Whether you’re looking to remove wrinkles or create a smoother appearance, Lower Eyelid Surgery can help you transform your under-eye area, so you look youthful and refreshed!

At Reflections, we focus on natural=looking results – and nowhere is this more important or more difficult to achieve than for the under eye. This area is incredibly complex not only in the cosmetics of the result, but also the functionality of the eyelid. So, it’s really critical that you chose a doctor who is experienced, skillful, and creates consistently excellent results for any under-eye surgery.

Lower Eyelid Surgery Results

On this page, you’ll find all the information you need to start to outline which procedures are right for you (your anatomy, your lifestyle, your budget, your preferences, etc.) and how to compare and vet the doctors you’re considering, so you can choose the plastic surgeon or cosmetic physician who’s best for your under eye surgery (and the “right one” isn’t necessarily the same for everyone).

What is Lower Blepharoplasty?

Lower Eyelid Surgery, or lower blepharoplasty, is any surgery that’s performed to the lower eyelid. In our practice, these types of surgery are used to reverse the signs of aging, or to correct abnormal or unattractive under-eye features. In general, the only other kind of surgery you would perform for the lower eyelid would be

Who Should Consider Lower Eyelid Surgery Instead of a NonSurgical Treatment?

Many times, patients will come to us and say “I just don’t want to have surgery” and that’s a very valid choice to make, but your feelings about whether you want to have surgery or not are not the only factors that should be considered when deciding whether or not to have surgery. Did you know that nonsurgical treatments generally accomplish different results or work for a different subset of people than surgical procedures?

Who Should Consider Lower Eyelid Surgery Instead of a NonSurgical Treatment?

  • You’ve tried Botox or Filler injections for your under eyes and aren’t happy with the results – Or have been told by our cosmetic physicians that these treatments won’t solve your concerns
  • You’ve tried nonsurgical skin tightening & collagen-building treatments (exilis ultra, thermismooth, microneedling with plasma therapy, lasers, etc.) and didn’t see enough of a change – OR were told by our doctors those treatments would provide enough of a change for your needs.
  • You don’t want the maintenance and re-treatment(and costs) that come with a nonsurgical procedure (and doesn’t necessarily come with a surgical procedure)

Surgery is a great option to have in our arsenal of treatments for the lower eyelid but it’s not the only option. We encourage you to explore your options – that previous link will take you to a page where we cover the full landscape of treatments – but we also hope you’ll leave room in your decision-making process for the guidance and medical opinions of our cosmetic physicians. Assessing your anatomy and hearing about your concerns, your lifestyle, and your budget allows us to plan out a treatment plan recommendation, and that’s accomplished during the consultation.

Types of Lower Eyelid Surgery

Depending on your unique facial anatomy and other factors, one or all of these techniques may be used in your lower blepharoplasty surgery. Whether the cause of your under eye concerns is aging-related, or simply a feature you’ve always had and wish to change, the same techniques are used to achieve the end result.

Lower Eyelid Skin Pinch

The skin pinch technique allows your surgeon to remove excess or loose skin from the eyelid without disturbing the tissue underneath, including fat or muscle. During this procedure, the skin is freed up along the lash line, excess skin is removed, and the incision line is hidden along the eyelash line, for a very discreet and natural-looking result.

This is the ideal procedure for those who have been botox-ing away wrinkles under their eyes for years and are no longer seeing much of a result, or for whom ThermiSmooth or Ulthera did not create enough of a result — or for those who simply prefer the minimal maintenance and impressive results of a surgical procedure over other non-surgical options.

If you have loose skin and bulging fat pads, this procedure is often performed after fat pad repositioning, in the same surgery. You want to perform the excess skin removal after the fat pad alterations, because that may impact the way the skin drapes over this area. So if you have both of these issues, the important thing not to do, is to not have a skin pinch done by a surgeon who isn’t also first addressing the fat pad layer below, because that can really lead to a bad result and more complicated revisions later.

Dealing with Fat (Or Lack Thereof) Under the Eyes: Hollowness vs. Puffiness

People generally experience 1 of 2 symptoms with fat under the eyes:

  1. There is a lack of fat, which creates an indentation which deepens over time, and will often continue down the cheek in one deep continuous indented groove. This should be corrected
  2. The fat under the eye almost appears to swell or become really puffy – this is sometimes after a time where that patient was hollow under the eye

Replacing Fat Volume

Removal or Repositioning of Bulging (herniated) Fat Pads Under the Eyes

What Does Lower Eyelid Surgery Not Treat?

One thing most patients don’t realize is that surgery will not improve skin quality, thickness, or texture – even though it will fix skin laxity (or excess skin). This is especially important for the lower eyelids, where pulling tight skin that is already very thin, delicate, and crepey will create a bad result. Since nearly everyone experiences thinning and loss of elasticity in their undereye skin, this is an important factor to consider.

When skin has lost its elasticity and you stretch it tight (remove all the excess skin), the skin once healed will continue to stretch out over time and become thinner and thinner. This is why we almost always recommend both a treatment to improve skin quality in addition to surgery. Most patients have these treatments performed during their surgery session, so it doesn’t have to feel like it’s another procedure and another recovery period. Here you can learn more about improving skin quality and elasticity for the under eyes.

Cost of Lower Eyelid Surgery

The cost of lower eyelid surgery varies from patient-to-patient depending on factors including the type of anesthesia used, the techniques used during your procedure, and the extent of correction necessary. Generally speaking, the cost of a lower eyelid surgery starts at about $5,500.

Financing Your Eyelid Surgery

At Reflections Center, financing is accepted for any procedure over $1,000, including lower blepharoplasty. We partner with Prosper Healthcare Financing and Care Credit, and patients can apply for financing in advance before their appointment. You may read more about your financing options here.


Patients return home after surgery, without

Recovery Experience

After your lower blepharoplasty, you can expect some swelling, bruising, and dry eyes. Cold compresses and ice packs can help to alleviate swelling and may be used during the first two days after the procedure. Your surgeon will likely prescribe pain medication for your initial days of the recovery period as well as ointments and eye drops. Patients should also wear darkly tinted sunglasses during the healing process to protect the skin of the eyelids as you heal.
You can expect to return to most normal activities within a week, except for vigorous workouts (think Crossfit, not a walk in the neighborhood), which need to wait for at least 2 weeks or until you are cleared by your plastic surgeon. A majority of bruising and swelling dissipates within two weeks after the procedure.

General Anesthesia or Local Anesthesia?

What Other Procedures Might You Consider Pairing with Lower Eyelid Surgery?

We talked a little bit above about how we mix together certain surgical and nonsurgical techniques to fully treat the under eye.
But what other concerns can be treated at the same time as your lower blepharoplasty procedure?

Many patients will find that their lower eyelids age more quickly (or rather that the signs of aging are more readily apparent here) than the rest of their face. Some patients will be able to delay lower eyelid surgery by first having nonsurgical treatments in their 30’s, 40’s, and even 50’s. They’ll delay surgery until their mid-50’s or beyond. Other patients will choose surgical intervention earlier, in their 40’s to mid-50’s, and those patients generally have a different set of procedures they’re likely to consider at that age range.

So which procedures can you pair with an eyelid surgery safely? The answer is nearly any procedure you want can be done at the same time as an eyelid surgery – the only caveat here is that we don’t want to do too much all at once, because your body will naturally focus on only a few areas to heal at one time, and we don’t want to overload your system. So your plastic surgeon can discuss what your individual limits may be here, but if you’re planning to have an eyelid surgery, and you’re considering some other tweaks, you should mention that during your consultation, because especially if both procedures would be performed under general anesthesia, there is a cost savings (both in money and your recovery downtime) to be had by having those procedures during the same surgical session.

Below we’ll cover the 2 groups that most commonly have lower eyelid surgery, and which procedures are generally being considered around that timeframe of life, as well.

The 40’s to Mid-50’s Patient

There are other parts of the face and body that also show aging quickly, and those include the neck, jawline, cleavage (or decollete), and/or body fat and skin changes from hormonal changes, weight fluctuations, and/or pregnancy. Now these are not always completely unrelated, as often weight fluctuations can play a role in how the under eye appears, especially when it looks hollow or sunken in – that can be a symptom of having lost weight. But the important thing to understand here is that we often see significant enough changes to the under eye in our mid 40’s to mid 50’s.

Most patients during that timeframe will also notice their neck skin becoming crepey, their chest may have a lot of sun damage by this point, and especially in perimenopausal women or those who have had multiple pregnancies, this is often when stubborn fat and loose skin in the mid-section (including drooping breasts) really starts to become noticeable and bothersome.

The Late-50’s or Older Patient

By the time you’re reached your late 50’s, there is usually signficant

  • Fat Transfer or Multiple Syringes of Filler help replace the lost facial volume and support – as always, we focus on creating natural results in a conservative manner
  • Facelift for jawline

  • How Do I Find the Best Lower Eyelid Surgeon for Me?

    Choosing your plastic surgeon for your lower blepharoplasty

    Why Choose Reflections Center?

    The Reflections Center team is dedicated to reaching your best results and understand that surgery is not always the ideal option for each patient. We won’t push you towards surgery if it’s not the right choice for you personally, and factor in your anatomy, health, and lifestyle into that decision.
    We also value honest assessment of each patient’s concerns, and won’t lie to you and say that filler or other nonsurgical treatments will lead to results when this is not possible. Surgery is sometimes a patient’s best and only option to truly address their concerns. When this is the right choice for you, you can put your trust in Reflection Center’s board-certified plastic surgeon, Dr. Joe Fodero.

    FAQs about Lower Eyelid Surgery

    Is lower eyelid surgery performed under general or local anesthesia?

    Lower eyelid surgery can be performed under either general or local anesthesia. Reflections Center prefers to limit general anesthesia use, but it is necessary in cases where there is more extensive treatment to the muscle, fascia, and/or fat pads around the eye. Generally, a simple skin pinch procedure and/or microfat transfer can be performed under local anesthesia. Your consultation will include not only a discussion of your anesthesia preferences, but a frank discussion of your health and well-being in relation to anesthesia choices. Your health is our first priority.

    Can upper and lower eyelid surgery be done at the same time?

    Yes, upper and lower eyelid surgery can be performed in a single surgical session. This is one of our most common combinations of treamtents.

    How long after lower blepharoplasty can I wear makeup?

    Patients are allowed to begin wearing makeup the day after surgery, but they must be careful to avoid applying that makeup in their incisions.

    For example, with any surgery performed on the eyes, it’s quite common to have some bruising. There are so many tiny blood vessels in these areas, that it’s really impossible to avoid them all, and most patients will have at least light yellow bruising that appears in the first few days. This bruising tends to be on the upper cheek/lower eyelid junction area – and that’s usually an inch or two below where the incisions are. Some patients cover this with large sunglasses, others want to use makeup, and that is perfectly fine. You just want to avoid makeup above the eye that could fall down into the incision line, and avoid placing makeup too close up to those incision lines.

    Your surgeon will advise you when you can start to cover your incision lines with makeup – generally this about the 2 week mark, after any sutures have been removed and the incisions are fully closed.

Board-Certified Plastic Surgeon at Reflections Center

Dr. Joe Fodero is a board-certified plastic surgeon with over 20 years of experience. For 20 years, Dr. Fodero has built an amazing resume of plastic surgery work in the New Jersey area and is recognized as a Top Plastic Surgeon in Rhinoplasty, Breast Augmentation, and Body Sculpting. We’re so happy he’s decided to join forces with the Reflections Center team of physicians.