LOWER BLEPHAROPLASTY IN NYC
Refresh Your Eyes with Under-Eye Bag Surgery by Dr. Robert Schwarcz
If your under-eyes constantly look puffy, shadowed, or tired—even when you're well-rested—it’s not just in your head. This area is often the first part of the face to show signs of aging, stress, or genetics. As volume shifts and the skin loses its elasticity, what once gave a youthful look can begin to appear hollow, sagging, or swollen. For many patients, lower blepharoplasty in NYC offers a permanent and natural-looking solution when skincare and makeup no longer make a noticeable difference.
Dr. Robert Schwarcz is a board-certified oculofacial plastic surgeon with more than 20 years of experience performing eyelid surgery. He is known for his artistic, conservative approach, with results that appear refreshed—not artificial. Lower blepharoplasty is one of his most requested procedures and is performed in our private, JCAHO-certified surgical suite on the Upper East Side of Manhattan. Consultations and non-surgical appointments are also available at our Rye, NY location for patient convenience.
What Is Lower Blepharoplasty
Lower blepharoplasty, or lower eyelid surgery, is a cosmetic procedure that corrects fat herniation, loose skin, fine wrinkles, and volume loss under the eyes. It works by removing or repositioning fat pads, gently tightening skin, and—if needed—adjusting the underlying muscle structure. The goal is to soften the transition between your lower eyelid and cheek, which helps eliminate that “tired” or “overfilled” look and creates smoother, more youthful contours. Unlike dermal fillers or eye creams, which offer temporary or superficial improvement, lower blepharoplasty addresses the root structural changes causing puffiness and sagging.
Why Do Under-Eye Bags Form
Under-eye bags and hollowness can develop for a variety of reasons. Aging is one of the most common, as the supporting structures around the eyes weaken and fat begins to protrude or settle in unnatural ways. Skin also loses its firmness with age, revealing puffiness more easily. Genetics can be another driving factor; some individuals are predisposed to developing eye bags or dark shadows early in life. Lifestyle plays a role as well—lack of sleep, poor diet, chronic allergies, and fluid retention can all make under-eye puffiness worse. However, when fat displacement and skin laxity are present, surgery remains the most effective option for long-term correction.
Candidates for Lower Eyelid Surgery
The best candidates for lower blepharoplasty are those who feel that their under-eye appearance doesn't reflect how energetic or youthful they feel on the inside. If you're bothered by chronic puffiness, sagging skin, or a hollow, tired look that doesn’t improve with rest or skincare, this procedure may be the solution. Candidates should be generally healthy, free from serious eye conditions, and non-smokers or willing to stop smoking during the healing period. Dr. Schwarcz also emphasizes realistic expectations—this surgery is not meant to create a completely different face, but rather to bring balance back to your natural features.
During your consultation, Dr. Schwarcz will often refer to photos of you taken 10 to 15 years ago. These serve as a blueprint for your surgery, helping him understand how your face has aged over time so he can recreate your youthful contours rather than invent new ones.
When Lower Blepharoplasty Might Not Be Right for You
Some patients may not be ideal candidates for surgery. If you have uncontrolled health conditions such as high blood pressure, diabetes, or bleeding disorders, you may need medical clearance first. Active eye infections or ocular diseases like glaucoma and chronic dry eye can also increase the risk of complications. Pregnancy and breastfeeding are additional factors that typically postpone surgical treatment. Patients who are unwilling or unable to commit to the recovery period may be better suited for temporary, non-surgical treatments. Dr. Schwarcz will guide you toward the most appropriate and effective option based on your unique health and goals.
Surgical Techniques: Customized to Your Needs
Dr. Schwarcz uses two primary approaches for lower eyelid surgery: the transconjunctival approach and the subciliary approach. The transconjunctival method involves making an incision on the inside of the lower eyelid, which allows for fat removal or repositioning without leaving any visible scar. This technique is often ideal for younger patients with prominent puffiness but little skin laxity.
For patients with both puffiness and excess skin, the subciliary approach is typically used. This method involves a small incision just below the lash line, which gives access to both the fat pads and redundant skin. The scar fades well over time, blending seamlessly into the lower eyelid. In some cases, Dr. Schwarcz may combine both techniques to achieve optimal results. His focus is always on subtle enhancement and preservation of your natural eye shape and character.
Fat Repositioning vs. Fat Transfer
Modern blepharoplasty isn’t just about removing fat—it’s about redistributing it for a more natural, smooth result. Fat repositioning involves moving the orbital fat pads to areas where volume has been lost, such as the tear trough or upper cheek. This creates a more even transition between the lower eyelid and mid-face.
In contrast, fat transfer—or fat grafting—involves harvesting fat from another part of your body (typically the abdomen or thighs), purifying it, and injecting it into hollow areas of the face. While this is a separate procedure, it is often performed in conjunction with eyelid surgery to restore fullness to the cheeks, temples, or tear troughs. Dr. Schwarcz will determine the best option—or combination of techniques—based on your facial anatomy and goals.
How to Prepare for Lower Eyelid Surgery
Planning ahead is essential to ensure a smooth recovery. Dr. Schwarcz recommends stopping any blood-thinning medications or supplements (such as aspirin, ibuprofen, fish oil, and vitamin E) at least two weeks before surgery. Smoking should also be discontinued, as it significantly affects healing. Most patients schedule their surgery two to three months before any major life events to allow time for full recovery. You’ll need someone to drive you home afterward and assist you during the first 24 to 48 hours, especially if IV sedation is used. During your pre-op visit, you’ll review your personalized surgical plan and receive a full set of instructions for preparation and aftercare.
What to Expect on Surgery Day
The procedure is performed under IV sedation in our fully accredited surgical suite in Manhattan. Surgery typically takes between one and two hours. Once you’re comfortably sedated, Dr. Schwarcz will mark your eyelid contours and make precise incisions based on the surgical plan. Fat will be removed, repositioned, or combined with laser treatment if necessary, and skin will be trimmed or tightened depending on your anatomy.
After surgery, you’ll recover briefly in our post-op area and return home the same day with full aftercare instructions and a follow-up schedule. Dr. Schwarcz’s meticulous surgical technique minimizes trauma to surrounding tissue, which contributes to faster healing and smoother results.
Lower Eyelid Surgery Recovery
Recovery after lower blepharoplasty is usually smooth and manageable. Swelling and bruising typically peak within the first three days. During this time, it’s important to keep your head elevated and apply cold compresses as directed. Prescription medications will be provided to manage any discomfort. Sutures, if used, are usually removed by day six or seven. Most patients are able to resume light activity and work between 10 and 14 days after surgery, depending on how visible bruising or swelling remains.
Within two to three weeks, you should feel comfortable returning to social activities, especially with the help of makeup. Over the course of one to two months, the under-eye area will continue to settle, and contours will become smoother. Full healing typically occurs within three to six months, at which point the results appear fully refined and natural.
Results You Can Expect from Lower Blepharoplasty
Lower eyelid surgery offers long-lasting, highly satisfying results. You can expect smoother skin beneath the eyes, a significant reduction in puffiness or bags, and a more refreshed, youthful look that still feels like your face. Many patients report improved confidence and satisfaction in how they present themselves, both socially and professionally. The results often last for a decade or more, though the natural aging process will continue. Regular skincare, sun protection, and healthy habits can help prolong the effects of your surgery.
Complementary Procedures
To achieve the most balanced and harmonious rejuvenation, many patients choose to combine lower blepharoplasty with:
Alternative Treatments
If you're not ready for surgery or have only mild under-eye concerns, non-surgical alternatives may provide a temporary solution. Options include:
While these alternatives can deliver meaningful improvements, they are not substitutes for the long-term results that surgery can achieve.
Why Choose Dr. Robert Schwarcz?
With over two decades of experience focused exclusively on facial surgery, Dr. Robert Schwarcz is recognized for delivering natural results that enhance each patient’s unique beauty. He performs every procedure personally, never passing surgical work to an assistant or junior provider. His patients appreciate the one-on-one care, artistic sensibility, and clinical precision that define his approach. All surgeries take place in his Upper East Side Manhattan office’s JCAHO-accredited suite, and follow-ups can be arranged in either NYC or Rye, NY.
Ready to Look Refreshed?
Click the Request an Appointment button below to schedule your consultation and take the first step toward under-eye rejuvenation with results that look effortlessly natural.
bleph·a·ro·plas·ty ˈble-fə-rō-ˌpla-stē
If your under-eyes constantly make you look tired, even when you feel well-rested, you’re not alone. For many people, the under-eye area is one of the first places to show signs of aging, stress, and genetics. Puffy bags, dark circles, loose skin, or a hollowed-out appearance can disrupt the balance of your entire face. When concealer stops cutting it, and skincare products don’t make a dent, lower blepharoplasty in NYC may be the next step.
Lower blepharoplasty—often referred to as lower eyelid surgery or lower lid surgery—is a surgical procedure that targets the lower eyelid region to correct puffiness, sagging, excess skin, and fat displacement. Dr. Robert Schwarcz, a board-certified oculofacial plastic surgeon with more than 20 years of experience, performs this delicate surgery with an artistic, conservative approach to ensure results look smooth and completely natural. Whether you're seeking surgery for eye bags, dark circles, or loose skin under the eyes, Dr. Schwarcz tailors each treatment plan to your unique anatomy and goals.