Lower Eyelid Surgery St. Louis - Lower Blepharoplasty Missouri

Do you have bags or dark circles under your eyes? Do you get comments from people that you look tired all the time? If so, you may be a candidate for lower eyelid surgery or lower blepharoplasty.

As we age, the thin eyelid skin under our eye descends down due to the effects of gravity. This same gravity affects the cheek and causes “jowl” formation. As a result, the eyelid skin which is usually over the cheekbone descends below the cheekbone, causing dark circles and giving a tired appearance. Furthermore, the deep structures under the eyelid can weaken, causing bulging of fat and the appearance of “bags” or swelling under the eye. Fortunately, there are options to improve this.

Dr. Cabbabe prefers to avoid removing fat from the lower eyelid. He sees many patients who have had fat removed from their eyelids and have a “cadaveric appearance” or “hollowed out” look. Dr. Cabbabe believes in fat preservation in the face and that the underlying problem is one of repositioning the fat rather than removing it. In the case of the lower lid; rather than remove fat, Dr. Cabbabe prefers to tighten the deep lower eyelid septum which is weak in order to prevent the fat from bulging. Occasionally, fat grafting is also recommended to rejuvenate and restore fullness to the lid – cheek junction.

Dr. Cabbabe often recommends a support procedure in conjunction with the lower blepharoplasty in order to reduce the complications associated with scarring in the lower lid from the surgery, such as ectropion. This can include a canthopexy or a cheek lift and often enhances the final result.

Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the face to give patients the best results possible to meet their desires. He is also an expert in minimally invasive cosmetic surgery of the face and has published on these topics. His patients have a natural, refreshed look after surgery. During your consultation, Dr. Cabbabe will carefully examine your entire face including the brow, upper and lower eyelids, face and neck. He will make recommendations in order to help you achieve your desired result while maintaining facial harmony. Dr. Cabbabe believes that the entire face should be in harmony and may recommend other procedures such as face lift, brow lift, upper blepharoplasty or neck lift to be done at the same time.

We believe that patients, their desires, and anatomy are all unique. Dr. Cabbabe believes that the key to a successful surgery is proper planning and discussion with the patient about their goals. Therefore, Dr. Cabbabe evaluates each patient and creates a customized surgical plan for all of his patients to meet their expectations. To schedule a consultation, call us at 314-842-5885 or complete the contact us form.

Traditional Lower Blepharoplasty

In this procedure, an incision is made below the eyelid margin (sometimes the incision is made inside the lower eyelid). Extra skin is often removed. The lower eyelid septum is tightened in order to decrease fat bulging below it. In certain patients with very lax skin, the muscle under the eyelid may be tightened to prevent scarring in the lower eyelid which may retract the skin down and cause dry eyes from the inability to fully close the eye.

Dr. Cabbabe is an expert in this area and has published on this topic in the prestigious Journal of Plastic and Reconstructive Surgery:

Cabbabe S, Andrades P, Vasconez LO, “Lateral orbicularis oculi muscle plasty in conjunction with midface lifting for periorbital rejuvenation”, Plastic and Reconstructive Surgery, October 2009:124(4):1285-93

While studying this topic, Dr. Cabbabe found that the overall complication rate for lower eyelid surgery may approach 50%, particularly in the cases where the cheek has descended considerably. He found that supporting the lower eyelid by raising the cheek (“midface/cheek lift or face lift”) decreased the complication rate substantially. As a result, Dr. Cabbabe may recommend a midface/cheek lift in addition to your lower eyelid surgery in order to decrease the risk of complications as well as improve the aesthetic result.

Lower Blepharoplasty for Patients Undergoing Face–Lift

If you are undergoing a face-lift procedure, Dr. Cabbabe may be able to address the lower eyelids through the same incision used for the face-lift. In this manner, scars are avoided on the lower lid as well as the associated complications. The muscles and septum below the eye are tightened in order to improve the appearance of the lid. The cheek is elevated as part of the face-lift. Some patients with a significant amount of redundant skin on the lower lid may require removal of skin through an incision below the eyelid.

Preparing for Surgery

Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, Coumadin or any other type of blood thinner. He will also ensure that your blood pressure has been properly controlled if you have high blood pressure. This operation can be done under general anesthesia or local anesthesia with sedation.

Recovery from Surgery

If this procedure is done by itself, most patients are able to go home the same day. Pain medication and antibiotics will be prescribed. Bruising and swelling may be present around the eyes for one to two weeks. Dr. Cabbabe will ask that you keep ice on the surgical site to decrease this. He will also ask you to keep your head elevated to decrease swelling. He may recommend eye drops for a period of time. Sutures will be removed within 5 – 7 days.

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