Lower Eyelid Blepharoplasty Transcutaneous Approach

The transcutaneous blepharoplasty approach addresses age-related dark circles and bags of the under-eye area through an incision made directly beneath the eyelashes. During surgery, an incision is made that allows the muscle of the lower eyelid to be tightened, while also creating space to trim and reposition excess skin and fat.

Lower Eyelid Blepharoplasty Transcutaneous Approach Overview - Everything You Need to Know

The Skinny

Lower Eyelid Blepharoplasty Transcutaneous Approach
avg. recovery
10 days
Is permanent
Surgical Procedure
$2000 - $4000

About the Procedure

Last Updated: 08.03.2021

A lower eyelid blepharoplasty performed with a transcutaneous approach addresses age-related concerns such as skin laxity and fat protrusion that interfere with a smooth transition from the lower lash line to the cheek. Before the procedure, the surgeon will do an initial evaluation to determine lid strength and laxity by performing a snap test. During this test, the lower eyelid will be pulled down and observed for how long it takes for the lid to return to its normal position without the patient blinking. An abnormal result may require a lid-shortening procedure to ensure optimal results postoperatively. Once your doctor has performed the initial evaluation, an anesthesia will be injected to numb the area. Following preoperative marking, an incision will be made directly beneath the lash line to expose the eye muscle. The fat that easily flows into this incision is removed and, once complete, the skin-muscle flap is replace and the incision is closed with a running suture. Surgical glue may be used in some cases to provide extra reinforcement, and surgical tape suspends the lid laterally.

The goal of a lower eyelid blepharoplasty is to remove skin and/or fat in order to reduce lower eyelid wrinkles, skin redundancy, and fat bulges.


Lower Eyelid Blepharoplasty Transcutaneous Approach addresses concerns such as:

Recovery Notes

Following surgery, the eyes will be swollen with some patients experiencing numbness and excessive tearing. Symptoms such as swelling and bruising will typically last a week or more. Cool compresses can be used to reduce puffiness. Sleep with the head in an elevated position. Strenuous exercise should be avoided for 2 weeks. Activities that strain the eyes such as reading, wearing contacts, watching tv, or using a computer should be limited. Avoid unprotected sun exposure for optimal healing.

Ideal Candidate

The ideal candidate for a lower eyelid blepharoplasty with a transcutaneous approach is older and has a large amount of fat protrusion, significant redundant skin, and prominent orbicularis muscle swag.

Not Recommended For

Lower eyelid blepharoplasty is not recommended for patients with a history of thyroid disease, bulging eyes, or chronic dry eye symptoms.

Side Effects

Side effects from a lower eyelid blepharoplasty with a transcutaneous approach may include increased scleral show, ectropion, difficulty in closing the eye when sleeping, blurred vision, swelling and bruising, scarring, bleeding, and changes in sensation.


  • Removes excess skin
  • Removes excess fat
  • Permanent
  • More youthful appearance


  • Higher risk of increased scleral show
  • Higher risk of ectropion

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