12/26/2025
⭐️ In a traditional lower bleph , we are taking fat away or removing fat that’s protruding through the muscle in the lower eyelids and causing puffiness or “bags”.
⭐️ The lower eyelid fat pads are made of thicker, fibrous fat that is found inside the eye socket, and with time or from genetics, this fat can push against the muscle and lead to visible bags, discoloration, and shadows. People who have this issue also frequently have subcutaneous volume and fat loss in the cheek or midface, or in the tear trough. This exacerbates that dark shadow or dark circles under the eyes.
⭐️ In many (not all) patients, if we remove the lower eyelid fat pads without restoring volume in the lower eyelid, tear trough, or cheek, we wind up with no bags, but with just an overall sunken, hollow, tired looking undereye.
For those reasons, I love combining fat grafting with my lower blepharoplasties, and with many of my other surgeries as well. I hope that helps, if you have questions drop them in the comments below and I’ll try to answer
