Lower
Blepharoplasty.

Anaesthesia Options for Lower Eyelid Surgery

Depending on your medical background, individual circumstances, and personal preference, lower eyelid blepharoplasty can be performed under local anaesthesia, local anaesthesia with intravenous sedation, or general anaesthesia.

During your consultation in Central London, Dr Kang will discuss the most appropriate anaesthetic option with you, taking into account comfort, safety, and the complexity of the procedure. Patient safety and wellbeing remain the priority throughout.

How Lower Eyelid Blepharoplasty Is Performed

Lower eyelid surgery is a highly precise procedure requiring specialist knowledge of eyelid anatomy, orbital fat compartments, and periocular support structures.

As an oculoplastic surgeon and eyelid specialist, Dr Swan Kang typically performs lower eyelid blepharoplasty through a carefully placed incision just beneath the lower eyelashes. This incision is designed to be discreet and follows the natural eyelid contour.

Through this approach, she can:

• Reduce or reposition lower eyelid fat ("eye bags")
• Address excess or lax lower eyelid skin
• Improve the eyelid–cheek junction
• Preserve eyelid support and long-term function

The goal is always a natural, refreshed appearance rather than an over-tightened or artificial result.

Transconjunctival Lower Eyelid Blepharoplasty

In selected younger patients with prominent hereditary eye bags but good skin elasticity, a transconjunctival approach may be recommended.

This technique places the incision on the inner surface of the lower eyelid, avoiding any external skin incision and leaving no visible scar. It is particularly suitable when the primary concern is fat prolapse rather than skin excess.

The surgical approach is tailored individually based on eyelid anatomy, skin quality, and ocular health.

Transcutaneous Lower Eyelid Blepharoplasty

In selected patients, a transcutaneous approach may be recommended for lower eyelid surgery. This technique involves a discreet incision placed just beneath the lower eyelashes, allowing direct access to both the skin and deeper fat compartments of the lower eyelid.

Through this approach, excess fat can be removed or repositioned, and lax or redundant skin can be carefully tightened to improve lower eyelid contour and reduce the appearance of under-eye bags and skin creasing.

The transcutaneous technique is particularly useful in patients with:

• Prominent skin excess or lower eyelid laxity
• Age-related descent of the lower eyelid–cheek junction
• Combined skin and fat prolapse contributing to under-eye hollowing or bags

Combined Lower Eyelid Surgery and Mid-Face Lift

In appropriate cases, lower eyelid blepharoplasty can be combined with a mid-face lift to achieve a more comprehensive rejuvenation of the lower eyelid and cheek region.

The mid-face lift addresses descent of the cheek fat pads, helping to restore volume and support to the lower eyelid–cheek junction. When performed alongside lower eyelid surgery, this can:

• Improve overall lower facial harmony
• Reduce hollowing and tear trough prominence
• Support the lower eyelid position and reduce tension on the eyelid
• Enhance long-term aesthetic stability

This combined approach is carefully tailored and is typically reserved for patients where mid-face descent significantly contributes to lower eyelid ageing changes.

As with all eyelid surgery, the choice of technique is individualised based on eyelid anatomy, facial structure, skin quality, and ocular health.

Recovery After Lower Eyelid Surgery

Following lower eyelid blepharoplasty, antibiotic ointment is applied to support healing and reduce the risk of infection. Patients are typically advised on a short course of postoperative ointment use.

Cold compresses and protective dressings may be used in the immediate postoperative period to help reduce swelling and bruising and support a smooth recovery.

Specialist Eyelid Surgery in Central London

Choosing an experienced Consultant Oculoplastic Surgeon is essential for eyelid surgery, as the eyelids play a vital role in both appearance and ocular protection.

Dr Swan Kang is a Consultant Oculoplastic Surgeon at Moorfields Eye Hospital, specialising in:

• Lower eyelid blepharoplasty
• Upper eyelid blepharoplasty
• Ptosis (droopy eyelid) correction
• Ectropion and entropion repair
• Eyelid reconstruction
• Chalazion and eyelid lump surgery

Her dual expertise in NHS tertiary referral practice at Moorfields Eye Hospital and private eyelid surgery in Central London ensures a high level of subspecialist care for both functional and aesthetic eyelid conditions.