Puffiness of the Lower Eyelids Corrected with a Lower Eyelid Blepharoplasty Only
Lower Eyelid Surgery - is performed to tighten up the loose skin and remove the bags under the eyes. There are three fat pads in the lower eyelid. When these are bulging and creating puffiness, the fat pads can either be removed or repositioned to fill in hollow areas.
There are two types of incisions
Subciliary - this incision begins just under the eyelid lashes and generally entails removing excess eyelid skin.
Transconjunctival - this incision is performed by tipping the lower eyelid downward and entering the lower eyelid tissue from within the inner eyelid conjunctiva.
Since there is no removal of skin, the procedure is best done if you have no loose eyelid skin or in combination with a laser to help tighten any looseness present.
Hollowness in the outer lower eyelid area sometimes requires lifting of the cheek pad in addition to the Lower Eyelid Blepharoplasty.
Lower eyelid incision - this can be used to lift the cheek or mid-face by using a Endotine Bioabsorbable Anchor to hold the cheek pad to the bone (orbital bone).
Temporal Incision - this can be used to pass an Endotine Bioabsorbable Anchor, which is what I prefer over using the lower eyelid incision
These are called by various names, such as the Trans Blepharoplasty Mid-Face Lift or a Temporal Mid-Face Lift.
I like to use the Bioabsorbable Endotine products by Coapt Systems (coaptsystems.com) which provide great support during the healing period and eventually dissolve away, just like a suture.
These Endotine anchors work well when signing of aging in the mid-face begin early, late 30's - early 40's of age.
Minimum Incision Face Lift - would be my preferred way to try and correct that eyelid hollow in most individuals.
Tear Trough Deformity - is when the lower lid has a crease along the inner 1/3rd of the eyelid, creating a trough where tears would flow. This is due to adherence of the skin to the bone.
Possible corrective surgery my involve repositioning the fat in the eyelids between the skin and bone or the use of fillers to add volume.
Sometimes fillers or fat can be used to soften the groove, however, on occasions this can become visible or felt as lumpiness.
If a Laser is being used to try and tighten the lower eyelid skin, caution must be taken not to apply the laser energy to the wrong skin types, which might result in permanent color changes to the skin.