Home · Procedures · Lower Blepharoplasty

Lower Eyelid Surgery

Lower
blepharoplasty.

The operation for genuine under-eye bags — not by scooping fat out, but by repositioning it to refill the hollow below. A smoother, rested lower lid that still looks unmistakably like you.

Hooded upper lids are a different operation — see upper blepharoplasty.

Procedure time
60–90 min
Anesthesia
Sedation / general
Back to work
~1 week
Social recovery
3 weeks

Bags are a volume problem, not just a fat problem

The classic under-eye bag is orbital fat that has slipped forward as the thin wall holding it back (the orbital septum) weakens with age. The old reflex was simply to remove that fat — and aggressive removal is exactly why some eyelid surgery from decades past left people looking hollow and skeletonized.

Dr. Ahn treats it differently. The bag almost always sits above a relative loss of volume in the tear trough and cheek just below it — so a great deal of lower blepharoplasty is really about adjusting topography: gently lowering the fat "hill" while refilling the "valley" beneath it. In the large majority of his cases, that means repositioning the fat over the bony rim rather than discarding volume the face will want later.

You may be a good candidate if…

  • You have persistent under-eye bags or puffiness that rest doesn't fix
  • People tell you that you look tired when you feel perfectly normal
  • A hollow, shadowed "tear trough" is deepening beneath the bag
  • Creams, and sometimes filler, haven't addressed what bothers you
  • You're in good general health with realistic, specific goals

The most important part of your consultation is sorting out which "ingredients" are actually creating your look — because several of them aren't treated by surgery at all.

The technique, in plain terms

Dr. Ahn's default is the transconjunctival approach — working through the inside of the eyelid, with no incision in the skin. It isn't only about avoiding a scar: it leaves the eyelid-closing muscle (the orbicularis) undisturbed, and injury to that muscle is a major cause of the pulled-down, rounded lid that is the most feared complication of lower-lid surgery. That's why this route is safer.

Through that hidden approach, the fat is repositioned to fill the tear trough (or, in select cases, conservatively reduced). When the lower lid is lax, he adds canthal support — a canthopexy or canthoplasty — to protect the lid's position and the eye's natural shape while it heals. Fat grafting and CO2 laser resurfacing are added when volume or skin quality calls for them; skin, when it truly needs removing, is redraped conservatively through a fine sub-lash incision. Every plan is built from the pieces your anatomy needs.

The framework

Why "tired eyes"
are rarely one thing.

What reads as bags is usually a mix of ingredients — and each answers to a different treatment. Dr. Ahn identifies every one, then you decide together which are worth addressing.

  1. 01 · Cause
    Orbital fat prolapse
    The true "bag" → fat repositioning
  2. 02 · Cause
    Tear-trough hollowing
    The shadow below the bag → fat repositioning / grafting
  3. 03 · Cause
    Skin quality & darkness
    Thin, crepey, pigmented skin → laser, peels, skincare
  4. 04 · Cause
    Fluid retention
    Puffiness that comes & goes → not surgery — treat the cause
  5. 05 · Cause
    Lower-lid laxity
    A loose lid → canthopexy / canthoplasty
  6. 06 · Cause
    Festoons / malar mounds
    Cheek swelling below the lid → treat fluid first; staged surgery
  7. 07 · Cause
    Midface deflation
    The cheek foundation drops → fat grafting

Read the full breakdown in the Journal

Recovery

What to
expect.

The lower lid bruises more colorfully than the upper — plan around that. The honest timeline most patients follow:

Days 1–5
Swelling & bruising peak

Cold compresses, then warm; head elevated. Slightly pink tears and briefly blurry vision are normal. Gentle walking only — no jogging or strenuous exercise.

~1 week
Back to work

Most return to work and light routine. With the transconjunctival approach there are usually no skin sutures to remove. Makeup and contacts are generally okay now.

2 weeks
Normal activities

Most patients resume their usual routine, including exercise.

3 weeks
Social recovery

Comfortable in social and professional settings. One side often heals faster than the other — completely normal.

~8 weeks & beyond
Settling — then quiet improvement

Close to the final result by two months, then continued improvement over the following months (and, when skin wasn't removed, often for years as the tissue conforms to the new contour).

Questions

Honest answers.

Should I get filler or surgery for my bags?
Filler is a good tool for a narrow job — a mild, hollow tear trough from real volume loss, in someone without a true fat bag. Used to "hide" an actual bag, it usually adds puffiness rather than fixing it, holds water, and lasts far longer than patients are told. If your main issue is a genuine bag, the definitive answer is structural. Dr. Ahn will tell you honestly which camp you're in — and some consultations begin by dissolving old filler first.
Will there be a visible scar?
Usually none. The default transconjunctival approach works from inside the eyelid, so there's no external incision at all. If a small amount of skin genuinely needs removing, it's redraped through a fine line just beneath the lashes, which fades to near-invisibility.
Will removing the bags make my eyes look hollow?
That's exactly the old-surgery look Dr. Ahn works to avoid by repositioning fat instead of over-removing it. He'll also point out anatomy that sets limits up front — for example, a deep orbital rim can leave the lid looking a touch concave — so your expectations match reality before you decide.
Will lower blepharoplasty fix my dark circles?
Sometimes — if your "dark circles" are really shadow cast by the bag and hollow, correcting the contour lightens them. But darkness from thin skin or true pigment isn't treated by surgery; those need lasers, peels, skincare, or sun protection. Telling these apart is a core part of the consultation.
Is this cosmetic or a medical procedure?
At Awaken, lower blepharoplasty for bags is a cosmetic, self-pay procedure — we don't bill insurance. Functional lower-lid problems (for example, a lid turning in or out) are medical cases Dr. Ahn handles through his separate practice, San Pedro Eye Care. Mention it at your consultation and he'll point you in the right direction.

Next step

Find out what's
behind your bags.

A consultation with Dr. Ahn sorts out which ingredients are creating your under-eye look — and includes a review of your photographs and a written plan with pricing.

Request a consultation (310) 791-2233

Related procedures

Eyelid

Upper Blepharoplasty

 Midface

Tear-Trough Rejuvenation

 Volume

Fat Grafting