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Lower Blepharoplasty

What is eyelid surgery (blepharoplasty)?

Cosmetic eyelid surgery (“blepharoplasty”) is a procedure that rejuvenates your eyelids. Many people have baggy or puffy lower eyelids, which can make you look tired and worn down. A lower blepharoplasty is the removal or repositioning of excess fat and can also involve tightening of the skin, which dramatically improves the appearance of your lower eyelids.

A blepharoplasty is an outpatient procedure but is performed on one of the most sensitive areas of your body, with a very specialized anatomy.  This is why we always recommend that patients seeking eyelid surgery have it performed by an oculoplastic surgeon, who has specialized training and expertise in the incredibly complex area around your eyes.

A lower blepharoplasty is performed on your lower eyelids and can be performed independently or at the same time as an upper blepharoplasty.

The results from your blepharoplasty can be life changing, helping you feel not only more confident in the way you look, but also in how you interact with others. Your eyes will be brighter, fuller and look less tired than they have in years.

Commonly asked questions

What should I look for when choosing a surgeon?

Selecting the right cosmetic surgeon is a choice that you live with for years, if not your entire life. A successful procedure will make you feel more like yourself and give you greater confidence for years to come. On the other hand, selecting the wrong surgeon increases your chances of having poor results, which can lead to additional costs, time, and heartache.

When choosing your surgeon, there are a few key points to keep in mind:

  • What credentials should my surgeon have? Making sure that your doctor has received the right training focusing on your issue. General plastic surgeons work on the entire body, and facial plastic surgeons perform work on the entire face. Dr. Liu is an oculoplastic surgeon and has completed an ASOPRS fellowship, making her one of the most highly qualified oculoplastic surgeons in North America. When you are having surgery done near your eyes, you want to make sure that you have a surgeon that was trained in the eyes, and general and facial plastic surgeons typically have inadequate training in this area.

  • Ask detailed questions. Make sure that your surgeon answers all of your questions clearly and is willing to spend the time with you to address all of your concerns. A physician that cannot give a clear answer as to how many of a particular procedure they have performed or how their training qualifies them to perform a procedure should be chosen with care.

  • What do other patients say? While a referral from a friend or colleague can be helpful in narrowing down a physician search, it is important to try and get a well-rounded view of the physician. Look online at their reviews at websites such as,, and on Google and Yelp. Getting the full picture of other patients’ experience with a physician can be helpful in putting your interaction with the doctor into the correct context.

What kind of anesthesia is used during a blepharoplasty?

A lower blepharoplasty is typically performed using intravenous sedation or general anesthesia at an off-site surgery center.

How much does a blepharoplasty cost?

It is difficult to provide pricing before a patient has had a consultation with Dr. Liu. The cost of a procedure can vary depending on what a patient needs and what the surgery will entail. More importantly, many patients come to Dr. Liu believing that they need a certain procedure, only to find out during the consultation that a different procedure will provide a better outcome.

How does Dr. Liu perform her lower blepharoplasty?

Dr. Liu approaches a lower blepharoplasty using a transconjunctival incision, a transcutaneous incision, or sometimes a combination of both, depending on the patient needs. The incision is made either inside your lower eyelid or right below the lower eyelashes, to hide any scarring. The lower eyelid fat pads are then either contoured and removed or moved further down into the cheek area to minimize any hollowing. Sometimes a canthopexy will be performed at the same time as the lower blepharoplasty to support the lower eyelid throughout the healing process.

The specific techniques that Dr. Liu uses will be selected based on your needs. Because Dr. Liu has such specialized training, she has access to a number of techniques that are not utilized by most other doctors, and she will tailor these techniques to get the best outcome for you.

Once Dr. Liu has achieved the desired restructuring and reshaping of your eyelids, she places sutures to smooth and reconfigure your eyelids.  The sutures are finer than a human hair and will either dissolve or be removed at 5-7 days after surgery.

How long does the procedure take?

A lower blepharoplasty typically takes about 1 – 2 hours from start to finish.

Does a lower blepharoplasty scar?

A lower blepharoplasty will have scars either on the inside of your eyelid or just below your eyelashes that may not be easily visible after you have fully healed. Non-specialized surgeons typically have results with more visible scarring.

Are there any risks to a lower blepharoplasty?

Eyelid surgery is generally a very safe procedure. When considering any eyelid surgery, it is important to inform your surgeon of any abnormalities of your eyes, vision, or your general medical health. It is important to remember that while all surgery carries some risks, even when performed by the most highly trained surgeon and at the best facilities. Below are some of the more common risks associated with eyelid surgery:

  • Pain

  • Swelling

  • Scarring

  • Infection

  • Excessive tearing

  • Adverse reaction to anesthesia

  • Dryness or burning of the eyes

  • The formation of whiteheads, or milia, that appear after suture removal; typically, the surgeon can treat these post-operatively

  • Difficulty keeping the eyes closed while sleeping; though temporary for most individuals, this particular complication has become permanent in others

  • On occasion, individuals have also reported experiencing blurred or double vision, but in most cases, these complications subside in a few days

The likelihood of serious complications arising from the procedure is typically influenced by both the surgeon’s skill as well as the patient’s individual response to the eyelid surgery. Certain severe risks or complications can be avoided by cooperating fully and completely following your surgeon’s instructions. With patience, a willingness to cooperate, and a qualified surgeon, the complications of eyelid surgery and any associated risks can be dramatically reduced.

What should I expect after surgery?

Surgery should be scheduled for a time when you can relax for at least 1-2 weeks. It is important to avoid any strenuous activity, heavy lifting, or bending down during this time to avoid complications and to promote the best healing. It is also important to avoid taking any blood thinning medications for at least two weeks prior to surgery. If you are on a blood thinning medication due to a specific medical condition, you will need to discuss this with Dr. Liu and your primary care physician prior to stopping any medication. Dr. Liu’s staff will review a list of common medications, supplements and vitamins that can cause your blood to be thinner.

Please note that Dr. Liu expects to see patients back in the office a few days after a procedure to ensure that the healing process is going as expected and that you are on track for a good result. Do not plan any travel immediately after your procedure.

I went to 10 plastic surgeons in the surrounding area got advice and opinions based the the procedures I wanted to have done. Dr. Liu addressed all my needs, was more thorough in her recommendations and more realistic about the outcome. I am confident beyond a shadow of a doubt that I made the right choice by using Dr. Liu and will continue for use her for any cosmetic procedure I may have...

Newport Beach

Dr. Liu is the top rated oculoplastic surgeon in Orange County.

Click here to read more patient testimonials.

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