Eyelid
Lower eyelid (eye-bag) surgery to reduce herniated fat and crepey skin — transconjunctival or transcutaneous, often with fat repositioning.
Medically reviewed by Ronald W. Kristan, MD, FACSOculoplastic SurgeonLast updated June 2026
Part of our complete guide to Blepharoplasty (Eyelid Surgery) — this page covers lower eyelid blepharoplasty in depth.
Lower eyelid blepharoplasty (lower eyelid surgery, often called “eye-bag” surgery) reduces the puffy bags and crepey skin of the lower lid that result from orbital fat pushing forward as the supporting tissues and skin lose their elasticity. It is most often performed for cosmetic rejuvenation, though it also has functional and reconstructive applications, restoring a smoother, less tired lower-lid contour.
Two routes are used, chosen according to how much skin excess is present:
Rather than simply removing orbital fat, modern technique often repositions it — draping it over the orbital rim to fill the hollow of the tear trough. This produces a smoother lid-cheek junction and a more natural, less hollowed result than excision alone. Lower blepharoplasty can be combined with fat repositioning or transfer to restore lost volume — see Fat Transfer & Repositioning.
Lower eyelid surgery suits people bothered by:
Because the lower lid is delicate, candidacy hinges on lid tone: pre-existing laxity raises the risk of the lid pulling down after surgery, so a snap-back/distraction test is part of the evaluation and a tightening step (canthopexy or, for greater laxity, canthoplasty) may be planned. Pre-existing dry eye is also assessed beforehand.
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Swelling and bruising of the lower lid and cheek are expected for 1–2 weeks. The most important specific risk is lower-lid malposition (retraction or ectropion), which is why tension-free technique and careful patient selection matter; pre-existing lid laxity may call for a tightening procedure (canthopexy) at the same time. Temporary dry eye and chemosis (conjunctival swelling) can also occur. Very rarely, bleeding behind the eye (retrobulbar hemorrhage) can threaten vision and requires urgent evaluation if you develop sudden severe pain, bulging, or loss of vision. For the full timeline, see Blepharoplasty Recovery.
To address the upper lids at the same time, see Upper Eyelid Blepharoplasty, or treat all four lids together with Four-Lid Blepharoplasty.
Lower blepharoplasty is the surgical option in our complete guide to under-eye bags.
Schedule a consultation with Ronald W. Kristan, MD, FACS to learn if this procedure is right for you.
