The development of bags under the eyes are very common with age. The weakening of the muscles and tissues in this delicate area, combined with loss of elasticity and migrating fat, creates a puffy look that many individuals dislike.
Dr. Jill Hessler addresses this issue with a lower blepharoplasty, which corrects under-eye bags and pockets of fat beneath the eye.
Lower blepharoplasty is primarily used to address under-eye bags and pockets of fat beneath the eye that give the face an aged, sad, tired appearance.
Lower blepharoplasty takes about one hour, and is performed with local anesthesia and a varying degree of sedation, depending on patient comfort.
If only fat needs to be removed from the lower eyelids, Dr. Hessler uses a hidden incision called a “transconjunctival blepharoplasty”. This incision is placed on the non-visible pink part of the eyelid called the conjunctiva, and then the fat pocket is either removed or re-distributed. This is called a “fat mobilization blepharoplasty”. If Dr. Hessler removes fat during your blepharoplasty, a very conservative approach is used. She will remove the bulging fat only in order to maintain a soft contour around the bony edges of the orbital rim.
If you have skin that needs to be removed with your transconjunctival blepharoplasty, a “skin pinch” is performed for your lower eyelids. This removes the desired amount of skin through an incision that is made just a few millimeters below the lower eyelid lash line. The thin lower eyelid skin generally heals very well, making the incisions barely visible.
Often, the lower eyelids do not need to have fat removed but instead need to have volume replaced if the eyes have a sunken or hollow appearance. The volume replacement can be achieved with tear trough injections, which are temporary dermal fillers such as Juvederm®, Restylane®, Perlane®, Evolence®, or Radiesse®. Tear trough injection results generally last between nine months and a year.
If you need volume under the eyes and prefer a longer-lasting alternative, a fat transfer can be done using extra fat from your own body (typically from the abdomen or thighs). Fat transfer is done by removing the extra fat via liposuction, purifying the fat cells, and then injecting small amounts of that fat where the lost volume is. Fat transfer can lead to very long-lasting results.
At Hessler Plastic Surgery, Dr. Jill Hessler performs all consultations and procedures herself. She will take into consideration such factors as your overall health, skin condition, and personal aesthetic preferences when creating your unique treatment plan. As the best lower blepharoplasty surgeon in Palo Alto, San Jose, and the Bay Area, Dr. Hessler will take exceptionally good care of you during your entire journey, from your initial consultation to your final follow-up appointment. Blepharoplasty is one of our top procedures, and is also one of Dr. Jill Hessler’s areas of focus. She is an award-winning, double board-certified facial plastic surgeon who is a leader in her field, currently serving as Chair of the Women on the Facial Plastic Surgery committee at the American Academy of Facial Plastic and Reconstructive Surgery. Her team of nurses and staff take pride in their outstanding patient-centric service, and will be with you every step of the way. To learn more about lower blepharoplasty or to make an appointment, simply contact us.
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Dr. Jill Hessler recognized as a 2026 Castle Connolly Top Doctors honoree
