Lower Blepharoplasty
To achieve a more rested look, Dr. Rad primarily performs a lower blepharoplasty, otherwise known as eyelid contouring for the lower eyelid. This procedure, designed primarily to correct the presence of severe under-eye bags and dark circles, focuses on removing the under-eye bags and filling the tear trough region.
Overtime, the fatty tissue behind the eyes can bulge forward and the tear trough indentation is what causes the appearance of the dark circles. If the darker coloration under the eyes is minimal, it’s recommended to start with a more subtle approach to treatments like injectable fillers. This can be a worthwhile and minimally-invasive solution that temporarily masks the appearance of undereye bags. For more severe dark circles under the eyes, the gold standard is surgical contouring by Dr. Rad, which offers scarless results that visibly remove the appearance of dark circles and the fatigued look that often accompanies it.
Patients of Dr. Rad’s who have undergone lower blepharoplasty are amazed at the subtle, yet transformative results his years of expertise provide.
“The beauty in a face should be noticed, not the work that went into it.”
- Ariel N Rad, MD, PhD, FACS
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01consultation
Our plastic surgery office in Washington DC is centered on your comfort and privacy. You’ll be received by our exquisitely attentive staff, and escorted to your own private cabana wherein you’ll feel relaxed and comfortable while consulting discreetly with Dr. Rad. First, Dr. Rad will determine if you are a good candidate for surgery and during your consultation you should decide if Dr. Rad is the right surgeon for you. Credentials are crucial and, in addition to being Board certified in plastic surgery, Dr. Rad is Assistant Professor at Johns Hopkins, and he enjoys an impeccable reputation as a top flight aesthetic surgeon. His facial plastic surgery expertise is sought out as one of the best surgeons in Washington DC, northern Virginia and the US.
02safety
Experience is everything when it comes to safety. Dr. Rad has performed thousands facial operations and he routinely performs lower blepharoplasty surgeries. He prides himself in achieving beautiful, natural results for both women and men, and he operates with safety at top of mind by working with expert anesthesia and nursing teams at DC’s top hospital-based surgery centers. In Dr. Rad’s hands, lower blepharoplasty surgery entails low risk and safety is always top of mind. Dr. Rad’s innate familiarity with facial anatomy, knowledge of safe navigation of the delicate nerves, muscles and blood vessels, and working with expert anesthesia and nursing teams, all translate to keeping patients safe.
03Technique
When performing a lower blepharoplasty, Dr. Rad uses the following protocol:
- Under Eye Bag removal with Dr. Rad is achieved by surgically removing the three small fat pads behind the eye that have progressively bulged forward over time. However, the tear trough beneath the undereye makes puffiness appear worse. Like a hill going into a valley, reducing the hill and filling the valley can level the terrain and Dr. Rad employs two approaches to achieve this: (1) transconjunctival lower blepharoplasty plus fat transfer: this approach features a hidden incision inside the eyelid through which protruding fat pockets can be removed safely and effectively. Ideal candidates for this approach are those with good skin tone and elasticity. The other procedure is called (2) subciliary lower blepharoplasty with fat transposition. This is best for patients with puffiness and also wrinkled lower eyelid skin, and involves an incision beneath the eyelid.
- Dr. Rad carefully separates the skin from the underlying muscle to redrape and smooth it, and then he shifts (transposes) fat pads into the tear trough region. This is one of the more technically challenging methods to perform well. Surgery involves very little discomfort.
- A light dressing is applied after which you can return home, driven by a friend or family member. The procedure is performed on an outpatient basis in almost all cases.
04recovery
05Aftercare
06longevity
Your vision for your results will emerge through detailed consultation with Dr. Rad, meticulous examination of your anatomy, and careful pre-surgical planning. While Dr. Rad’s surgical approach is unique for each patient, the goal of naturalness remains constant. To see Before & After results, visit our gallery page.
frequently askedQuestions
How do I know if I’m a good candidate for under eye bag removal?
As previously mentioned above, surgical removal of undereye bags should be reserved for moderate to severe cases of dark circles only. Though dark circles tend to develop as we get older, this procedure is not age restricted. Many people can struggle with bags at an early age due to several genetic factors. As with any surgical procedure, patients for lower blepharoplasty should be of good overall health and have a firm understanding of what the procedure can and cannot do. An ophthalmology evaluation is needed to ensure that there is no evidence of retinal disease or glaucoma.
If you are interested in the procedure but wondering whether you’re a good candidate for lower eyelid contouring, Dr. Rad would gladly sit down with you during your consultation and discuss your aesthetic goals and determine whether the procedure is right for you. He may suggest an alternative such and fillers or other related procedures. In some cases, a combination of treatments like facial fat grafting in order to restore volume to deflated cheeks and under-eye regions.
What non-surgical options do I have?
Collagen-stimulating treatments such as Laser restore skin elasticity and, when combined with a daily eyelid-focused skincare regimen the need for surgery can be delayed. Injectable filler can be used to fill the tear trough, but often this does not achieve 100% correction and also are temporary.
Why do I look tired?
Under Eye bags make us look tired or older. The problem is twofold: (1) protruding fat pockets cause the lower eyelids to bulge out, and (2) deep tear troughs, the indentation that appears underneath our lower eyelids, makes puffiness appear worse. The combination causes dark circles under the eyes which make us look tired or older
How does surgery make me look rested?
Surgery must address both puffiness of the eyelids and the indentations below them. Dr. Rad focuses on creating a smooth contour from eyelid to cheek called the “lid-cheek junction”. Smooth contour translates visually to a rested appearance. Dr. Rad tailors his approaches uniquely to each patient's anatomy to minimize downtime.
What is the cost of under eye bag removal?
An upper eyelid lift costs $3,500, whereas lower eyelid lift costs $4,500. Cost for comprehensive treatment of the upper and lower eyelids with facial fat transfer to fill sunken cheeks and tear troughs is approximately $12,000 to $15,000. Cost depends on facial anatomy, complexity of surgery, first-time or revision surgery, location (in-office versus hospital OR), and the experience, training and skill of the plastic surgeon.
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