What is lower blepharoplasty with a tear trough implant and fat re-draping?

It is a lower eyelid surgery that smooths the lid–cheek junction. Under-eye bags are addressed and a contoured tear trough implant supports the hollow, while existing orbital fat is carefully repositioned (re-draped) to blend the transition instead of removing fat aggressively.

Who is a good candidate for this combined approach?

Patients with true under-eye bags plus a distinct tear trough groove (hollow) and a sharp lid–cheek junction are typical candidates—especially when fillers no longer give smooth, durable results.

How does fat re-draping differ from fat removal?

Instead of excising fat (which can look hollow), the surgeon repositions your own fat to fill the trough and blend contours. This preserves volume for a more natural, long-term result.

What does the tear trough implant do?

The implant provides subtle, stable support under the inner lower eyelid–upper cheek groove, reducing shadowing and improving the transition where a structural hollow exists.

Where are the incisions for lower blepharoplasty?

Bags are often accessed through a hidden inner-lid (transconjunctival) incision. If skin tightening is needed, a fine subciliary skin incision just below the lashes may be added. Implant placement is performed through these same access points.

How does this compare with fillers or fat grafting?

Fillers can camouflage mild hollows but may be temporary or look puffy in some patients. Fat grafting adds volume but is technique- and take-rate-dependent. Surgery with re-draping and an implant offers structural, longer-lasting smoothing when bags and a deep trough coexist.

What is recovery like?

Expect bruising and swelling for 1–2 weeks, with continued refinement over several additional weeks. Cold compresses, head elevation, lubrication, and activity restrictions are used early on per your surgeon’s instructions.

Potential risks include bruising, swelling, asymmetry, contour irregularities, visible or palpable implant edges, infection, prolonged edema, dry-eye symptoms, and rare lid malposition. Careful planning and aftercare reduce these risks.

Will the result look natural?

That is the goal. By preserving and repositioning your own fat and using a conservative implant for support, the lid–cheek junction is blended for a rested, non-hollow look rather than an over-resected appearance.

Can the implant be adjusted or removed later if needed?

Yes. If contour or comfort is not ideal, the implant can often be revised or removed. Discuss revision policies and expectations with your surgeon during consultation.

How long do results last?

Surgical contour improvements are long-lasting. Normal aging continues, but most patients enjoy many years of smoother under-eyes compared with temporary filler-based approaches.

What should I discuss at consultation?

Confirm candidacy (bags + trough depth), incision plan, need for skin tightening or resurfacing, implant choice/size, expected recovery timeline, risk minimization, and alternatives such as filler or fat grafting.

Case Study: Lower Blepharoplasty Transformation

Procedure	Lower Blepharoplasty (Eyelid) With Tear-Trough Implant and Fat Re-draping
Location	Austin, TX
Procedure Length	45 minutes
Anesthesia	IV Sedation
Cost	$$
Down Time	1 day in public with sunglasses, 10 days without
Longevity	Lifetime
Risks	Numbness, Asymmetry, Eye Injury, Infection
Benefits	Happier, Rested, Younger Appearance
Alternatives	Injectable Filler (Restylane), Fat Transfer, Nothing
Problems Cured	Hollowing and Dark Circles Under Eyes
Procedure Performed By	Louis W. Apostolakis, MD, Board Certified Facial Plastic Surgeon
Commonly Combined Procedures	Upper Blepharoplasty (Eyelids), Facelift, Browlift, Skin Resurfacing

Notes:
The lower eyelid cheek junction, known as the tear-trough, is a common area of dissatisfaction. The appearance of dark circles is in large part due to shadows cast into this depression. The sunken area creates a tired, unhappy appearance. The condition often exists in young and old, but younger people with an otherwise brighter appearance tend not to notice it as much. It is a result of deficient skeletal support and overlying sunken soft tissue which may worsen with age.

Categories Cosmetic Surgery, Facial Plastic Surgery

CASE STUDY – LOWER BLEPHAROPLASTY (EYELID) WITH TEAR-TROUGH IMPLANT AND FAT RE-DRAPING

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