Lower Blepharoplasty
New Jersey

Before your lower blepharoplasty in New Jersey Dr. Ramesh will thoroughly examine the patient to determine if they are the ideal candidate for the procedure. The following are the significant examinations before lower eyelid surgery:

Medical history
Our medical history exams include eye dryness, current illness, ophthalmic medications, and latex or drug allergies, and the doctor will also discuss the patient’s expectations for the procedure.

Physical examination
With physical tests, we will check the current state of the eyelid, concentrating on the following areas:

• Ocular surface
• Blink strength and rate
• Presence of lagophthalmos (incomplete eyelid closure)
• Pupillary exam, visual acuity, and extraocular motility

Prior to surgery, Dr. Ramesh will use a surgical pen while you are seated upright to mark the hollow borders. He will then use a local anesthetic containing lidocaine to numb the area under operation.

There are two approaches to this surgery; transconjunctival and transcutaneous. The transconjunctival approach is ideal for almost every patient as it is safer and reduces the risk of postoperative changes to the eyelid shape (eyelid retraction or ectropion). During lower blepharoplasty in New Jersey, Dr. Ramesh makes an incision through the inside of the lower lid. This allows direct access to the three lower eyelid fat pads without interfering with the orbital septum and orbicularis oculi muscle. Dr. Ramesh removes the excess portion of these fat pads, and then either repositions the existing fat or transfers microscopic fat grafts from the abdomen, thighs, or flanks to address the hollowness at the tear trough.

He will then tighten the lower lids to restore the almond shape and prevent lower eyelid malposition. Finally, he will address the skin by either removing a small strip (“skin pinch”) through a hidden incision underneath the lashes (subciliary line), or by performing skin resurfacing with either a laser or a chemical peel. Dr. Ramesh does not routinely perform transcutaneous lower blepharoplasty as it is not necessary for an excellent cosmetic result and exposes you to unnecessary risks of eyelid retraction. After the treatment, he closes the incisions with absorbent catgut sutures or fine monofilaments.