If Lower Blepharoplasty Is Needed for Drooping Eyes

Even in moments when you are not consciously aware of it,

because of the naturally moving facial muscles and

the relatively thin, delicate skin around the eyes,

the eye area ages faster than other parts of the face.

As drooping eyes develop, or as the muscles

under the eyes weaken, fat may clump together

excessively or protrude, and even the under-eye

area may begin to sag.

Because this can make the face look tired all the time

and appear older than one’s actual age,

many people begin considering ways to improve it.

However, depending on the causes and the specific

changes involved, the approach used to enhance

positive outcomes can differ from person to person.

For that reason, it is best to first determine whether

lower blepharoplasty is the right method for you

before making a decision.

Problems such as skin irritation around the area,

dry eyes, and blurred vision caused by excessive

eyelid sagging are mostly corrected through

upper blepharoplasty. Among these, if the under-eye

area is particularly loose and dark circles have become

wider, lower blepharoplasty may be worth considering.

Depending on the case, it may be performed together

with under-eye fat repositioning, and there are also

situations where both are necessary. To achieve a

natural result, thorough examination and judgment are

needed in order to decide what plan should be used.

For convenience, the term lower blepharoplasty is used,

but these days the approach is further subdivided into

more detailed methods tailored to each person’s

characteristics. By identifying and applying a

combination of methods suited to the individual,

the procedure analyzes eyelid sagging and orbital fat

ptosis, as well as the degree of protrusion, and then

performs removal, reinforcement, and repositioning.

Once sagging begins, various changes associated with

aging tend to appear at the same time. Therefore,

more serious areas are corrected actively, and if there

are tissues that may become even looser or have weaker

support in the future, those are addressed as well.

When elasticity declines and the firm layer of under-eye

skin becomes thinner, the color of hidden capillaries

starts to show through.

As the face ages and the strength of the various tissues

that make it up gradually weakens and their connections

become looser, the skin begins to sag downward and

may fold at the ligament areas, creating fine wrinkles

that were not there before.

If the dark circles in the area that has lost elasticity look

wider and darker, fat repositioning is used to move fat

into the needed areas and reinforce the lower layer.

At this stage, the amount of fat must be handled very

carefully in order to create volume naturally, so more

precise techniques such as nanofat grafting are needed.

When sagging skin begins to appear,

you may also experience a bulging under-eye appearance

at the same time.

The reason for this previously absent contour is that the

orbital fat that has always been present inside has moved

out of its original position and extended into the septal

area.

This happens when the septum, which plays a role in

holding the under-eye fat in place, weakens. One of the

most concerning aspects is not only the uneven area

under the eyes, but also the shadow formed below the

hollowed contour, which can look like dark circles.

In lower blepharoplasty, the septum is strengthened and

secured so that it can regain its proper function.

When the displaced fat layer is returned to its original

position, the area becomes flat and neat again, and the

shadow caused by the protrusion can also be removed,

allowing a tired-looking appearance to be refreshed.

If there is too much fat or if there are hollow areas that

also need to be corrected at the same time, then in

addition to reinforcing the septum, options such as fat

removal and fat repositioning are considered as well.

A deep hollow line near the area between the eyes and

the nose, which remains like a pronounced crease, is also

one of the main factors that make a person look older.

The tear trough ligament is a structure that originally

helps keep the skin from sagging.

When sagging becomes severe, only the surrounding area

sags while the ligament remains firmly fixed, creating a

sunken appearance. This can look like a deep crease and

make the person appear older.

If only the tear trough has changed and both the fat and

the septum are otherwise in good condition, the hollowed

area can be corrected with microfat grafting. However,

if the fat has already protruded significantly, the

changed ligament is released and the orbital fat is

repositioned to fill the hollowed area.

Because there are many factors that create an aged

appearance, there are also many different approaches

that may be carried out alongside lower blepharoplasty.

Among them, even if the midface soft tissue is not the

cause of under-eye sagging, it may still be treated for

aesthetic reasons because it can make the condition look

more pronounced.

If the volume of the front cheek is somewhat weak or if

the maxilla has not developed in proportion to the face,

the aging changes may appear more severe than in others.

In such cases, the lacking volume is carefully restored

without overcorrection so that the area from the eyes to

the front cheek connects naturally.

Because the factors involved are so varied, improvement

is considered by examining multiple aspects in a

comprehensive way, including septal reinforcement, fat

fixation and repositioning, and adhesion of the tear

trough ligament.

As aging progresses, problems in the orbicularis oculi

muscle and the skin and tissues of the midface also occur,

and various changes appear in the tension of the lower

eyelid area, the septum, and the orbital fat. For this

reason, the situation must be assessed carefully, along

with the amount of skin to be excised and whether a lift

procedure is needed.

Depending on each person’s characteristics, some of the

loosened skin may be removed, and if the tension is

severe, lateral canthopexy may be applied to help the

lower blepharoplasty result appear more natural.

Above all, it is important to preserve the existing

appearance so that the original under-eye fat and facial

impression are not lost. The incision should be kept as

small as possible and its position carefully chosen so

that scars are not visible.

Please check in advance whether a minimal incision is

made just below the eyelashes so that the scar is not

exposed and swelling and bruising are minimized. After

the procedure, please also follow the instructions and do

your best to recover well.

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