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Lower Eyelid Lift

At Parker Center for Plastic Surgery in Paramus, lower eyelid surgery helps people from Ridgewood and throughout Bergen County, North New Jersey, and surrounding areas correct puffy under-eye bags and lax lower eyelids to restore a smooth, rested look.

Quick Facts

• 113,229 patients had eyelid lift surgery in 2019.*
• Most patients are worried about under-eye bags, but eyelid hollowing can happen too! Dr. Parker uses targeted fat grafting to create a smooth contour.
• Your custom lower eyelid lift may include a combination of fat removal, repositioning of skin, and post-surgery chemical peel.

* Statistical information listed here is drawn from 2019 The Aesthetic Society data.

Eyelid Lift
 Before & After Photos

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Before & After

Case: 1 of 8

Case #883

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This 53 year old patient had her herniated fat repositioned into her “tear troughs” as well as excess skin removed. In addition, a lateral canthopexy was performed for lower lid support.

Before & After

Case: 2 of 8

Case #87

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This 42 year old patient was referred to Dr. Parker by another patient. She asked Dr. Parker to improve the appearance of her upper and lower eyelids. The patient was bothered by the excess skin on her upper lids and puffiness in her lower lids. At the patient’s request, Dr. Parker performed a lower lid blepharoplasty first, then two years la... Read More

Before & After

Case: 3 of 8

Case #1017

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This 55 year old existing patient asked Dr Parker to improve his upper and lower eyelids. He was bothered by the puffiness of his lower eyelids, asymmetric upper eyelids and eyebrows. In addition, he had read on Dr Parker's website about having the corrugator muscles resected at the time of upper eyelid blepharoplasty to minimize, or eliminat... Read More

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Case: 4 of 8

Case #90

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This 60 year old patient was first referred to Dr. Parker 3 years ago by her primary care physician with concerns about the heaviness of her upper eyelids. Dr. Parker performed an upper lid blepharoplasty on the patient to remove her excess skin and a small amount of herniated fat. She healed well after the surgery. She returned 3 years later... Read More

Before & After

Case: 5 of 8

Case #104

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This 61 year old existing patient of Dr. Parker’s requested improvement in the appearance of her eyelids. She was bothered by their aging appearance and that her lower eyelids had become increasingly puffy over the past 2-3 years. At surgery, Dr. Parker performed a conservative upper lid blepharoplasty removing skin only. Regarding the lower... Read More

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Case: 6 of 8

Case #44

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This 77 year old existing patient of Dr Parker’s requested facial and neck rejuvenation. She complained of her “turkey” neck, prominent jowls, heavy upper eyelids and puffy lower eyelids. The patient reported her weight to be stable. Dr Parker performed an upper and lower lid blepharoplasty as well as a face and neck lift. The patient is very... Read More

Before & After

Case: 7 of 8

Case #1100

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This 74 year old patient was referred to Dr Parker by another patient. She asked Dr Parker to improve the appearance of her upper and lower eyelids. Specifically, she was bothered by her redundant upper lid skin and puffiness of her lower lids. Dr. Parker performed an upper eyelid blepharoplasty with an internal browpexy. Regarding her lower... Read More

Before & After

Case: 8 of 8

Case #880

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This 34 year old patient underwent fat removal alone through a transconjunctival approach.

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Keep in mind that each patient is unique and your results may vary.

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Dr. Parker’s approach to lower lid blepharoplasty is highly individualized, as no one patient’s face and eyelids age in the same way. He will evaluate your facial features and recommend a course of treatment based on the condition of your skin, fat, and muscle as well as the contour of your eyelid/cheek junction. He will fully discuss your options with you during your initial consultation.

Choosing the Right Procedure for You

The main cause of a tired, or puffy appearance to the lower eyelids is herniated “transconjunctival fat,” or fat underneath the eyelids. Lower eyelid rejuvenation almost always involves the removal or repositioning of this transconjunctival fat. Dr. Parker will adjust his technique depending on your age, the condition of the surrounding skin, and your desired results.

Page Contents

• Fat Removal Only: Ideal for younger patients with good skin conditioning
• Fat Repositioning: to smooth depressions in the tear troughs
• Fat Removal or Repositioning with TCA Chemical Peel: to smooth puffiness, tighten & smooth wrinkles
• Fat Removal or Repositioning & Skin Removal: to smooth puffiness & address sagging, aging skin
• Fat Removal or Repositioning, Skin Removal & TCA Peel: to smooth puffiness, tighten sagging skin & improve skin tone for dramatic rejuvenation
• How will lower eyelid surgery results look over time?
• What is recovery like after lower eyelid surgery?

Transconjunctival Fat Removal Only

Before & After: Lower Eyelid Fat Removal Only*

This procedure is typically performed on younger patients who have good skin quality but have herniated fat causing puffiness of the lower lid. Dr. Parker makes an incision on the inner aspect of the lower eyelid to avoid an external scar. He then removes the herniated fat through this incision.

A transconjunctival blepharoplasty will correct the puffiness under your eyes and make you look well-rested and younger without any visible scarring. The procedure takes approximately 45 minutes to perform, most commonly using intravenous sedation to make you comfortable. You will be monitored in our recovery room for about one hour and then discharged home.  The eyes are not bandaged and there are no sutures to remove.

Paul M. Parker, M.D., FACS

Board-Certified Plastic Surgeon

Known for his surgical talent and caring personality, Dr. Parker has been serving the community for over 25 years. He has dedicated his practice to the education, safety, and comfort of his patients—making each one feel as important as family.

Meet Dr. Parker

Transconjunctival Fat Repositioning to Improve the Tear Trough

Before & After: Lower Lid Fat Repositioning*

This procedure is typically performed on younger patients who have puffiness of the lower lid due to herniated fat and a depression in their tear trough area, but good skin quality. Dr. Parker makes an incision on the inner aspect of the lower eyelid to avoid an external scar. Instead of removing the herniated fat, he repositions it from its original location to fill the depression in the tear trough. If Dr. Parker points out that you have a tear trough depression, he will likely recommend this procedure to give you a more natural look in your lower eyelids than fat removal alone can accomplish.

A transconjunctival blepharoplasty with fat repositioning will correct the puffiness under your eyes and fill the tear trough depression. This will make you look well-rested and younger without any visible scarring. This procedure takes approximately one hour to perform, most commonly using either intravenous sedation or general anesthesia to make you comfortable. You will be monitored in our recovery room for about one hour, and then discharged home.  The eyes are not bandaged, and there are no sutures to remove.

Transconjunctival Fat Repositioning & TCA Peel

Before & After: Lower Eyelid Lift & TCA Peel*

This procedure is typically performed if you have puffiness of the lower eyelids due to herniated fat, crepiness, fine wrinkling and/or discoloration (surgeons call it “hyperpigmentation”) of your skin, with or without a depression in the tear trough area. Dr. Parker will make an incision on the inner aspect of the lower eyelid to avoid an external scar. If there is a tear trough depression present, he will reposition the herniated fat from its original location to fill in this depression. If there is no tear trough depression, Dr. Parker will remove the fat. He will then treat the crepiness, fine wrinkling and/or discoloration of your lower eyelid skin by applying a trichloroacetic acid (TCA) peel to it. This will tighten up the skin as well as improve any discoloration present.

This procedure will correct the puffiness under your eyes, fill any tear trough depression, and improve the appearance of your lower eyelid skin. This will make you look well rested and younger without any visible scars. This procedure takes approximately 75 minutes to perform, most commonly using intravenous sedation or general anesthesia to make you comfortable. You will be monitored in our recovery room for about one hour, and then discharged home. The eyes are not bandaged, and there aren’t any sutures to remove.

Transconjunctival Fat Repositioning & Skin Removal

Before & After: Lower Eyelid Fat & Skin Removal*

Dr. Parker typically performs this procedure if you have both puffiness of the lower lids due to herniated fat and excess skin that requires removal, with or without a depression in the tear trough area. He makes an incision on the inner aspect of the lower eyelid, providing direct and safe access to the herniated fat. If there is a tear trough depression present, he will reposition the herniated fat from its original location to fill the depression in the tear trough. If there is no tear trough depression, Dr. Parker will remove the fat and then suspend the lateral canthal tendon (on the outer aspect of the eyelid) upward with sutures to minimize the risk of lower lid retraction during the healing process. Finally, Dr. Parker will make an incision just beneath the lash line and conservatively remove excess skin.

This procedure will correct the puffiness under your eyes and fill the tear trough depression if it is present. It will also improve the appearance of your lower eyelid skin. This will make you look both younger and well-rested. Though a lower lid scar is present, you will have a difficult time finding it.

This procedure takes approximately 90 minutes to perform. Either intravenous sedation or general anesthesia is most commonly used for your comfort. You will be monitored in our recovery room for about one hour and then discharged home. There are no bandages on the eyes, and sutures are removed within four to five days.

Fat Injections to Lower Eyelid Hollowing

Fat grafting to the lower eyelid area, which plastic surgeons refer to as the nasojugal groove and tear trough areas, “shortens” the apparent length of the lower eyelid. This results in a youthful, attractive smooth transition from the lower eyelid to the cheek.

After fat is harvested by Dr. Parker, it is purified and very carefully injected deep in a sub-muscular/pre-periosteal plane. He then carefully massages the fat to help create a smooth contour.

Fat Repositioning, Skin Removal & TCA peel

Before & After: Lower Eyelid Lift & TCA Peel*

This procedure is typically performed if you have:

• puffiness of the lower lids due to herniated fat
• excess skin which requires removal
• crepiness, fine wrinkling and/or discoloration (surgeons call it “hyperpigmentation”) of your skin and,
• the above with or without a depression in the tear trough area.

Dr. Parker makes an incision on the inner aspect of the lower eyelid, providing direct and safe access to the herniated fat. If there is a tear trough depression present, he will reposition the herniated fat from its original location to fill the depression in the tear trough. If there isn’t any tear trough depression, Dr. Parker will remove the fat. He will then suspend the lateral canthal tendon, on the outer aspect of the eyelid, upward with sutures to minimize the risk of lower eyelid retraction during the healing process. Dr. Parker will make an incision just beneath the lash line and conservatively remove excess skin. Finally, to treat the fine wrinkling and/or discoloration of the skin, he will carefully apply a trichloroacetic acid (TCA) peel to the area. This will tighten up the fine wrinkling of the skin as well as improve any discoloration present.

This procedure will correct the puffiness under your eyes and fill the tear trough depression if it is present. It will also improve the appearance of your lower eyelid skin. This will make you look well rested and younger. Though a lower lid scar is present, you will have difficulty finding it.

This procedure takes approximately 90 minutes to perform, and Dr. Parker employs intravenous sedation or general anesthesia to make you comfortable. You will be monitored in our recovery room for about one hour, and then discharged home. The eyes are not bandaged, and sutures are removed within four to five days.

How Will Lower Eyelid Surgery Results Look Over Time?

Lower Eyelid Surgery Results Age Naturally with You*

When performed by an experienced, skilled plastic surgeon, eyelid surgery results last for years and age naturally with you. You can keep your rejuvenated eyes looking their best by practicing good skincare habits, wearing sunscreen daily, and maintaining a healthy lifestyle.

What Is Recovery Like After Lower Eyelid Surgery?

While everyone heals differently, there is little, if any, postoperative pain following any of these lower eyelid procedures. Swelling is usually moderate and discoloration minimal. Both typically subside within 10 to 14 days. Camouflage make-up may be applied after 10 days. Patients may return to normal activities in 10 days and exercise in 2 weeks.

During both your consultation with Dr. Parker and in your pre-op education visit with our Nurse Educator, your anticipated recovery will be discussed in detail.