There are two types of lower blepharoplasty: the external approach and the internal approach.

The internal approach, also known as ‘transconjunctival lower blepharoplasty,’ is the preferred option for removing eye bags as it avoids leaving any visible scars.

The following diagram illustrates the three fat pads in the lower eyelid. An individual may have one or more of these fat pads enlarged, which may necessitate removal.

The followoing idagnoam illustrates the location of the fat pad in cross section. The fat can be removed by external appraoch (through the skin) or by internal approach (from conjuntiva).

The external approach, or “transcutaneous lower blepharoplasty,” is the preferred option if you wish to address both eye bags and excess skin. However, this approach comes with the drawback of potential scarring and ectropion.

On the other hand, we advocate for the internal approach, or “transconjunctival lower blepharoplasty,” as it does not leave a scar, and there is no risk of ectropion.

It is mandatory requirement of two preoperative consultations and 1 week of cooling off period. You will need to get a GP referral to see Dr Kim. Body Dysmorphic Disorder will be assessed during the first consultation.

The procedure involves the following:

1. Dr Kim will identify the fat pads to be removed.
2. Local anaesthetic injection.
3. Transconjunctival incision.
4. Identify the fat pockets.
5. Remove prolapsed fat in small increments until the bags are gone.
6. Insert dissolving stitches.
7. The process generally takes 45- 60 minutes.
8. You will need to return in one week for a follow up
9. You will need to return in 6 weeks for a final check.

There is a significant difference in the way individuals recover after the surgery.

The downtime after lower eye bag surgery is typically 1-2 weeks, and most patients choose to take 2 weeks off work.

We advise you to avoid heavy exercises, bending over, and situations where you need to exert yourself for 3-4 weeks.

There are a number of complications that are generally associated with all surgeries, and some specific to upper blepharoplasty. Most complications are temporary and heal spontaneously.

Some of the things that could go wrong are:

• scarring is hidden in the conjunctiva (no externally visible scar).
• pain (usually paracetamol is sufficient),
• prolonged swelling lasting for few weeks up to 3 months.
• bleeding after discharge (need to return to the clinic to stop the bleed),
• assymetry (10% normal) requiring correction,
• blurred vision (usually few days due to swelling),
• dry eyes (need some lubricating eyedrops),
• over and under correction (careful planning to avoid this),
• not meeting patient’s expectations,  
• infection (we routinely give antibiotics),
• allergic reaction,
• red eyes and chemosis (usually resolvet after 1-2 weeks, may need eyedrops),
• death and blindeness. We are not aware of any cases of blindness and death from blepharoplasties performed under local anaesthesia in Australia.

As per Good Medical Practice Guideline, we would like to notify you that:

• Any surgical, invasive, nonsurgical, or laser procedure carries risks.

• Complications do and can occur.

• Previous success is not a promissory indication of future success.

• Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

• All before and after photos on this site are Dr Peter Kim’s work.

• Copyrights reserved by Dr Peter Kim.