Lower Eyelid Surgery in Langhorne, Bucks County, PA

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If you always look tired or you can't get rid of the puffy bags below your eyes, a lower eyelid lift, also known as a blepharoplasty, may help to refresh your appearance. In the lower lids, recontouring mainly involves finding a solution for the bulging fat causing the lower lids to look puffy and removing excess skin. There are a myriad of ways to accomplish this; the key is to customize the procedure for each patient’s unique anatomy and goals. Dr. Alan Brackup of Cosmetic Surgery Specialists in Langhorne, Bucks County, PA is a double board-certified oculofacial plastic surgeon. Dr. Brackup is both an ophthalmologist and oculoplastic surgeon, which gives him an advantage when working on the delicate skin around the eyes during lower eyelid surgery. During your consultation he will select the approach that works best for each patient's unique anatomy.

Surgical Technique

Most lower lid blepharoplasty patients are good candidates for a hidden incision inside the lower lids. This is called a transconjunctival approach, and allows the surgeon to sculpt the lower lid fat from the inside. This technique offers the advantages not only of an invisible, but also of decreasing the risk of postoperative eyelid drooping and rounding of contour. If skin tightening is necessary, Dr. Brackup can either make a fine incision under the lashes for skin removal, or use a laser to tighten the skin and remove wrinkles, without the need for any skin incision at all. Additional techniques are sometimes used to especially help the appearance of dark circles under the eyes.

Non-Surgical Enhancement

Similar to the upper eyelid surgery non-surgical options, for some individuals, nonsurgical eyelid rejuvenation is a better choice than an operative procedure. Factors such as individual anatomy, health, lifestyle, and finances may all lead one to this approach rather than surgery. Fortunately, we can often achieve astounding results using nonsurgical alternatives. There are multiple approaches we take, tailoring a treatment plan to each individual patient.


  • For many patients, the dark hollows under the eyes are their most objectionable concern. Here, we frequently use hyaluronic acid fillers to achieve immediate and dramatic improvement, with no downtime. We can also use your own fat for the longest lasting result. Don’t believe it? Check out our before and after gallery.

Botox and Dysport

  • Frequently, we will add Botox or Dysport around the eyelids and crow’s feet to soften lines. Either by themselves, or in concert with fillers, the results can be remarkable. A natural softening of the appearance of aging.

Laser Skin Resurfacing

  • The use of lasers has been an important addition to our armamentarium of nonsurgical eyelid enhancement over the past 20 years. The multiple lasers we use can achieve significant tightening of eyelid skin, with resultant improvement in wrinkles as well. A very high-tech solution to a difficult problem, again without any surgery involved.

During/After Surgery

Lower eyelid surgery is usually performed with the patient under monitored sedation at our accredited surgical facility. General anesthesia is not required. It takes approximately 1 hour to complete both lower lids or 1– 1.5 hours if an upper and lower eyelid lift are being combined. After surgery, patients should apply a cold compress or ice pack to their eyes to minimize swelling. Patients will need a few days before they return to their normal activities and should avoid strenuous activity like exercise until they are cleared. For the first few days, there may be swelling and discoloration around the area. It is advised that your head be elevated for the first couple of weeks. Although postoperative discomfort is typically minimal, pain medications will be prescribed post operatively. We will also provide you with a regimen of vitamins and supplements to take pre and post operatively to reduce the incidence of bruising and swelling.

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Lower Eyelid Surgery FAQs

Long Lasting Results?

The results of a lower eyelid lift are typically long lasting, but normal aging will continue to occur. While the lower eyelids will never be as bad as they were before eyelid surgery, gravity, sun exposure, and other factors will still gradually add signs of aging. Most patients only need a lower lid blepharoplasty once in their life, but a touch-up surgery or injectable fillers may be considered if the patient wants to refresh their results.

Wrinkles and Crow's Feet?

Crow’s feet may be better treated with a procedure such as a brow lift as the results of the eyelid surgery are mostly confined to the eyelids only. Eyelid surgery can also be combined with a nonsurgical procedure such as BOTOX®, which combats wrinkles around the eyes.

Upper and Lower Lifts?

It can be very beneficial to have both upper and lower eyelid lifts performed at the same time so Dr. Brackup can make all improvements at once to avoid multiple anesthesia charges and to create a more dramatic result.


Complications are rare, however there is little room for error. These procedures are often best performed by surgeons with specialized ophthalmology and plastic surgery training. Dr. Brackup has performed thousands of these procedures, and utilizes this experience to achieve your best possible outcome. You should adhere to care instructions prescribed by Dr. Brackup and staff to minimize any risks as the eyes can be sensitive after surgery. Patients must always take precaution of protecting the eyes from the sun during the first few weeks of recovery.

Goals of Eyelid Surgery?

A natural result is always our goal. We are looking for a smooth, youthful lower lid, without hollowing or changes in eyelid contour.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.