How is a lower blepharoplasty done ?
Procedure done under local anesthesia and in day-care.
- 1.A line drawing is made on the lower eyelid, just under the eyelashes.
- 2.Injection of local anesthesia. This solution is buffered to markedly reduce the pain of injection.
- 3.Incision of both the skin and underlying muscle.
- 4.Wide dissection of this muscle/skin flap in order to identify the underlying fat
- 5.Incision of the flimsy and bulging septum.the fat is visible underneath this structure
- 6.Excision of fat in three compartiments : inner, medial and lateral fat.
- 7.Coagulation of bleeding vessels before closing
- 8.In rare cases, removal of some skin, very conservatively.
- 9.Closure of the skin with separate suture of a fine resorbable thread.No need to remove these sutures . The skin heals with a very fine scar, unnoticeable after a few weeks.
In cases where the eyelid is very inelastic, a lateral suspension ligament (lateral canthal ligament ) can be tightened in the same session
The fat can be resected, but it can also be repositioned over the bony orbital rim in cases where there is a deficient volume at that level. This procedure is done in patients which have bags but also a depression under the bags. The technique is called a SOOF procedure (Sub-Orbicularis Oculi Fat repositioning)
In a soof procedure ,the-bag fat is rewrapped over the arcus marginalis or orbital bony rim to obliterate the crease and create a smoother transition.