Method 2: Transcutaneous Lower Blepharoplasty (with skin removal)
This surgery is usually reserved for individuals in their fifties to sixties where excess skin of the eyebags is coupled with significant laxity. The procedure involves removing a strip of skin just below the lower eyelash margin. As with most invasive procedures, there is a longer down time in terms of healing and the need to remove stitches. However, the results can be very dramatic if it is performed with a mid face lift in the same setting. Wrinkle lines below the lower eyelid are usually reduced significantly. The procedure is usually performed under intravenous or general sedation.
A classic case of significant eyebags (fat pads) with potential skin laxity requiring skin removal
Picture from Dr Meronk
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| 1. Incision line marked | 2. Incision through skin | 3. Muscle buttonholed |
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| 4. Muscle opened | 5. Orbital septum identified | 6. Skin-muscle flap created |
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| 7. Orbital fat visualized | 8. Temporal fat pad exposed | 9. Temporal fat trimmed |
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| 10. Middle fat pad exposed | 11. Middle fat pad trimmed | 12. Nasal fat pad exposed |
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| 13. Excess fat gone | 14. Excess skin marked | 15. Excess skin trimmed |
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| 16. Tissue removal complete | 17. Wound sutured | 18. Final result |
Surgery performed by Frank Meronk, Jr., M.D.