Lower Eyelid Surgery (Lower Blepharoplasty)

Lower eyelid surgery at Klinika Kasiopea removes the excess skin and herniated fat pads responsible for under-eye bags, deep tear-trough shadows and lower-lid wrinkles that make the eyes look tired regardless of how rested a person actually feels. The procedure takes 80–90 minutes under local anaesthesia, with patients awake throughout and leaving the clinic the same day. The surgical incision is placed immediately below the lower lash line — a position where the resulting scar heals imperceptibly within the natural skin texture. Lower blepharoplasty is frequently performed alongside upper eyelid surgery as a comprehensive periocular rejuvenation.

Lower eyelid blepharoplasty addresses the anatomical changes in the lower periorbital region that accompany ageing: skin laxity, accumulation of excess lower-lid skin, and prolapse of the orbital fat pads through the weakened orbital septum. These fat pads — the medial, central and lateral compartments — create the characteristic rounded bulges known as under-eye bags. In many patients, a concurrent shadow forms in the tear-trough groove between the bag and the cheek, deepening the tired appearance. At Klinika Kasiopea, lower blepharoplasty is performed under local anaesthesia with the patient fully awake. The operative approach — transcutaneous or transconjunctival — is selected based on how much skin removal is required. In younger patients with minimal skin excess where the primary issue is fat prolapse, a transconjunctival approach (incision inside the eyelid, leaving no external scar) may be preferred. In patients with excess lower-lid skin, the transcutaneous approach places an incision directly below the lower lash margin. The procedure takes 80–90 minutes. Fat pads are repositioned or partially removed to flatten the bag contour, and excess lower-lid skin is conservatively excised — the surgeon intentionally leaves a small skin reserve to prevent the lower lid from being pulled outward (ectropion), a known complication of over-aggressive skin removal. Fine sutures close the incision and are removed at the clinic approximately one week post-operatively. Post-operative care mirrors that for upper eyelid surgery: elevated head position, cold gel compresses, avoidance of eye strain and screen use for three days, no makeup during healing, and deferral of saunas, swimming and strenuous activity for four weeks. In some patients, initial tightness and minor lid position changes normalise over two to four weeks as swelling resolves. Patients aged 40 and above are the primary beneficiaries. Lower blepharoplasty is commonly combined with upper eyelid surgery (together 29,000 CZK), and occasionally with injectable tear-trough correction using hyaluronic acid filler for patients who have both structural excess and volume deficit in the orbital rim region.