What are the Different Incision Techniques for Lower Eyelid Surgery?

What are the Different Incision Techniques for Lower Eyelid Surgery?

Your lower eyelid area plays a vital role in your facial appearance. Sagging skin and fatty deposits of the lower lids can make a huge impact on your overall look. Whether you’re born with eye bags or develop them over time, puffy or droopy lower lids can make you look more tired or angry than you feel. Sometimes fillers can help refresh your look, but for most people with lower eyelid concerns, a surgical solution is best for rejuvenating your eyes and restoring your youthful appearance.

There are many different approaches to lower eyelid surgery. At Mountain Lake Plastic Surgery, we offer customized surgery tailored to each individual patient. While some patients with severe aging changes will require a more extensive procedure, there are less invasive options available for patients with more minor concerns. Your surgeon will do a thorough facial analysis and help you choose the best approach for you.

External Incision

The external incision, also commonly referred to as the ‘subciliary approach,’ is usually the preferred technique for patients with loose or sagging skin of the lower eyelids. An incision is created just under the lower eyelashes and provides access to deeper structures, like muscle and fat, while also allowing for skin removal. While there is a visible external scar, it will gradually fade over time and become almost imperceptible. This approach tends to cause more swelling than the internal incision and may lead to a longer recovery.
A variation of the external incision is a ‘pinch blepharoplasty’. This is a minimally invasive way to remove skin, using an external incision, without exposing the deeper structures of the lower eyelid. A pinch blepharoplasty can be used if the patient wishes to solely address excess skin and wrinkling or it may be used in conjunction with an internal incision for patients who have excess fat and only a small amount of loose skin.

Internal Incision

The internal incision is referred to as the ‘transconjunctival approach,’ and is attractive to many patients because there is no visible incision on the eyelid. An incision is placed on the inner pink tissue of the lower lid. With this approach, Dr. MacLennan and Dr. Schmidt can sculpt the lower eyelid fat according to the patient’s goals and needs. There is typically less swelling and recovery is faster than the subciliary approach.

The disadvantage of this technique is that is does not allow for removal of sagging skin and wrinkles, so these areas of concern will not change. Most often, younger patients with tight skin but stubborn eye bags or fatty deposits are the best candidates for an internal incision.

Which Technique is Best?

As with every surgery, there is no one-size-fits-all approach that will give every patient the same results. Each case is unique, and what best suits one individual may lead to inadequate results for another. If your main concern is fatty tissue but your skin tone is good, an internal incision may be best for you. However, if you have noticeably loose skin and severe wrinkling, you may be better served by an external incision.

Determining the best approach to your lower blepharoplasty is not a decision you should make on your own. Your plastic surgeon will listen to you concerns, analyze your face, and help you make an educated decision about which techniques will help you achieve your goals.

Where to Seek Lower Blepharoplasty Treatment

Finding a surgeon that you can trust to make permanent changes to your appearance is not a choice that should be taken lightly. Seek out someone who listens to your goals and thoroughly explains the process of surgery and recovery to you. At Mountain Lake Plastic Surgery we strive to provide high-quality comprehensive care. To learn more about which lower blepharoplasty approach would best suit your eyelid concerns, schedule a consultation with Dr. MacLennan or Dr. Schmidt.