Lower Blepharoplasty: Is There Incision and Non-Incision Surgery for Lower Eyelid Surgery?!

Before getting into the main point, please read the symptoms below first and see how many of them apply to you.

▲ Dark circles are severe.

▲ The area under the eyes is bulging outward.

▲ The tear trough is deeply sunken, with pronounced lines.

▲ Fine wrinkles under the eyes make me look older.

▲ There are not many wrinkles under the eyes, but as I get older, the under-eye area feels dull.

As you read the above, did any of it resonate with you? In addition to the symptoms that apply to you, you may also notice that their severity can differ.

If you touch the area under your eyes with your hand, you can feel that the inside dips inward.

If you think about our skull, the area where the eyeballs sit is open, and the skin outside surrounds the eyeballs, so there is naturally no thick plate supporting the skin. In addition, because the eyelids originally serve to protect against harmful substances that could enter the eyeballs through blinking and to spread tears, blinking is frequent as well.

As a result, the skin itself is very delicate, making it a part of the body that inevitably ages quickly. Some people begin to develop more severe dark circles and visible tear troughs as early as their mid-20s. But is the under-eye area of someone in their mid-20s the same as that of someone in their 50s or 60s?

Usually, many people in their 20s to 40s take very good care of themselves these days, so even if aging appears under the eyes, there are many cases where the skin still has good elasticity and the wrinkles are not severe.

However, once you reach your 50s, the skin significantly loses elasticity and begins to sag, which can cause the orbital fat beneath it to protrude outward and appear bulged, and can also lead to more pronounced wrinkles in the skin.

These are the kinds of issues that lower blepharoplasty is meant to improve.

"When you say lower blepharoplasty, don't you usually mean under-eye surgery for middle-aged people?"

That's right.

It is also commonly called "middle-aged eye surgery."

However, the lower eyelid refers to the lower eyelid, so in fact, if it is surgery related to the under-eye area, it can encompass a variety of procedures. Even people in their 20s can undergo lower blepharoplasty if they have severe under-eye dark circles or need fat repositioning. The difference is simply in the method used compared with people in their 50s and older. Today, I want to talk about this.

Two Methods of Lower Blepharoplasty

1. Incision method

This is the middle-aged eye surgery that many people are familiar with.

It is recommended when the area under the eyes is bulging outward, elasticity has significantly decreased, wrinkles are numerous, and the tear trough is deeply sunken. In surgical procedures, the biggest reason for dividing the approach into incision and non-incision methods is the extent of the treatment area.

With an incision, the medical team can observe the skin more closely during surgery, and because they can make various changes to the structures of the under-eye skin altered by aging, there are far more things that can be done.

This is exactly why incision-based lower blepharoplasty is recommended for middle-aged patients. Middle-aged patients do not simply have protruding under-eye fat.

Their skin has lost so much elasticity that wrinkles are excessive and the tear trough is deeply sunken, making the overall appearance look unfavorable. In such cases, applying a non-incision method narrows the range of treatment, making it difficult to improve elasticity or wrinkles.

With an incision, it is possible to make an incision in the skin close to the eyelashes, remove some of the sagging skin and fat, and then pull the skin and muscles upward and secure them in place. As a result, the under-eye area can become flatter, and some improvement in wrinkles can also be expected.

Many people worry about visible scars, but the incision is sutured with fine stitches so that it is hidden beneath the lower eyelashes, and over time it improves to the point where it is barely noticeable.

However, at Ribbon Plastic Surgery, we believe recovery is just as important as the result, so please keep in mind that we also provide delicate scar care after surgery. :)

2. Non-incision method

On the other hand, the non-incision method involves a micro-incision on the inner side of the lower eyelid. By "inner side," we mean the sensitive tissue that appears when you turn the skin under the eyes outward.

After a small incision in the conjunctiva, some unnecessary fat is removed from the inside or repositioned to the area with dark circles, that is, the "sunken area of the skin."

Because lifting cannot be performed, this method is chosen by people whose skin still has elasticity and whose wrinkles are barely visible. In other words, it is also called <under-eye fat repositioning surgery>, and you can understand it as this type of procedure.

The important thing is that you cannot simply assume that middle-aged people must undergo the incision method, or that younger people must undergo the non-incision method.

That is usually how it is done, but because each person ages differently depending on genetics, lifestyle, and other factors, please be sure to visit for a detailed diagnosis!

You are also welcome to visit Ribbon.

We will kindly answer your questions. Thank you for reading this long post. :)