photo in the middle) and then add a laser to remove the wrinkles (bottom photo).


This is a complicated case where a patient had quite a lot of excess skin. But a more intricate version of the open lower blepharoplasty still got the job done.


And here is a case of transconjunctival lower and upper blepharoplasty with canthopexy and skin pitch.

You were probably wondering just how many plastic surgeries celebrities have. Well, we know for sure that many famous people have blepharoplasty. Read this article to know who does!

Mitigating Risks: Scars, Bleeding, and Others

Blepharoplasty gained popularity in the ’80s and ’90s, and since that time, the techniques doctors use have become more advanced. Today, lower blepharoplasty doesn’t carry too many risks—it is considered a minimally invasive, safe, and transformational procedure. The most frequent question patients ask is: “Does a lower blepharoplasty leave scars?” Modern blepharoplasty uses a technique called transconjunctival blepharoplasty[1], which means that the tiny scar you get is hidden underneath the eyelid and, thus, is invisible.

Mitigating Risks

The other complications include intensive bleeding (mitigated by proper preparation), risk of infection (extremely rare and mitigated by antibiotics), and need for further surgery (also rare, but can happen to patients with very complicated medical conditions. There is also a condition called “dry eye” and to prevent it, a surgeon must conduct a quality pre-operative evaluation and choose the suitable technique[2].

Overall, the risks of lower blepharoplasty are low, but it is crucial to follow the medical recommendations. Some of those we’ll cover now!

Doctor’s Insights You Must Know

Dr. Avila has provided us with numerous valuable insights we are excited to share with you. In this section, we’ll discuss the most crucial details about preparing for lower blepharoplasty surgery and the dos and don’ts of aftercare.

How to Prepare for a Lower Blepharoplasty Surgery

The pre-operative period is vital for the success of the surgery, and there are several crucial steps you need to take before getting an operation. The doctor will emphasize these to you, but the prior knowledge will help you shape your expectations and ask your surgeon more insightful questions.

How to Prepare for a Lower Blepharoplasty Surgery

💊 Follow medical restrictions 

There are certain medications that you should be avoiding for at least two weeks before the operation. The most well-known entries on the list are aspirin, ibuprofen, and herbal supplements. These medications include substances that cause increased bleeding that complicates the surgery and leads to much more significant bruising after the operation.

👨‍⚕️ Follow the evaluation procedures

It is essential to conduct all the necessary medical evaluations. The doctor will thoroughly assess your medical history and guide you to the testing lab. Quite often, a patient is asked to do blood testing and ECG.

🚬 Quit smoking

Smoking can have a severe negative impact on your body’s healing ability, so it is strongly advised to quit smoking several weeks before the lower blepharoplasty operation. When asked about precautions a patient should take, Dr. Alejandro Avila says:

Smoking is a big no. It is better to quit 4 or even 6 weeks before the operation and don’t start smoking again at least 4 weeks after. It’s because smoking is a big risk factor for wound healing problems. And when you have a wound healing problem, you can get an infection as well.”

🤨 Avoid questionable unscientific practices

One example of such practice is drinking large quantities of pineapple juice to reduce swelling after the operation—a trend that became popular on TikTok and Reddit. Dr. Avila doubts this idea: “Overdoing fruit and vegetable juices is another way to intensify bleeding during the surgery, so I advise against it.” 

Researchers from other medical fields also highlight that pineapple extracts are known to decrease blood coagulability[3]. The point is—never hesitate to seek advice from a specialist and always verify the credibility of your sources!

lower blepharoplasty

What Is the Proper Aftercare?

😴 Take time to rest and recover

The swelling will not go away in a day or two, so it is advised to take time off of work until the discomfort reduces. In most cases, patients need about a week to be able to get back to work and 3 months to recover completely.

❄️ Apply the cooling as prescribed

This is the most essential part of your aftercare process. There are several slightly different ways of cooling the eyelid, but the point is that you need to be able to apply cooling many times per day in 20-minute segments.

🌙 Use a proper sleeping position and a sleeping mask

It is important to avoid pressuring the eyelids while you are in the early aftercare stage. You should sleep in a slightly elevated position (about 30 degrees) and wear a sleeping mask to avoid tearing the stitches and pressuring the eyelids.

How Much Does Lower Blepharoplasty Cost

Finally, we got to the “how much” question. Of course, the lower blepharoplasty price depends on your location, but we’ll try to give you an estimate and explain the cost breakdown. Lower blepharoplasty is more expensive than upper blepharoplasty because it requires much more time and precision. In the words of Dr. Avila:

“The lower eyelid is not forgiving. You have to be very precise with the operation, and you also need the experience to be able to do the right indication for this kind of procedure.”

The price of lower blepharoplasty surgery usually goes above $2,000 and includes fees for the consultation, room, equipment, work of a surgeon’s team, and post-operative consultations. Keep in mind that if you are getting a medical lower blepharoplasty, the cost may be covered by the insurance.

lower blepharoplasty


A decision to get surgery is often taken with caution and nervousness, and rightfully so. However, lower blepharoplasty belongs to a category of the least invasive and risky procedures. An experienced surgeon can help you with numerous eyelid conditions, as well as boost your confidence, as without “puffy eyes” you’ll look like a decade-younger self.

We interviewed a board-certified plastic surgeon, Dr. Alejandro Avila, from Munich, Germany, and he kindly agreed to share some of his knowledge. We covered benefits, risks, and before and after images of lower blepharoplasty to help you make an educated decision. Also, you now know where the lower blepharoplasty prices come from.

We hope this article brought you valuable knowledge about lower blepharoplasty surgery and helped you find the answers you were looking for!


💸 How Much Does Blepharoplasty Cost?

The lower blepharoplasty price is bigger than the upper blepharoplasty because it is a bit more complicated and time-consuming. The cost is usually above $2,000 and depends on your location and individual facial characteristics.

⌛ How Many Years Does Blepharoplasty Last?

Unlike face volume augmentations or upper blepharoplasty, the effects of lower blepharoplasty are usually life-lasting. In rare cases, however, you might still need to get a correction in the future.

👀 What Does the Eye Look Like After Blepharoplasty?

After the lower blepharoplasty operation, the eyelid will be swollen for a week or two. After that time, the swelling will reduce and heal completely in approximately 3 months. The goal of the surgery is to make you look like your younger self.

🛌 How Many Days Should I Rest After Blepharoplasty?

You should expect to be away from work for about a week after lower blepharoplasty lower blepharoplasty before the swelling becomes less significant. During this period, you need to follow doctor’s guidelines that include frequent cooling, antibiotics, and pain medication.

🧐 What Can Replace Blepharoplasty?

If you are looking for a cosmetic lower blepharoplasty, you might also consider injecting a hyaluronic acid filler. The downside of this method is that it is only a temporary solution, and you’ll need to visit a doctor again after some time.


  • [1] Patel, B. C., Volner, K., & Malhotra, R. (2019). Transconjunctival blepharoplasty.
  • [2] Zhang, S. Y., Yan, Y., & Fu, Y. (2020). Cosmetic blepharoplasty and dry eye disease: a review of the incidence, clinical manifestations, mechanisms and prevention. International journal of ophthalmology, 13(3), 488.
  • [3] Kaur, H., Corscadden, K., Lott, C., Elbatarny, H. S., & Othman, M. (2016). Bromelain has paradoxical effects on blood coagulability: a study using thromboelastography. Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis, 27(7), 745–752.
  • Before and after photos taken from: Wolfson Eye Institute. 2021, (January 19). Lower Blepharoplasty. [Video]. YouTube. https://www.youtube.com/watch?v=4YSOS_MHii0 

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