Lower Eyelid Surgery


Lower eyelid surgery, also known as a lower blepharoplasty, is a great procedure for patients to improve the appearance of the bags under their eyes, which can give patients a tired appearance. Excess eyelid skin is removed during the procedure, as well as fat, and the underlying tissue can be tightened and re-positioned to improve the overall appearance. Dr. Charles Hsu, a plastic surgeon in Beverly Hills and Koreatown, has performed many successful lower eyelid surgeries that make his patients look younger and more awake.

Best Candidate for Lower Eyelid Surgery

  • Excess skin and fine, crepe paper type lower eyelid wrinkles

  • Bags and dark circles under the eyes


Dr. Hsu will first ask about the patient’s specific goals for the lower eyelid surgery. He will examine the lower eyelid area with the eyes open and closed.  Dr. Hsu will then give his assessment and discuss how the surgical plan will be individualized for the patient’s anatomy. Since each patient's anatomy and surgical goals are different, the patient and Dr. Hsu will work together to reach optimal aesthetic results. 

Surgery Details

Lower blepharoplasty procedures are performed under general anesthesia for approximately 2 – 3 hours.  Dr. Hsu will create a small incision underneath the lower eyelashes, ensuring that the scar is well hidden. He will then open up the skin in that area to remove the excess fat. Much like the upper blepharoplasty, Dr. Hsu will tighten any laxity of muscle and remove excess skin as needed. If upper and lower blepharoplasties are done in conjunction, the procedure will last approximately 3 – 4 hours.

Click here to view 3D Animation provided by the American Society of Plastic Surgeons

Recovery and Post-Op

After the surgery, patients should use a cold compress or hand towel in 20 minute intervals on the surgical area for the first 48 hours to help minimize swelling. Patients should plan to stay home from work and limit activities for a prescribed time after surgery to give the eyelids a chance to heal. The amount of time it takes for each patient to recover varies.

From Dr. Hsu

“Both upper eyelid surgery and lower eyelid surgery are two of my favorite procedures for patients. These usually give excellent results with immediately visible benefits for patients. The eyes and their surrounding skin are some of the first areas of the face to experience changes with aging, so early rejuvenation of these areas can make a dramatic difference.

In the lower eyelids, I will vary my approach based on the individual patient. In some patients, it is purely an excess skin problem causing lower eyelid skin wrinkling. In others, there is some muscle weakness that can be addressed with tightening. In others, there is an issue of excess fat causing a bulging eye bag appearance. The approach to each patient needs to be individualized based on what specifically is causing the suboptimal appearance.”

Frequently Asked Questions

  • What are the different techniques for lower eyelid surgery?

    With traditional blepharoplasty, Dr. Hsu will make the incision in an inconspicuous site along the lash line and smile creases of the lower lid. In a transconjunctival approach, he will correct eyelid puffiness caused by excess fat by making an incision inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. The type of eyelid surgery technique will be chosen based on the patient’s facial features and aesthetic preferences. The goal is to help you achieve the most beautiful and natural-looking results.

  • Lower eyelid surgery recovery tips?

    • For the easiest recovery period, patients should have the following items readily accessible at home:

    • Ice cubes, ice pack, or freezer bags filled with ice, frozen corn, or peas (based on recommendation for cold application to the eyelids)

    • Eye drops or artificial tears (ask Dr. Hsu to recommend the proper type)

    • Over-the-counter painkillers, which Dr. Hsu will recommend

    • Clean washcloths and towels

    • Small gauze pads

    • Sunglasses

  • What can I expect in my final results?

    Lower eyelid surgery results should be long lasting. Lower blepharoplasty is usually performed to remove eye bags and puffiness around the eyes, and it should only need to be performed once. Your final results will present a more youthful and brighter appearance. No more worrying about eye bags that gave you a more tired and older appearance.