• Lower-blepharoplasty

Blepharoplasty Thailand

Heredity, time, and environmental factors can cause the fat and skin of the lower eyelid to become baggy and wrinkled. The result is a tired and aged appearance. Lower eyelid surgery, also called lower blepharoplasty, can help reverse the signs of ageing and help patients look and feel their best.

With blepharoplasty, your surgeon can reshape the excess fat and drooping skin of the upper eyelid. Additionally, he can minimise bags under the eyes and tighten the lower eyelid skin. Most eyelid surgery patients remark that the surgery resulted in a more rested, refreshed and happy appearance.

While most people decide to have eyelid surgery to minimize the signs of ageing, even some people in their late 20s and early 30s can benefit from lower blepharoplasty.

Operation techniques


Two common types of blepharoplasty exist: transcutaneous (with incision going through the outer skin) and transconjunctival (requiring incisions from the inside of the eyelid).

Surgeons perform transcutaneous blepharoplasty by cutting through the eyelids from the outside, usually below lower eyelids lashes, where scars would be less visible. A well-placed incision can be virtually invisible when fully healed.

This approach often includes making incisions and flaps of the orbicularis oculi muscle.  The fragile orbicularis oculi muscle is crucial as it supports the lower eyelid. If the integrity of the muscle is compromised, the shape of the eye can be changed.

When drooping and sagging is notable, the incisions may stretch out towards the temples where they would be concealed by crow’s feet. The surgeon then separates the skin from muscle and fatty tissue, removing excess fat and trimming loose skin and muscle.

Unlike transconjunctival blepharoplasty, the transcutaneous kind requires sutures to cover the incision. Transcutaneous eyelid surgery is most suitable for patients who have bulges and wrinkles.

Patients considering a transcutaneous blepharoplasty should be aware that darker skin may result in darker pigmentation (hyperpigmentation) along the incision line.


The transconjunctival approach is frequently performed to remove fatty tissue from under the eye that produces bulging puffy “bags”. No skin is removed in this method.

During the procedure, the surgeon pulls away the lower eyelid from the eyeball. Het then performs an incision from the inside of the eyelid, either with a scalpel or laser. The fat will then be removed or rearranged accordingly. The incision will then be closed with sutures.

Transconjunctival blepharoplasty normally works well for people having more elastic and thicker skin. Some surgeons prefer this operation technique because it is less invasive and heals quicker than the transcutaneous method. Furthermore, it also gives the surgeon the ability to examine the result of the operation by reversing the eyelids to the natural position and make corrections accordingly.

One of the biggest advantages of transconjunctival blepharoplasty is the almost invisible incision line. The operation can also be done with a laser or electric cautery device. However, the procedure does not remove excess skin and is more suitable for patients who only have bulges.


Since lower blepharoplasty is performed near the eyes, it is a riskier procedure than some other types of aesthetic surgery.

Before the operation, patients should avoid taking inflammatory medications, including over-the-counter drugs like ibuprofen and aspirin. Other supplements increasing the risk of bleeding must also be avoided for about two weeks prior the surgery.

Surgeons will advise you to refrain from smoking one or several days before the procedure. Consuming alcohol shortly before surgery is also inadvisable as it may increase bruising. Keep your medical history ready and present it to your doctor during the consultation, especially if you suffer from hypertension, heart disease, diabetes or are allergic to any drugs.

You can increase your comfort by bringing sunglasses on the day of the operation. Wash your face with clean water and do not apply any makeup. Contact lenses should be removed for the time of the surgery and patients with hypertension need to keep their blood pressure below 40/90 mm Hg. For safety reasons, patients carrying a pacemaker cannot be considered for the lower blepharoplasty.


A blepharoplasty surgery usually takes about one hour if performed on the lower eyelids. Your doctor will most likely use local anaesthesia (a painkiller injected around the eye) with oral sedation to numb the area where the incisions will be made.

The patient’s eye will be protected by a metal shield placed over the cornea of the eye. Your surgeon will then make an incision from one end of the lower eyelid to the other.

Through these cuts, your surgeon will separate the skin from the underlying tissue and remove the excess fat, skin, and muscle. Next, the surgeon will close those cuts with tiny stitches.

Post Operation

After surgery, patients should use ice-cold compresses continuously on the first day following the surgery, gradually decreasing the number and frequency of compresses over the following five to seven days. The gauze can be removed one day after receiving the operation.

Patients should refrain from alcohol and some medications (including aspirin) for approximately two weeks. Patients are advised to follow your doctor’s prescriptions strictly.

Discoloration around the eyes and some swelling is normal after blepharoplasty and will vanish itself within two to four weeks. A post-operative examination should be done around four weeks after surgery.

Stitches – if any – should be removed five days after surgery. To speed up the healing process, use eye cream on the incision lines after. Avoid rubbing eyes and contact your doctor immediately in case you experience any irritations or pain.

Side effects may include but are not limited to:

  • Discomfort
  • Swelling
  • Excessive tearing
  • Hematoma (rare)
  • Ectropian causing lower eyelid to invert (rare)