Welcome to our guide to lower eyelid blepharoplasty! As an expert oculoplastic surgeon specialising in aesthetic eye surgery, Dr Koutroumanos was asked to outline the different types of lower eyelid blepharoplasty procedures.

We aim to explain the various techniques – transcutaneous, transconjunctival, fat subtraction, and fat redistribution – in simple terms, so you can make an informed decision about the best option for your needs.

Our Expert Team

By choosing our clinic, you are entrusting yourself to a team of dedicated professionals who focus on achieving natural outcomes in aesthetic eye surgery.

We understand that your appearance matters to you, and our goal is to help you achieve a refreshed and rejuvenated look while maintaining the natural beauty of your eyes.

The two cornerstones of our work are:  (1) Absolutely no signs of surgery and (2) Quick and seamless recovery.

Understanding Lower Eyelid Blepharoplasty

Lower eyelid blepharoplasty is a surgical procedure aimed at improving the appearance of the lower eyelids. As we age, the delicate skin and supportive tissues around the eyes can weaken, leading to drooping, puffiness, and wrinkles.

Lower blepharoplasty can address these concerns, giving your eyes a more youthful and vibrant appearance.

Types of Lower Eyelid Blepharoplasty

1. Transcutaneous Lower Eyelid Blepharoplasty:

Transcutaneous blepharoplasty is the traditional approach to lower eyelid surgery. In this technique, a discreet incision is made just below the lash line.

Through this incision, excess skin and fat can be removed, and the tissues can be tightened. This procedure allows for precise and when needed, extensive correction of the lower eyelids.

The incision line will disappear without 3 weeks leaving no visible signs of a scar.

2. Transconjunctival Lower Eyelid Blepharoplasty:

Transconjunctival blepharoplasty is a more modern approach that involves making an incision inside the lower eyelid, so there are no visible external lines from day one. It is Dr Koutroumanos technique of choice for patients in the younger end of the spectrum.

This technique is primarily used to address puffiness caused by excess fat deposits. By accessing the fat through the inner lining of the eyelid, the surgeon can remove or reposition the fat, resulting in a smoother, more youthful appearance.

3. Fat Subtraction Lower Blepharoplasty:

Fat subtraction lower blepharoplasty is a technique that focuses on the removal of excess fat deposits without the need for significant skin excision.

This method is suitable for patients with good skin elasticity but have bulging fat pockets under their eyes.

The fat is gently extracted, leading to a smoother contour of the lower eyelids.

4. Fat Redistribution Lower Blepharoplasty:

Fat redistribution lower blepharoplasty is an advanced technique that aims to reposition the fat deposits rather than removing them.

The surgeon redistributes the fat to fill in hollow areas and create a natural, harmonious transition between the lower eyelid and the cheek. This method can address both puffiness and under-eye hollows.

Both 3 and 4 can be carried out through the transconjunctival or the transcutaneous approach.

Choosing the Right Technique

During your consultation, Dr Koutroumanos will assess your unique facial anatomy, concerns, and desired outcomes to recommend the most suitable technique for you.

Factors such as skin elasticity, fat distribution, and the presence of under-eye hollows will guide the decision-making process.

The Lower Eyelid Blepharoplasty Procedure in Detail

Lower eyelid blepharoplasty is typically performed under local anesthaesia with sedation or general anesthaesia, depending on your preference and the extent of the surgery.

The procedure usually takes 1 to 2 hours, and you can return home the same day.

Recovery and Results of a Lower Eyelid Blepharoplasty

After the surgery, you may experience mild swelling and bruising, which will gradually subside over the following 2 weeks, sometimes faster.

It is important to follow the post-operative care instructions provided by our team to ensure optimal healing.

Results will vary depending on the chosen technique and individual factors but can generally be seen within a few weeks, revealing a more youthful and refreshed appearance.

I had a low blepharoplasty in June and Dr Koutroumanos did a fantastic job. I am a professional career woman and only have limited time. Dr Koutroumanos achieved the impossible. He and his office not only accommodated my busy schedule but the result was amazing. I was able to meet friends after only 9 days without anyone can tell. Yet, my colleagues who I haven’t seen for more than 20 years said that I have not changed and look beaming! I will most definitely always recommend him.

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Choosing Our Expert Team

When you choose our clinic, you are placing yourself in the hands of a highly skilled and experienced team who deal exclusively with eye and eyelid surgery day after day. Our focus on natural outcomes means that we prioritise your unique features and aim to enhance your appearance while maintaining the natural beauty of your eyes. We are committed to your safety, satisfaction, and long-term well-being.

Contact us today to schedule a consultation with our expert oculoplastic surgeon and discover how lower eyelid blepharoplasty can help you achieve your desired aesthetic goals. Our team in London, UK, is ready to provide you with the care and expertise you deserve.

Book Your Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos:

This guide is designed to provide you with a clear understanding of Meibomian Gland Dysfunction (MGD), the various types of blepharitis, chalazion, and stye. As an oculoplastic surgeon and eyelid expert, Dr Koutroumanos is dedicated to your eye health and offers expertise in seamless removal of all types of eyelid lesions, as well as the medical management of blepharitis. This comprehensive document will equip you with the knowledge needed to make informed decisions about your eye care.

Understanding Meibomian Gland Dysfunction (MGD)

Meibomian glands are small oil-producing glands located within the eyelids. MGD occurs when these glands become obstructed or dysfunctional, resulting in an insufficient release of oils onto the surface of the eyes. This can lead to dry eyes, discomfort, and other related issues. MGD is closely associated with the development of chalazion and stye.

Types of Blepharitis

Blepharitis is a common condition that causes inflammation of the eyelids. There are two main types: a. Anterior Blepharitis: This occurs at the base of the eyelashes, often due to bacterial infections or skin conditions. b. Posterior Blepharitis: This affects the inner eyelid, primarily due to Meibomian gland dysfunction.


A chalazion is a localised swelling or bump on the eyelid caused by a blockage of one of the Meibomian glands. This blockage leads to the buildup of oils, resulting in inflammation. Chalazion is often painless but can cause cosmetic concerns and occasionally affect vision if it grows large.

Stye (Hordeolum)

A stye is an acute infection or inflammation of the eyelid, typically affecting the glands at the base of the eyelashes. Styes are usually painful, red, and appear as a small pimple or boil on the eyelid. They can be caused by bacteria entering the glands or by blockages in the oil-secreting glands.

Symptoms and Signs

Common symptoms of MGD, blepharitis, chalazion, and stye may include:

  • Dryness, itching, or burning sensation in the eyes
  • Redness and swelling of the eyelids
  • Crusting or flaking along the lash line
  • Sensitivity to light
  • Watery or sticky discharge
  • Blurred vision or fluctuating vision quality
  • Presence of a painless bump (chalazion) or a painful red lump (stye)

Treatment Options

Medical: Applying a warm compress to the affected area can help open blocked glands, promote oil flow, and alleviate symptoms.

Lid Hygiene: Regular eyelid hygiene using prescribed cleansers can remove debris and bacteria from the eyelid margins.

Antibiotics: In cases of bacterial infection, oral or topical antibiotics may be prescribed to treat styes.

Steroid-Containing Ointments: Your oculoplastic surgeon may prescribe steroid-containing ointments to reduce inflammation and promote healing in certain cases of chalazion and blepharitis.

Surgical Options:

  • Incision and Curettage: For persistent or large chalazia, a minor surgical procedure called incision and curettage may be performed. Dr Koutroumanos, our eyelid expert, is highly skilled in performing this procedure. It involves making a small incision and removing the contents of the chalazion. The procedure is typically performed under local anesthesia and is generally well-tolerated.
  • Stye Drainage: If a stye does not resolve with conservative measures, your oculoplastic surgeon may perform a small incision to drain the abscess and alleviate symptoms.

Eye Drops and Ointments:

  • Artificial Tears: Lubricating eye drops can provide temporary relief from dryness and discomfort associated with MGD, blepharitis, chalazion, and stye.
  • Antibiotic Ointments: In certain cases, your doctor may prescribe antibiotic ointments to address bacterial infections and promote healing.
  • Steroid-Containing Ointments: To reduce inflammation and aid in healing, Dr. Koutroumanos may recommend steroid-containing ointments in specific cases.

Recovery Period and Expectations

Following a chalazion removal procedure, you can typically expect the following:

  • Minimal discomfort and swelling in the treated area, which usually resolves within a few days.
  • Use of prescribed antibiotic ointments or drops to prevent infection and aid in healing.
  • Instructions for post-operative care, including proper eyelid hygiene and the use of warm compresses as recommended by Dr Koutroumanos.
  • A follow-up appointment to monitor your healing progress and address any concerns.

We hope this guide has provided you with valuable insights into Meibomian Gland Dysfunction, the various types of blepharitis, chalazion, and stye. Led by Dr Koutroumanos, our clinic specialises in the diagnosis, seamless removal of all types of eyelid lesions, and medical management of blepharitis. We are committed to providing you with the best possible care and expertise. Please feel free to contact us to schedule an appointment or for any further questions you may have. Trust in our expertise, and let us guide you towards healthier and happier eyes. Check our reviews on site or at Top Doctors.

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Book a consultation with Dr Nick Koutroumanos to discuss your concerns:

Eyelid bumps can easily go away using home remedies. If the lump interferes with your vision, doesn’t respond to home treatment, or is too painful to bear, seek medical treatment. Understanding what causes eyelid bumps can also aid prevention and decision-making as some conditions may require eyelid surgery. Here’s an overview of eyelid bumps as well as the different types, symptoms, treatment, and prevention:

What Is An Eyelid Bump?

An eyelid bump is any painful lump at the edge of your upper or lower eyelid.

Some appear red and are located where the eyelash meets the eyelid. Bacteria and oil gland blockage are the common causes of most eyelid bumps, and the condition is generally harmless. You don’t necessarily require medical treatment as bumps can go away with basic home care. Other cases are severe and call for prompt medical care and diagnosis.

Types of Eyelid Bumps

Before considering treatment for your eyelid issue, you should know the type of bump. Understanding what kind it is and the underlying cause will determine your treatment options. All eyelid bumps can fall into these primary categories: styes, a chalazion, viral papilloma (warts), cysts (sebaceous and apocrine cysts), and xanthelasma.

  1. Styes: A stye occurs when bacteria penetrate the oil glands in your eyelids, Styes are common and round, with a red bump close to the eyelash. It can make you feel sore or itchy around the eyelid and increase sensitivity to light, resulting in teary eyes. A style requires a few days to form, and you can have more than one on the same eyelid.
  2. Chalazion: A chalazion is another common type of eyelid bump stemming from issues with the oil gland. It’s an inflammatory lesion that develops when your tear gland or oil-producing glands in the eyelids get blocked. A chalazion can grow to a bigger size than styes and is generally painless. The bump can, however, interfere with your vision, depending on its location and size.
  3. Viral Papilloma (Warts): Viral papilloma generally occurs in middle-aged or elderly adults. It is benign and painless and appears as a simple skin tag on the eyelid. Standard removal of this eye bump includes excision, where the doctor will surgically remove the wart from the eyelid.
  4. Sebaceous Cysts and Apocrine Cysts: Apocrine cysts are rare but benign cystic tumors of the apocrine sweat glands. These nodules may appear along the eyelid margin. Sebaceous cysts are also benign. Visit your doctor to assess the condition of your eyelid. They will determine whether you have eyelid cysts or a different kind of bump.
  5. Xanthelasma: This eyelid bump stems from fat buildup under the skin. Xanthelasma is generally harmless, yellowish, and occurs more in older people. Such eyelid bumps can also indicate high cholesterol levels. If xanthelasma interferes with your vision or becomes painful, consider medical treatment as this may suggest other issues, such as bacterial infection (stye).

Symptoms of Eyelid Bumps

Eyelid bumps manifest in different symptoms depending on the type. Most lumps are either red or the color of your skin and appear along the edge of the eyelid.

The bump may be tender or firm, and others result in watery eyes, gritty, scratchy sensations, and light sensitivity. Eyelid bumps can be mild or harmless, but you should seek medical attention if you experience the following:

  • Your eyes become teary/watery
  • There’s discharge from your eye
  • The white part of your eye changes color
  • The bump causes trouble seeing
  • Your eyes hurt in low lighting
  • The bump grows or gets extremely painful
  • You experience eyelid blistering and bleeding in the eyelid bump
  • Your eyelid becomes scaly, crusty, or reddish

What Causes Bumps on Eyelid?

Stye eyelid bumps occur when bacteria enter the oil glands in your eyelid, causing inflammation. Those with blepharitis and other eyelid inflammation conditions are more likely to get stye bumps. Chalazion bumps can form when the eyelid oil glands and tear glands are blocked. A style that fails to drain can become a chalazion. Xanthelasma bumps appear when fat collects below the skin surface and may indicate an underlying condition.

Preventing Eyelid Bumps

You can do various things to prevent developing eyelid bumps. Practicing good hygiene is essential in stopping the spread of bacteria and preventing stye eyelid bumps. Make sure you don’t touch your eyes until you’ve washed your hands. If you have blepharitis, rinse your eyelids at least once a day and use a warm compress as soon as you feel irritation. You can also keep xanthelasma bumps at bay by controlling cholesterol levels and eating healthy.

Eyelid Bumps Treatment

Not all eyelid bumps are avoidable or resolved without treatment. If you’re concerned about a stye or chalazion bump becoming bigger or more painful, consult a professional immediately. Some bumps resolve with common home remedies, but others may require advanced procedures like eyelid surgery to restore normal function. Here’s a look at popular treatment options for eyelid bumps:

Home Care
A warm compress is a popular home care treatment for eyelid bumps. Holding a warm compress for about ten minutes up to four times a day can help loosen and drain blockages in the glands. Heat and compression can also aid healing, but these homecare practices aren’t required for xanthelasma.

Medical Care
If the eyelid bump doesn’t respond to warm compress and routine hygiene, you should involve a medic. The eye is a delicate organ and requires experienced ophthalmologists and eye surgeons to correct. Your doctor will determine whether the bump needs puncturing, draining, antibiotic cream and drops, or eyelid surgery.

Do I Need Eyelid Surgery?

Bumps, such as a large chalazion that doesn’t go away on its own, may require surgery. Eyelid surgery will remove the bump and treat the wound to protect your eye from infection. Surgery can also correct fluid drainage and blockage issues. Dr Nick Koutroumanos specialises in the eyelid, eye socket, and peri-ocular surgery.

Book Your Consultation

Concerned about your eye health? Book a consultation with Dr Nick Koutroumanos:

Eyelid surgery is a big undertaking, and there are many questions to ask your oculoplastic surgeon during consultation. The best approach is to prepare a list of questions about everything you need to know about the procedure. After consultation, you should feel ready and adequately informed to decide. Here are four sets of questions to ask during your oculoplastic consultation:

1. Questions About the Oculoplastic Surgeon

Oculoplastic surgeons specialise in performing functional and cosmetic eyelid and facial area surgeries. The eyelid, eye socket and surrounding structures are very delicate and require precision. You need a reputable, trustworthy surgeon with the proper training, experience and skill for the procedure. Ask these questions during the first consultation:

  • Which institution did you attend for medical school, residency training and fellowship training program?
  • Do you perform specific eyelid surgeries (blepharoplasty, peri-ocular surgeries, ophthalmologic services, upper/lower eyelid)?
  • How long have you performed surgeries, and how many procedures have you completed?
  • Do you have a license from the state to perform eyelid surgeries? Are you board certified?
  • Does your surgical facility have a verifiable accreditation from a national/state-recognised accrediting agency?
  • Do you have verifiable references and testimonials from your past eyelid surgeries?
  •  What is your success rate with patients like me?

Asking questions about the surgeon will help you identify skilled, experienced professionals with a license and board certification. It also helps to build trust between you and the surgeon to focus on getting ready for the procedure. The goal is to find top eyelid surgeons and clinics in your area.

2. Questions About the Surgical Procedure

Undergoing a surgical operation comes with concerns, and you also have specific objectives you want to achieve with the procedure. The consultation offers the best opportunity to learn the ins and outs of the operation, including whether you are the right candidate. Here are some questions to ask your oculoplastic surgeon about the procedure:

  • Am I a good candidate for eyelid surgery?
  • What does surgery accomplish? Are my goals reasonable?
  • Where will the surgery take place?
  • Which anesthesia is used in the procedure?
  • What steps are involved/what happens during the surgery? How long will it take?
  • Are there any side effects, risks or complications? How do you handle such situations?
  • How long until I’m discharged from the hospital/clinic?
  • Will I have scarring? How long will it take to heal?
  • What can I do to enhance the results of the procedure?
  • What options do I have if the outcomes don’t meet my expectations?

Questions about the procedure will provide informative answers to determine if you want to follow through or find other solutions. It’s crucial to ask everything you need to know to be comfortable. These questions will also help you understand the limitations and set realistic goals.

3. Questions About Required Preparations

Your surgeon will recommend a few changes in your lifestyle and daily activities to prepare for the procedure. It’s vital to follow all instructions for pre and post-surgery to enhance the outcome and speed healing. You should ask the surgeon all kinds of questions to help you get ready for the operation. Here are some top inquiries:

  • For how long should I stop smoking before the procedure?
  • What medications, supplements or vitamins should I stop taking? How long in advance do I stop taking them?
  • Can I eat, drink and take a shower on the morning of my surgery? Are there any specific outfits I should avoid or wear to the clinic?
  • How do I prepare for the day of my surgery? At what time should I arrive at the clinic?

You shouldn’t rush oculoplastic surgeries. A consultation will help you plan for the day of surgery and adjust your lifestyle to be in the best shape and health for the procedure. Good preparation is critical for successful eyelid operation and faster recovery. You should be open and honest with the surgeon about your lifestyle and daily activities.

4. Questions About Post-Procedure Recovery

Plastic and oculoplastic surgeries can leave you incapable of performing your daily activities. In the case of eyelid surgery, you’ll experience discomfort, swelling, double vision and other symptoms. Arranging for someone to pick you from the surgery facility and stay with you for the night of the procedure is vital.

You need to review the following questions in advance to plan for your operation:

  • When do I go home after the procedure?
  • How will I feel immediately after surgery?
  • How long will my recovery take?
  • Do I need special medication for recovery?
  • Will I need prescribed painkillers?
  • How soon can I resume regular activities (washing my face, wearing makeup, going out in public, exercising, driving or going to work)?
  • Do I need special gear like an eye patch or glasses?
  • When should I come back for a follow-up visit?
  • How do I minimise the chances of a complication or scarring?
  • Who do I contact in case of a complication or emergency?
  • What limitations should I be aware of during recovery?
  • Can I maintain long-term results? How?

Eyelid Surgery with Dr Nick Koutroumanos: Your Solution to Rejuvenated Eyes

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is an expert in ophthalmic plastic and reconstructive eyelid surgery including upper and lower blepharoplasty.

Book Your Oculoplastic Consultation

Ready to explore how eyelid surgery can enhance and rejuvenate? Book a consultation with Dr Nick Koutroumanos: