Lower blepharoplasty

Excess and bulging skin in the lower eyelids is common with age. While over-full upper eyelids cause functional problems, reduction of the lower lids is strictly a cosmetic procedure (but can cause functional problems if not carefully done!)

I can do this operation under local anaesthetic at my clinic though it’s a little less pleasant than upper eyelid surgery: you have to keep your eyes open as otherwise your upper lashes get in the way.

An incision is made just beneath the lashes and carried laterally beyond the corner of the eye for 1 – 1.5 cm. The skin of the eyelid is lifted. At this stage fatty bulges can be removed or fat can be added if you have a “tear trough depression”. Excess skin is trimmed off. The risk of doing this is that the lid can be dragged down if too much is removed. If nothing is done to tighten the lid, the skin trim must be very conservative. The thin sheet of muscle beneath the skin  (eyelid closing muscle – orbularis oculi) can be tacked to the bone coverings laterally to provide support and allow more eyelid skin to be removed and I do this – conservatively. If this hitch is done tightly the eyelid skin reduction can be greater but  this alters the shape of the eyelid opening and this to my eye is unacceptable.  


  • It’s important to note that removal of excess lower skin does not get rid of fine lines
  • Over- or under-reduction.  I am very careful to avoid over-reduction as this can cause white to show beneath the iris (“scleral show”) or an unnatural shapeof the eyelid opening – see above.
  • See risks common to all operations.

Contact Details



5 Naseby St




FaxF: 03 355 9249

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