One of the major complications of lower blepharoplasty surgery (cosmetic lower lid surgery) is lower lid retraction (pulled down lids). Lower eyelid retraction leads to the white showing under the iris (colored part of the eyes). This called scleral show (sclera is white part of eyes). When this occurs the eyes become red, irritated, and dry. The dry eyes can lead to reflexive tearing. Repairing this condition (lower eyelid retraction) requires a specialist in eyelid surgery who is well trained in procedures such as canthoplasty surgery (open link) http://drmassry.com/#/1-1, canthopexy surgery, and midface lift surgery (open link) http://drmassry.com/#/1-0 .
Below is an example of a woman who had lower lid retraction (pulled down lower lids) from surgery by another surgeon. On the right are her photos after repair (canthoplasty surgery, midface lift surgery) by Dr. Massry.
Eyelid bags and depressions can be treated non-surgically with filler. Around the eyelids Dr. Massry (Beverly Hills Ophthalmic Plastic Surgery) prefers to use Restylane as his filler of choice. Traditionally, eyelid filler (Restylane) has been injected around the eyes with needles. While the results have been good, there is often significant bruising and swelling associated with the treatment.
Recently, blunt-tipped microcannulas have been developed for injection of filler to any area of the face. While these have taken hold, few injectors have been comfortable with injections around the eyes. Dr. Guy Massry, an experienced eyelid filler injector has transitioned almost all his eyelid filler injections to the use of the microcannula. Dr. Massry prefers this method, as it is safer (no chance of injecting into a blood vessel), more comfortable (not painful), easier to perform, and yields minimal to no bruising and swelling.
Below is an example of a woman who had Restylane eyelid filler injected to the hollows under the lower lids to improve appearance. On the right are her immediate post-injection photos. Note that there is slight redness (gone in 30 minutes) and no bruising and swelling
Blepharoplasty is a form of eyelid surgery whereby eyelid “bags” are removed.This can include upper or lower eyelid blepharoplasty, or both upper and lower eyelid blepahroplasty (four lid blepharoplasty).In a subset of lower eyelid blepharoplasty patients eyelid fat can be preserved, rather then excised.The fat bags are still removed from where they are excessive (BAGS), but the fat rather transferred or repositioned to areas of adjacent eyelid hollows or depressions.
This is called lower eyelid blepharoplasty with fat repositioning
This is an advanced form of lower eyelid blepharoplasty, performed only by eyelid surgery specialists (experts).
Below is an example of a woman who presented with lower lid bags and an associated depression (tear trough).Dr. Massry performed lower lid blepharoplasty with fat repositioning on her to reduce the eyelid bags and the hollow.On the right is her after picture.