What to Expect From a Lower Eye Lift

When you glance in the mirror, are you bothered by sagging, wrinkles, or bags in the under-eye area?

If so, you can smooth out and tighten that area with a lower lid blepharoplasty – also known as a lower eye lift.

The lower eye lift is not a one-size-fits-all procedure though. So knowing what to expect from the procedure will depend on which approach the plastic surgeon takes.

Different Approaches to a Lower Eye Lift

A qualified and board-certified plastic surgeon will always perform a comprehensive examination of the skin, tendon, muscle, and fat compartments to determine which approach is appropriate for the patient.

Transconjunctival Approach

Eyelids serve three purposes – to keep the eyes properly moisturized, to protect the eye, and to provide expression to the face. Because human interaction and expression is such a huge part of our lives, the area around the eyes is one of the first to surrender to aging.

Thus, it’s not uncommon for younger people to develop prominent fat bags without excess skin under their eyes. These can be addressed through a transconjunctival approach which removes the fat without leaving a visible incision or scar.

No-Touch Technique

In cases where there is skin laxity, a pinch of skin may also be removed just under the eyelashes. This is called a no-touch technique – meaning that the orbital septum is not violated (or touched) which can minimize complications.

Trans-Septal Fat Removal

For patients who are experiencing significant aging of the skin and sagging muscle, the plastic surgeon needs to elevate a skin and muscle flap off of the septum and remove the fat trans septally.

From there, the muscle can be trimmed and tightened with an orbicularis oculi hitch suture. This approach with limited surgical invasiveness is proven both safe and effective in reversing muscle descent with skin redundancy, while simultaneously providing lid support.


The primary support structure for the lower eyelids is the lateral canthal tendon. It’s located under the skin at the outer corner of the eye. Meanwhile, the orbital muscles provides additional support and enables the opening and closing of the eye.

As we grow older, the lateral canthal tendon and muscle begin to stretch and sag and the lower eyelid becomes weak. A tendon tightening procedure called a canthopexy can serve as a support for lower eyelid skin without cutting or detaching the tendon and muscles.

The canthopexy supports weak eyelid tissues, increases muscle tone, and improves the shape of the eye while restoring the supporting structures.

Treatment of the fat can include removal for large bags until the excess is flush with the bony rim, also known as the orbit. The surgeon is careful to avoid over resection which can create a gaunt appearance. The fat can also then be flipped over, rather than removed, to cover the deep tear trough and bony rim.

If there is a lack of orbital fat, some patients may benefit from fat grafting.

Experience Rejuvenation With a Lower Eye Lift

Get rid of sagging skin and those under-eye bags with a lower eye lift. Contact us today to speak with one of our surgeons about which approach is right for you.

Each one is highly effective, non- or minimally invasive, and guaranteed to bring a smile back to your face when you gaze into the mirror.