Lower Blepharoplasty Surgery
Lower Blepharoplasty, Lower Eyelid Bags Surgery
Lower Blepharoplasty or Under eye “bags” and “eyelid bags” are common complaints among our patients. They make the face look tired and older. Eyelid “bags” are caused by fullness or relative fullness of the bottom eyelids caused by prolapsed or herniation of the orbital fat (fat surrounding the eyeball in the eye socket). This is due to eyelid aging but can happen in many younger individuals due to genetics. “Dark circles” are caused by relative hollowness under the eyes (below the bags) in the area of the tear troughs or orbital rim. The darkness is mostly due to a “shadow” phenomenon where the full area above the hollow area casts a dark shadow below it.
The under eye hollowness (aka tear trough deformity) could be genetic or it could be due to loss of upper cheek fat and descent (fall) of the cheeks. Another important aging change is that the skin of the bottom eyelids loses elasticity and stretches, resulting in ‘excess’ lower eyelid skin and wrinkles.


Who is a Candidate for Lower Blepharoplasty ?
- If you have puffy fat pockets (bags) in the bottom eyelids that create a tired or aged appearance.
- If you have wrinkled, saggy, loose lower eyelid skin.
Intended Results
- Natural looking, youthful, rested eyes.
Dr. Taban is a lower blepharoplasty specialist in Beverly Hills. He also performs corrective revision lower blepharoplasty in those patients who have had bad results or complications. This includes from prior eyelid surgery, such as post-blepharoplasty eyelid retraction, scleral show, rounding of eyes, poor eye closure (lagophthalmos) with dry eyes, etc. Please visit our website under Revision Eyelid Surgery for more details.
Lower Blepharoplasty Surgery & Eyelid Bags
There are various nonsurgical and surgical cosmetic treatment options for lower eyelid bags, dark circles, and bottom eyelid wrinkles, depending on the variables involved in each individual. Therefore, it is important for each person to have an individualized treatment plan.
In lower eyelid bags surgery, fat in the lower eyelids can be removed or repositioned through a scar-less incision hidden on the inner surface of the eyelid (transconjunctival blepharoplasty), thereby creating a more smooth, natural, rested appearance to the eyes.
Dr. Taban is an expert cosmetic blepharoplasty surgeon, who uses a special technique to reposition or redistribute the fat under the eyes to concurrently fill in the hollow area below it, called transconjunctival lower blepharoplasty with fat repositioning. This special cosmetic eyelid procedure achieves two things at the same time: 1) removes under eye fat pads; 2) fills in the hollow tear trough area (dark circles). VERY IMPORTANTLY, this procedure avoids the hollow sunken eye appearance if fat is merely removed.
The hidden transconjunctival (inside lower eyelid) incision has additional advantages: 1) the scar is hidden; 2) the incision is stitch-less with much quicker healing; 3) avoids potential damage to the orbicularis oculi muscle (responsible for closing the eye and blinking) which can cause the lower eyelids to get pulled down (eyelid retraction) with inability to close the eyes (lagophthalmos) and dry eyes. This is especially important with patients with prominent eyes (negative vector) who are at increased risk if proper technique is not used. With proper technique, lower blepharoplasty can safely be done on any patient, including those with prominent bulging eyes or negative vector eye/orbit morphology.
Additional eyelid bags treatment options are available to address wrinkled, loose skin on the lower eyelid, if present. Laser resurfacing or a chemical peel can be performed at the same time as transconjunctival lower blepharoplasty to smooth and tighten the loose lower eyelid skin. Alternatively, incision can be made just below the eyelashes (subciliary or infraciliary incision) and excess skin removed (skin pinch technique).
A special technique, named orbicularis plication, may also be performed to tighten the underlying muscle in the bottom eyelid, which helps with excess skin in the bottom eyelid and festoons (bags in upper cheek area).
The goal of transconjunctival lower blepharoplasty (with fat repositioning, with/without skin pinch skin removal) is to create a NATURAL, smoother under eye area for a rested appearance WITHOUT causing eyelid retraction or altering (rounding) of the eye shape. A transcutaneous lower blepharoplasty is not recommended as it often results in a surgical, unnatural eye appearance and possibly dry eyes from poor eye closure and blinking.
Lower blepharoplasty for eyelid bags can be combined concurrently with other cosmetic eyelid or facial procedures, including upper blepharoplasty (“eyelid, lid Lift,” “quad-blepharoplasty”), droopy eyelid (ptosis) surgery, brow lift, canthoplasty, midface lift, facelift, fat injections, and laser skin resurfacing.
Read more about eye bags surgery from WebMD.com.
Nonsurgical Treatment of Under Eye Bags or Dark Circles
A nonsurgical treatment for under eye bags and dark circles requires filling in the relative hollowness below the “fullness” or “bags,” thereby camouflaging or hiding the eye bags. But there is a limit to how much filler can or should be injected to give natural results, without creating excessive swelling or puffiness from the filler.
In general, young patients don’t usually have under eye fatty prominence; rather, they have inherited hollowness below the eyelids (tear trough deformity) and they are ideal for injectable dermal fillers (Restylane, Belotero) in the sunken under eye area, instead of surgery (lower blepharoplasty).
What to Expect During the Procedure
Cosmetic lower blepharoplasty is performed under local anesthesia with oral sedation (similar to a dental procedure) in the office or local anesthesia with IV sedation (conscious sedation, similar to that used for colonoscopies) in an outpatient surgical center, with quick recovery. General anesthesia is not necessary and it is best avoided as it prolongs systemic recovery.
With the patient relaxed, the eyelid is numbed. The patient is able to open and close his/her eyes during the procedure with comfort, which helps the surgeon achieve the best possible results and correct any eye asymmetry, etc. The incision is made inside the lower lids (transconjunctival), avoiding external incisions and scarring, unless excess skin needs to be removed as well, in which case an incision just below the lashes is also made.
Alternatively, a chemical peel or laser resurfacing can be done to tighten the skin. If there is significant “laxity” of the bottom eyelid, canthopexy, canthoplasty or lower eyelid tightening procedures may be done at the same time to prevent drooping of lower eyelids after lower blepharoplasty.
Recuperation and Healing
The recovery process after cosmetic eye bags surgery is practically painless, with bruising/swelling of the eyelids for about 1 week. The transconjunctival incision does not require any sutures. If an incision was made below the lashes for a skin pinch, then absorbable sutures are used. The vision remains intact since no patch is necessary. Eye makeup may be worn following incision healing. Normal activities, including contact lens wear, can be resumed 1 week after the procedure.
Finding a Cosmetic Lower Blepharoplasty Surgeon
Natural results are key to any cosmetic procedure, especially when it comes to the eyes. In regards to lower eyelids, it is extremely crucial to achieve natural looking results AND avoid known complications of lower blepharoplasty (pulling down of lower eyelid or eyelid retraction, sclera show, inability to close the eyes, scarring, etc).
“Prevention is the best treatment,” therefore, avoidance of these complications is critical. Dr. Taban in Santa Barbara is an oculoplastic specialist (reconstructive and cosmetic eyelid plastic surgeon), with expertise in cosmetic blepharoplasty and revision blepharoplasty surgery. Dr. Taban in Los Angeles uses minimal invasive approach (transconjunctival incision +/- skin pinch) with fat preservation to give best possible, natural result. He is double board certified by American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), American Board of Ophthalmology (ABO/AAO), and a diplomat of American Board of Cosmetic Surgery (ABCS).
During your consultation for blepharoplasty with Dr. Taban in Beverly Hills/Los Angeles or Santa Barbara, he will evaluate your eyes and face, and come up with detailed surgical plan, customized to each individual patient, depending on their exact anatomy/problem and desired goals. Dr. Taban in Los Angeles will discuss any other complimentary cosmetic eyelid procedures, such as upper blepharoplasty (eyelid lift), droopy eyelid (ptosis) surgery, canthoplasty, brow lift, and eyelid fat injection, that may be performed at the same time to achieve the best NATURAL looking, youthful cosmetic result.











Beautiful woman with obvious under eye fat bags causing tired eyes, underwent scarless lower blepharoplasty (transconjunctival technique with eye fat bags repositioning).
Before & After Eye Plastic Surgery Photos
Contact the Los Angeles Oculoplastic Specialists!
Dr. Taban is one of the leading oculoplastic surgeons in the Los Angeles region. Please use our online contact form to schedule an appointment for your next eyelid or eye treatment.
Next, read about Sunken Eye Treatment.
Five star service! Why you ask? Dr. Taban is an oculoplastic surgeon (eye plastic surgeon). He saw my mom and performed surgery to remove the bags under her eyes. ... You really get a feel for their compassionate care. ... Thank you so much for taking care of my mom. With her new confidence, she's even more beautiful!
Kristine D. November 2, 2016
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After extensive research, I decided to go with Dr. Taban for my lower transconjunctival (inner incision) Blepharoplasty and I'm 100% happy with the results ... I highly highly recommend Dr. Taban!!
kaligirl77 November 2, 2016
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All I can say is WOW! Dr. ... Dr. Taban removed the fat below his eyes and moved it to flatten out the hollow area above his cheek bone. ...We could not be happier with the outcome.
Tina Aho November 2, 2016
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I'm very satisfied with the results of the procedure performed by doctor Taban. The lower puffy eye bags and wrinkles were removed and the upper eyelids lifted. I would recommend Doctor Taban without hesitation ...
cgrealself November 2, 2016
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Dr. Taban changed my life! He is the most compassionate and gentle doctor, and he helped me cure my biggest insecurity. I had the worst under eye bags, and I never knew it could be cured. When I visited him, he recommended lower blepharoplasty surgery. I underwent surgery, and couldn't be happier with my results. He is truly the most amazing doctor I've ever been to, …. Everyday I wake up so grateful to have been treated by Dr.Taban! I can finally enjoy life now!
Tania P
April 2018
May 16, 2018
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Dr. Taban from Los Angeles to whom I am very grateful for putting my eyelids back to its original stage. My eyelids and the whole around eye area has been destroyed by using awful eyelashes growth drops Lumigan prostaglandin with fat atrophy of around the eye area... It took me very long to sort this problem out, many mistakes on the way (fillers wrongly applied, etc.) … Dr. Taban, expert on any problematic issues with your eyes who was able to help me with my destroyed around the eyes area, for which I am very grateful to him ...
May 16, 2018
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I'm 38 years and have always taken care of my skin. Good genes have helped me look younger than my actual age. But the one thing that I've had since my late 20's are under eye bags. Most of the time I looked tired even though I wasn't. I got tired of looking tired. Even with 8 hours of sleep I still had bags. ... I had lower blepharoplasty (by Dr Taban) awake with local anesthesia. I was really nervous about this but he was so good that honestly I didn't feel anything. I've been so incredibly happy with the results. … My mom was also so happy with the results that she ended having the same procedure with him. ...
May 16, 2018
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You look so tired” I can't tell you how many times in my life these words have been uttered to me. …start to feel insecure… I have never been interested in altering my face … Dr. Taban was straight to the point, gives you all the facts, and makes you feel very comfortable. … My number #1 worry was that my eye shape would change and he was very adamant that it would not, he was right … I was extremely nervous going into surgery (transconjunctival lower blepharoplasty) and in hindsight it was so easy. The procedure took about an hour but felt like 15 minutes. I was under local anesthesia and I couldn't feel anything. Recovery was very fast. … took pain medication a few hours after surgery … My results have been fantastic. I look like myself but rested! … I 100% recommend.
May 16, 2018
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Dr. Taban impressed me from consultation all the way through check up. It is very clear from the start that he knows what he is doing and that you are in good hands. I had fat pads with extra skin under my eyes that caused me to look tired and old…I felt so comfortable that I decided to do my upper lids also (besides lower blepharoplasty). Friends and family tell me all the time what a difference it has made. I feel more confident and am very glad that I did it...
May 16, 2018
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