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Lower Eyelid Surgery

Lower eyelid surgery, or lower blepharoplasty, is a surgical procedure used to rejuvenate the contours of the lower eyelid space, which is considered mainly the region between the eyelashes and the midface. 

It is also used to correct functional problem that arises from lower eyelid malposition which is related to chronic eye dryness.

Lower eyelid surgery is usually done in in conjunction with upper eyelid surgery, but also with other facial plastic surgery procedures like facelift or brow lift.


  • Safe procedure, rejuvenation result will last for several years
  • Can combined with other aesthetic treatments – upper blepharoplasty, brow lift, facelift, rhinoplasty, etc.
duration: 1 hour
back to work: 7 days
full recovery: 2 weeks


Lower eyelid surgery, or lower blepharoplasty, is a surgical procedure used to rejuvenate the contours of the lower eyelid space and in some occasions the cheek area.

Good candidates are patients with:

  • Excessive and sagging lower eyelid skin
  • Fat bulging in the lower eyelids that appear as puffiness - eyelid bags
  • Cascading hammocks of lax skin and orbicularis muscle - festoons
  • Folds at the border between eyelid and cheek which disturbs the natural youthful contour
  • Droopy eyelids that revels to much white below the iris (ectropion, scleral show)
  • Asymmetric lower eyelids
  • Dryness of the eye related to facial nerve paralysis

Not good candidates are patients with:

  • People with unrealistic expectations
  • Fine wrinkles lateral to the eyes
  • Dry eyes syndrome
  • Protruding eyes with negative vector

Your expectations


During your consultation for lower eyelid surgery, the surgeon will assess your anatomy of the lower eyelid space and the adjacent cheek area. It is important to correctly diagnose the cause of eyelid problem (skin sagging, fat or muscle prolapse, fluid collection, etc.) in order to be able to make proper surgical plan. All this will be discussed with you in details.  

Your surgeon will ask question about dryness or watering of your eyes. Any problem you may have with your tear function will be evaluated with additional tests. 

Your surgeon will evaluate the position of the eyelid. In case it is too far from the iris, reveling too much of the white in the lateral part, an additional procedure called cantoplasty / cantopexy will be discussed. It involves reconstruction of the lateral cantal ligament, making it tighter while at the same time creating a more youthful and pleasing shape of the eyes. 

Be prepared


Lower blepharoplasty surgery can be performed under local anesthesia with mild sedation for which no special preparation is needed.

However, general anesthesia may be utilized in appropriately selected patients or when other surgeries are planned as well (facelift, etc.).
In case of general anesthesia, you will be instructed to take certain steps: 

  • Medical evaluation by the anesthesiologist in our OR center
  • Take certain medication or adjust current medication
  • Sometimes laboratory testing, cultures, or a cardiac film
  • Your surgeon will ask you about your past medical history including medications you are taking, allergies, smoking habits, previous surgery and more. 
  • To improve healing, you are advised to stop smoking both preoperatively and postoperatively for at least 2 weeks. 
  • Also, you may have to stop taking aspirin, anti-inflammatory drugs and other supplements as they can increase the chance of bleeding during surgery and bruising after surgery.

Know more about


Lower blepharoplasty can be done using two approaches:

  • Open, transcutaneous: an incision is placed in the skin just below the eyelashes
  • Closed, transconjuctival: an incision is placed on the inner side of the eyelid

Decision on which approach to use depends on your anatomical features, which your surgeon will analyze and discuss with you.

With lower eyelid surgery we reduce or reposition the fat underneath the thin circular eye muscle. Furthermore we can tighten the ligament towards the corner of your eye and remove excessive skin. These surgical improvements will reduce the tired, puffy look that usually start to develop in the 40ies. Shadows will disappear and the lower eyelid will look tighter, fuller, and younger.

Time to heal


During the first 24 h after the operation, your skin incision will be taped loosely with small strips to minimize swelling and bruising in the operated area. After that ointment may be applied over the incisions. Artificial tear drops may be prescribed to prevent eye dryness in the early postoperative period. Ice packs can be applied over the operated area in the first 24 to 48 hours and during sleep your head needs to be elevated.

The recovery period after lower eyelid correction is usually short and you may start doing your daily routines as soon as the following day. Initial wound healing may take 7-10 days, after which sutures will be removed. At that time, you will be able to return to work and normal activity. Cosmetics can help camouflage any bruising. Although your new youthful look will be satisfactory at this time, it may take up to three months for your complete recovery - as the swelling dissipates and incision lines refine and fade. You must practice diligent sun protection and use darkly tinted sunglasses until the healing process is fully complete.


Lower eyelid surgery is a more delicate procedure than upper eyelid surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications. All this will be fully discussed with your surgeon prior to your consent. The most common side effect of lower eyelid surgery is bruising of the lower eyelid, which subsides in several days. Crème that speeds up this process will be prescribed to you. 

Other relatively common side effects are:

  • Swelling at the lid/cheek border
  • Chemosis- swelling of the eye conjunctiva

These side effects need time to naturally resolve, so reassurance is very important. Eye drops based on corticosteroids and facial lymph drainage and massage can speed the process. 

Other potential complications of the surgery are rare and may necessitate an additional treatment: 

  • Scarring
  • Eversion of the lower eyelid
  • Malposition of the lower eyelid
  • Infection
  • Temporary changes in skin sensation or numbness of the eyelashes
  • Asymmetry

They will take care of you






Additional information


·   Lower eyelid surgery is delicate and can be performed using several techniques, all of which are performed in our clinic. 

·   The final decision which technique to use will depend on your facial anatomical features, wishes and needs. Your surgeon will discuss this with you.

·   The downtime after surgery is around 7-10 days, after which you can resume your work activities.

·   In case a complication occurs, we will analyze it and treat it immediately.

·   The results of your lower blepharoplasty are immediately visible. 

·   The final results will appear after 3 months when all post-surgical swelling is resolved and incision lines have faded.

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LF Medical Group building

Poliklinika Lohuis Filipović 

Medical Group d.o.o.

Trg J.F. Kennedyja 6b 

10 000 Zagreb, Croatia


Tel: +385 1 2444 646

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