A couple of special things about lower lid Blepharoplasty or lower lid lifts. There's a couple other things that can be done. Typically, it's an incision just under the lash line and it curves out at the side. We take a little bit of skin, sometimes a little bit of the muscle. If the muscles thicken in guys in the summer, a lot of squinting it can get thick, and sometimes a little bit of fat if that lower lid has some bulging fat. Try and smooth it out and make it nice.
In some people, we'll go through the inner part of the eye and just take out a little bit of fat, with or without a little bit of lasering to the lower lid to tighten up some wrinkled skin. So it's without a scar on the outside and it's not painful. It heals up very quickly. It's a nice way to do it.
Finally, there is the occasional patient we actually put a small silicone implant along the lower orbital rim, and we use a Flowers implant made by Doctor Flowers or invented by Doctor Flowers in Hawaii. It's very nice for somebody who says “I've had bags under my eyes since I was 13.”
And typically this is not an aging problem. This is because the orbital rim is a little too shallow, a little bit too deep. The fat of the lower eyelid hangs out. It's been that way their whole life and it's a very nice operation for that problem.
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