Lower Eyelid Surgery Sydney (Lower Blepharoplasty)

Cosmetic Concerns Procedure Information Risks & Complications Procedure FAQs Procedure Pricing

Lower eyelid surgery (also known at lower blepharoplasty) is a procedure that removes excess skin, and corrects bulging fat, from the lower eyelid and can be performed in both men and women. Some key benefits of lower eyelid surgery are:

Reduces under-eye bags

Lower blepharoplasty can effectively correct under-eye bags caused by excess fat deposits or loose skin. By removing or repositioning the fat, the procedure creates a smoother and more youthful contour. Correcting this drooping of the lower eyelid that results in showing of the white sclera below the iris.

Minimises puffiness and dark circles

Lower eyelid surgery targets puffiness and dark circles that can make individuals appear tired or aged. The procedure can tighten the skin and eliminate excess fluid, resulting in a rejuvenated and refreshed look.

Improves overall facial harmony

The eyes play a significant role in facial aesthetics. By addressing sagging or baggy lower eyelids, the surgery can restore balance and harmony to the face by smoothening the lower lid and cheek junction.

Long-lasting results

Lower blepharoplasty offers long-lasting results. While the aging process will continue, the improvements achieved through surgery can significantly endure, providing patients with sustained satisfaction over time.

Potential vision improvement

In some cases, lower eyelid surgery can alleviate vision impairment caused by sagging skin or fat protrusion. By removing the excess tissue, the procedure can enhance peripheral vision and overall visual acuity.

Women and men seek lower blepharoplasty surgery to:

Feel more refreshed and look more youthful
Feel confident
Correct festooning of the lower eyelid that makes them look older
Remove excess skin from the lower eyelid

The best candidates for lower blepharoplasty are men and women who:

Are physically and mentally healthy
Have realistic expectations

Lower eyelid surgery may not be suitable for men and women who:

Have multiple medical problems
Are on blood thinning medication
Have unrealistic expectations
Have multiple eye problems such as dry eyes, changing visual acuity.
Ectropion of the lower eyelid or multiple lower eyelid scars from previous surgery

Lower blepharoplasty can provide dramatic results once the initial bruising and swelling settles
down.

Some patients chose to combine lower blepharoplasty surgery with:

Upper Blepharoplasty
Brow lift surgery
Face and Neck Lift
Facial fat grafting
Non-surgical treatments such as fillers whilst under anaesthetic.

For more information on other procedures please read the other sections of this website.

Dr Aggarwal

Dr Aggarwal is a well regarded, respected, highly skilled and experienced Specialist Plastic Surgeon. Graduating at the top of his class throughout his training, Dr Aggarwal has completed fellowship training at some of the world’s most prestigious reconstructive and cosmetic plastic surgery institutions in Canada and the USA. He continues to publish research is prestigious plastic surgery journals, and is actively involved in the training of future plastic surgeons.

What sets Dr Aggarwal apart from others is his personal, affable and warm nature. Not only does he pay attention to detail, to producing natural, beautiful results but he ensures that the patient’s journey is just as special as their outcome. Dr Aggarwal looks after patients at one of Sydney’s most prestigious public hospital campuses (POWH/SCH/RHW), and operates privately on Sydney’s North Shore. Dr Aggarwal has treated thousands of patients throughout Sydney and beyond who have achieved outstanding results under his care.

Procedure Snapshot

Anaesthetic: GA by accredited anaesthetist
Time: 1-2 hours
Duration of stay: Day Surgery
Hospital: Any of the hospitals where Dr Aggarwal works.

Medicare/Health fund rebate: There is no rebate for lower blepharoplasty which is considered to be a cosmetic procedure.
Recovery: You go home the same day. You are required to use ice packs to minimise bruising and swelling. Most people can resume work within 1-2 weeks.
Results: A lower blepharoplasty can produce a dramatic change in one’s appearance but results vary from person to person.

Cosmetic Concerns

I am concerned regarding the scars of a lower blepharoplasty – will people know?

The art of a beautiful eyelid surgery is inconspicuous scars combined with a result that looks natural and beautiful without looking like you have had an operation.
The scar of a lower blepharoplasty is placed in the lower eyelid just below the lash line. In some people it is possible to have a scar only on the inside of the lower eyelid.
In general, while in the short term the external scar may be visible, the eyelid skin heals very well and provides for a barely visible scar long term.

I have had a previous lower blepharoplasty. This has resulted in an abnormal lower eyelid position – can it be fixed?

A well performed lower blepharoplasty avoids abnormal position of the lower eyelid which can easily occur from scarring that occurs after surgery.
Dr Aggarwal will make a careful assessment of your face during the consultation, and advise what is needed – this can vary from lower eyelid suspension procedures such as a canthopexy or canthoplasty, and occasionally full thickness skin grafting.

I have a lot of bulging fat in my lower eyelid – can this be removed during surgery?

Yes.
If you have limited skin laxity, and good skin quality it is possible to just remove the fat from the lower eyelid through an incision on the inside of the lower eyelid, thus avoiding all external visible scars.
Dr Aggarwal aims to try and achieve a natural result – the key in blepharoplasty surgery is to remove only the problematic bulging fat without over-resection. Removal of too much fat can produce a skeletonised look to the eyes which looks very aging.

Procedure Information

The procedure is usually performed under general anaesthesia given by an accredited anaesthetist in a fully accredited and licensed facility. The procedure takes one to two hours and patients go home the same day.

Incisions

Dr Aggarwal will mark you before your procedure, taking into account the amount of skin that needs to be removed – usually the amount of skin removed is minimal
The scar of a lower blepharoplasty goes from the medial corner of the eye (medial canthus), under the lash line to beyond the lateral corner of the eye to remove the adequate amount of skin.
In some people an incision is made on the inside of the eyelid to remove fat from the lower eyelid. This can sometimes avoid the external scar altogether.

The Procedure

Local anaesthetic is carefully injected just under the skin.
The skin is incised and a flap of the lower eyelid skin and muscle is raised
If required bulging fat is removed and any bleeding controlled
The lower eyelid fascia (septum) is tightened

A lower lid supporting stitch is placed (canthopexy)
The skin is then carefully closed, and any excess skin removed.
The sutures are left long and carefully taped to the skin of the face.

After your lower eyelid surgery

Dr Aggarwal will place steri-strips over the loose ends of the sutures – you must keep these dry and intact until you see Dr Aggarwal after the surgery.
You will be instructed to use frequent ice packs over the eyes as this significantly reduces bleeding and bruising post upper eyelid surgery.
It is also a good idea to keep your head elevated when you sleep at least for the first 2 nights.
You will be given a script for antibiotics by Dr Aggarwal which you must continue for 1 week. You will also be given appropriate pain relief medications.
While most sedentary activities can be resumed when you go home, you must lay low and not exert yourself. You should refrain from any activity that raises your blood pressure for the first 72 hours. Most people are able to return to normal work at 1-2 weeks.
Dr Aggarwal will see regularly after your discharge from hospital.

Risks & Complications

Every surgery carries risks, and therefore one must consider if risks outweigh the benefits for your own personal situation. If they do then the surgery may be well worth it. Dr Aggarwal will discuss the pros and cons of surgery with you during your consultation.

General Complications

Risks of anaesthetic – there are general risks of going under an anaesthetic such as a mild stress on the heart and lungs, risk of reaction to anaesthetic drugs and risk of blotting in the legs. These risks are generally low in patients who are otherwise fit and healthy.
Bleeding (1-2%) – any bleeding is controlled during surgery however unexpected bleeding can occur in the immediate postoperative period. If this occurs it will necessitate a return to theatre to control the bleeding. If fat has been removed there is a small chance that bleeding can cause a threat to vision, and therefore you must report immediately to Dr Aggarwal if there is any change in your vision.
Infection (<1%) – this is very rare. However you are given antibiotics during induction (when you are going to sleep), as well as a course of oral antibiotics after your surgery to keep this risk to a minimum.

Specific Complications

Deterioration in vision – this is a very rare complication as a result of bleeding which needs immediate attention. If this emergency is not rectified immediately it can lead to blindness or reduced vision in the affected eye.
Lower eyelid malposition – scarring from surgery can lower the position of the lower eyelid, resulting in the show of the white part of the eye (the sclera) below the coloured part of the eye (iris). Severe cases can result in significant eye irritation, tearing, grittiness, and inadequate aesthetic appearance.
- To avoid this Dr Aggarwal takes careful attention to never remove excess skin, and to also support the lower eyelid through a canthopexy manoeuvre.
- Mild cases of malposition can improve through scar massage and support, however severe cases may require repeat surgery.
Asymmetrical scars – There can be a difference in how each eyelid behaves to surgery and skin tension, and can produce an asymmetry to the scars, albeit the aim is to get them as symmetrical as possible.
Hypertrophic or poor scars – How one’s body behaves to scarring is individual and largely genetic. Some types of skin are more prone to hypertrophic or keloid scarring, and some individuals and families are more prone to this. We will routinely advise you on how to improve the quality of scars over time. You should also discuss any history of abnormal scarring with Dr Aggarwal preoperatively.
Recurrence of fat bulging – occasionally despite removal of fat, bulging of fat can recur, and create a recurrence of lower eyelid ‘bags’.

Procedure FAQs

Do I need a referral for a lower blepharoplasty?

It is not necessary to obtain a referral for lower blepharoplasty.
If you do obtain a referral it is possible to claim a Medicare rebate of approximately $73 for the initial consultation
There are no Medicare or health fund rebates for a lower blepharoplasty procedure, however, as it is considered to be a cosmetic procedure.
If you are combining this surgery with other procedures that may carry an item number (such as an upper blepharoplasty) you are best to obtain a referral. This is needed to claim rebates for the procedures that are covered by Medicare and health funds.

Where can I see Dr Aggarwal?

You can see us at our main practice at Gordon, or at our other locations at Hornsby, Hunters Hill or Camperdown.
Please scroll to the bottom of the page to find out more information about these locations.

Where will I have my operation?

Any of the hospitals where Dr Aggarwal works – usually Hunters Hill Private or SAN Day Surgery Hornsby.

What can I do to prepare for surgery?

Cease fish oil, and other supplements such as Ginkgo, Ginseng.
Please discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.
Stop smoking well in advance of surgery.

Will I be able to exercise after surgery?

You must not do any activity that raises your blood pressure for 72 hours
Most people are able to resume most activities at 1-2 weeks.

Will I need special medications after surgery?

Dr Aggarwal will provide you with the necessary scripts for antibiotics and pain relief.

Do I need to wear any special garments?

No
However you will be required to use regular ice packs over the eyes for the first 48 hours.

Will I need further surgery?

Can I travel in an airplane after surgery?

Yes
However we always encourage patients not to be away overseas shortly after having a procedure, so that we can closely follow your recovery and address any concerns that may arise.

When will I be able to swim after a lower blepharoplasty?

You can swim in a pool or beach after 2 weeks once all wounds have healed.

When will I be able to drive after a lower blepharoplasty?

It is best to not drive for the 24-48 hours after lower eyelid surgery as the swelling initially may interfere with your vision.

Do you offer local anaesthetic or sedation for lower blepharoplasty?

Lower blepharoplasty is performed under General Anaesthetic so can only be offered in an accredited private hospital setting.

Are there any alternatives to lower blepharoplasty?

Unfortunately no – the only way to remove excess skin (and fat) from the lower eyelid is through direct excision.

Procedure Pricing

A quote for this procedure will be provided to you after a consultation with Dr. Aggarwal. You can also call or email our office for our current indicative pricing.
This fee is all inclusive, which includes
- Surgical fees
- Hospital theatre fees
- Anaesthetist fees
- Follow up
Please note that the above prices do not include
- Preoperative consultation fees
- Other procedures such as upper blepharoplasty, brow lift, or other facial cosmetic procedures.

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