Lower Blepharoplasty

Lower eyelid rejuvenation is designed to improve the under-eye area when “bags,” shadowing, or crepey skin make you look more tired than you feel. Some patients notice puffiness that doesn’t go away even with good sleep and hydration. Others are bothered by a deep tear trough that creates a dark, hollow appearance—especially in photos or bright overhead lighting. Many people have a combination of both, along with changes in skin texture over time.

The lower eyelid is delicate. It’s also closely connected to cheek support, midface volume, and eyelid tone. That’s why the best plan is rarely one-size-fits-all. A thoughtful approach prioritizes eyelid function and natural contour first, then refines skin, volume, and shape in a conservative way.

At Kavali Plastic Surgery and Skin Renewal Center in Atlanta—serving Buckhead and Sandy Springs—board-certified plastic surgeon Dr. Carmen Kavali tailors lower eyelid rejuvenation based on the true cause of your under-eye changes. Treatment may be surgical, non-surgical, or a combination. The goal is a rested, refreshed look that still looks like you. Individual results vary.

You may be a good candidate if you:

• Have persistent under-eye bags or puffiness
• Notice tear trough hollowness or shadowing that makes the under-eye look darker
• Have fine lines, crepey texture, or loose lower-lid skin
• Feel your eyes look tired even when you’re well-rested
• Want improvement while preserving a natural lower-lid shape

Lower eyelid planning is especially individualized if you have any of the following:

• Dry eye symptoms, contact lens sensitivity, or eye irritation
• History of eyelid surgery or facial surgery
• Eyelid laxity or a tendency for the lower lid to “pull down”
• Thyroid eye disease or other conditions that affect eyelid position
• Significant cheek descent or midface volume loss

During your consultation, Dr. Kavali will review eye history, medication/supplement use, and overall health to determine which approach is safest and most likely to deliver a natural improvement. Some patients are better served with non-surgical options first; others benefit most from surgical correction when anatomy supports it.

Your consultation is designed to identify what’s actually driving your under-eye appearance and match that to the right treatment plan. Dr. Kavali will evaluate:

• Fat pad prominence: whether true “bags” are present and how they affect contour
• Tear trough depth: the anatomy that creates shadowing and the lid-cheek transition
• Midface/cheek support: cheek position and volume (often a key factor in under-eye shadows)
• Skin quality: laxity, fine lines, pigmentation, and texture
• Lower-lid tone and laxity: an important safety variable for surgical planning
• Overall balance: how changes in the under-eye relate to the brow, cheeks, and jawline

You’ll also discuss your preferences: how subtle or noticeable you want improvement to be, what “refreshed” means to you, and what you want to avoid (for example: looking hollow, overly tight, or “operated on”). Dr. Kavali will explain benefits, limitations, and realistic expectations, including what surgery can and cannot change. Individual results vary.

The under-eye area rarely changes in isolation. In many patients, the appearance of under-eye bags and hollowness is influenced by cheek descent and midface volume loss. When it’s appropriate, combining procedures can improve harmony and consolidate recovery.

The under-eye area rarely changes in isolation. In many patients, the appearance of under-eye bags and hollowness is influenced by cheek descent and midface volume loss. When it’s appropriate, combining procedures can improve harmony and consolidate recovery.

Common combinations may include:

• Lower eyelid rejuvenation + facial volume restoration: when hollowness and a strong tear trough are key concerns (case-dependent)
• Lower eyelid rejuvenation + facelift: when broader facial laxity contributes to an overall tired appearance
• Lower eyelid rejuvenation + neck lift: when the goal is comprehensive facial rejuvenation
• Lower eyelid rejuvenation + skin resurfacing: in select cases to improve fine lines and texture (case-dependent)

Not everyone needs combination surgery, and not every patient benefits from adding more procedures. Dr. Kavali recommends additional procedures only when they support better balance, a safer plan, or a more predictable aesthetic outcome. Individual results vary.

1) Is the main issue puffiness, hollowness, loose skin—or a combination?

“Bags” are often caused by prominent fat pads, while tear trough shadows are commonly related to volume loss and contour changes. Loose skin can add crepey texture and fine lines. The best treatment depends on which factor is most dominant for you and how these factors interact.

2) Surgical vs. non-surgical: which fits your anatomy and goals?

Non-surgical treatments can improve mild volume loss or early texture changes for selected patients. Surgical rejuvenation is often more effective when there is significant fat pad prominence, meaningful skin laxity, or structural concerns that are unlikely to improve with injectables alone.

3) Lower-lid support: how do we protect eyelid position?

Maintaining natural eyelid position is one of the most important parts of lower eyelid rejuvenation planning. Dr. Kavali evaluates lid tone and laxity and may recommend supportive measures in select cases to help reduce the risk of eyelid pulling, shape changes, or exposure-related irritation during healing. Recommendations are individualized.

4) Volume strategy: refine fat, reposition fat, or restore volume?

Modern lower eyelid rejuvenation often emphasizes balance rather than aggressive removal. In some cases, conservative refinement or repositioning can smooth the lid-cheek junction. In others, careful volume restoration may be more appropriate. The safest option depends on your anatomy, eyelid tone, and desired look.

When surgery is appropriate, lower eyelid rejuvenation may be performed using different approaches based on your anatomy and goals. Two common surgical access options include:

• Transconjunctival approach: an incision inside the lower eyelid (often used when the primary goal is addressing fat pads with minimal external skin work)
• Subciliary approach: an incision just beneath the lash line (sometimes used when skin tightening or additional external access is clinically appropriate)

While each plan is individualized, a typical surgical flow may include:

1. Anesthesia: local anesthesia with sedation or general anesthesia, depending on the plan and whether procedures are combined

2. Incision placement: selected to prioritize safety, eyelid function, and your goals

3. Contour correction: conservative refinement and/or repositioning when indicated, focused on smoothing rather than “hollowing”

4. Skin refinement: selective tightening or trimming when appropriate (case-dependent)

5. Support measures: considered in select patients to help maintain lid position during healing (case-dependent)

6. Closure: meticulous closure designed for subtle scarring and smooth healing

Procedure time varies, especially when combined with facial rejuvenation procedures. Dr. Kavali will explain what to expect for your specific plan.

Most patients go home the same day with a responsible adult. Early aftercare commonly includes:

• Cold compresses as directed
• Head elevation while resting and sleeping
• Prescribed ointment or drops if recommended
• Temporary restrictions on heavy lifting, bending, and strenuous activity
• Keeping the area clean and avoiding rubbing the eyes

Swelling and bruising are common early on. Some patients experience temporary dryness, irritation, or increased sensitivity. These symptoms usually improve as tissues settle, but timelines vary by individual.

Recovery depends on your surgical approach and whether other procedures are performed at the same time. Many patients experience:

• Days 1–3: peak swelling and bruising; rest, elevation, and compresses as directed
• Week 1: a follow-up visit to assess healing and eyelid comfort
• Weeks 2–3: most bruising improves; many patients feel more comfortable returning to social activities
• Weeks 4–8+: continued refinement as swelling resolves and tissues settle

Makeup timing, contact lens use, and return-to-exercise guidance are individualized. Dr. Kavali will provide specific instructions based on your healing progress and the details of your plan.

All procedures carry risk. Lower eyelid rejuvenation considerations may include:

• Bleeding, infection, delayed healing
• Temporary dryness, irritation, sensitivity, or watery eyes
• Asymmetry or under-correction/over-correction
• Temporary contour irregularities during healing
• Changes in eyelid position (risk varies; anatomy-driven planning helps reduce risk)
• Scarring (typically subtle, depending on approach)
• Anesthesia-related risks

Dr. Kavali will review how risks relate to your anatomy, eye history, and treatment plan. No surgical outcome can be guaranteed, and individual results vary.

Lower eyelid rejuvenation can help you look more rested and improve the under-eye contour, but it does not stop aging. Long-term appearance is influenced by skin quality, sun exposure, genetics, and natural volume changes over time.

Helpful long-term habits include:

• Sun protection (sunglasses and sunscreen where appropriate)
• Gentle skincare and avoiding aggressive rubbing
• Maintaining stable weight (large fluctuations can affect facial volume)
• Staying consistent with follow-ups as recommended

Lower eyelid surgery requires precision, conservative judgment, and an anatomy-driven approach that protects eyelid function while improving aesthetics. Kavali Plastic Surgery and Skin Renewal Center is led by board-certified plastic surgeon Dr. Carmen Kavali.

You can learn more about board certification standards through the American Board of Plastic Surgery and the American Board of Medical Specialties. You may also view results here: Before & After Photos. Individual results vary.

Lower eyelid rejuvenation cost in the Atlanta area varies depending on whether treatment is surgical or non-surgical, the technique used, and whether procedures are combined. Many surgical cases fall within an approximate range of $6,000 to $12,500+, though your personalized quote may be lower or higher depending on complexity, facility fees, and anesthesia fees.

Your consultation will clarify what is included and what may be separate. Financing options may be available for qualified patients. Learn more here: patient financing.

If you’re considering lower eyelid rejuvenation in Atlanta, Buckhead, or Sandy Springs, the next step is a consultation to determine whether your concerns are best addressed with surgical blepharoplasty techniques, volume restoration, skin-focused treatments, or a combination approach.

To schedule, call 404.250.3333, email [email protected], or request an appointment via the contact page. For surgery scheduling questions, you may also email [email protected].

What’s the difference between under-eye “bags” and tear trough hollowness?

“Bags” are often caused by prominent fat pads, while tear trough hollowness is typically a contour/volume issue that creates shadowing. Many patients have a combination of both, which is why treatment is tailored to your anatomy.

Will I look “pulled” after lower eyelid surgery?

A natural outcome is a primary goal. Conservative tissue management and attention to lid tone and support help protect eyelid position and avoid an overdone look. Individual results vary.

How long will bruising last?

Many patients see significant improvement in bruising within 10–14 days, though timing varies based on individual healing and the technique used.

Can fillers replace lower eyelid surgery?

Fillers can help certain patients with mild hollowing, but they do not remove prominent fat pads or tighten significant skin laxity. In some situations, fillers can worsen puffiness. A consultation determines what’s appropriate for your anatomy.

Can lower eyelid rejuvenation be combined with facial volume restoration?

Yes. In selected patients, volume restoration can help soften hollowness and improve the lid-cheek transition. Whether it’s right for you depends on anatomy, goals, and overall facial balance.

When can I wear makeup or contact lenses again?

Many patients resume makeup and contact lenses after early healing, but timing varies. Dr. Kavali will give individualized guidance based on incision healing and eye comfort.