The Under-Eye, Redefined
Aging around the eyes often begins before the rest of the face shows signs of time. For many, it begins with puffiness, sagging, or dark circles beneath the eyes—changes that cannot be reversed with skincare alone. Lower blepharoplasty, also known as a lower eyelid lift, is a specialized procedure that treats these signs of aging by removing or repositioning fat, tightening the skin, and restoring the natural shape and tone of the lower eyelids.
At RENATA Facial Cosmetic Surgery in New York City, lower blepharoplasty is performed by Dr. Renata Khelemsky, a double board-certified and fellowship-trained facial cosmetic surgeon. Her signature approach combines precise surgical technique with a refined aesthetic sensibility, aiming to restore a rested, natural look. Choosing a board-certified specialist with experience in both cosmetic and reconstructive eyelid procedures is key to achieving a safe, beautiful, and individualized result.
Lower blepharoplasty, also known as a lower eyelid lift, is a type of cosmetic surgery that focuses on correcting issues in the lower eyelid, including excess skin, visible fat pads, and deep tear troughs that cast shadows and create “dark circles” beneath the eyes. These features can create a chronically tired appearance, even when one is well-rested. In younger patients, puffiness may be caused by an excess amount of lower eyelid fat and genetics rather than aging. In older individuals, changes in the skin, underlying muscles, and fat distribution contribute to under-eye bags and sagging.
Dr. Renata performs both traditional fat-excision as well as fat-preservation blepharoplasty, depending on the patient’s anatomy. In many cases, a fat-preserving approach is used. In either case, Dr. Renata’s signature approach to lower eyelid rejuvenation takes into consideration several layers of eyelid aging, including the skin, muscle, fat, and ligaments of the lower eyelid.
Multi-Layered Lower Blepharoplasty
In select cases, targeted fat removal is used to reduce prominent under-eye bags caused by bulging fat within the orbit, or eye compartment. Dr. Renata uses a transconjunctival approach—accessing the fat from the inside of the lower eyelid—which avoids external incisions and helps preserve the natural structure of the eyelid. This technique allows for precise sculpting while minimizing disruption to surrounding tissues. She takes a conservative approach, removing only the excess fat necessary to improve contour without creating a hollowed appearance. Each treatment plan is tailored to the individual to ensure a balanced and natural-looking result. Addressing the fat is the first layer of Dr. Renata’s multi-layered assessment and approach.
Rather than removing fat entirely, Dr. Renata often prefers repositioning lower eyelid fat to smooth the transition between the eyelid and cheek. Since fat is considered an asset in the aging face, preserving it helps prevent post-surgical hollowing—especially in patients with naturally low facial fat or small cheekbones. Using a transconjunctival approach, Dr. Renata accesses the fat from inside the eyelid, avoiding visible external incisions.
The fat is carefully shifted into a surgically created pocket, often over the tear trough, to soften its appearance and restore lost volume. This technique is particularly effective for patients with under-eye hollowness or midface volume loss, as well as for younger patients who have had suboptimal results with fillers, such as persistent swelling or irregular texture. Unlike fat grafting, which uses fat from other parts of the body and can lead to unpredictable results due to a lack of native blood supply, fat preservation maintains the fat’s natural connection—supporting better healing and more stable, natural-looking outcomes. Addressing the fat - either through removal or preservation - is the first layer of Dr. Renata’s multi-layered assessment and approach.
In some patients, lower eyelid aging involves not just fat prominence but also laxity of the skin and underlying muscle, leading to loose, folded, or heavily wrinkled skin beneath the eyes. In these cases, Dr. Renata may perform a skin-muscle lift to tighten and improve the lower eyelid’s structure. This technique addresses both the skin and muscle as a single layer, providing more comprehensive rejuvenation than fat correction alone.
A discreet incision is placed just beneath the lower lash line, healing well over time. This approach allows for the safe removal of excess lower eyelid skin, reducing the redundant folding seen at rest and during movement like smiling. Skin-muscle lifting is ideal for patients with moderate to advanced aging and is often paired with fat repositioning and CO₂ laser resurfacing for enhanced, natural-looking results. It forms the second and third layers of Dr. Renata’s surgical approach to lower eyelid rejuvenation.
Maintaining proper support of the outer corner of the eye (the canthus) is critical in lower eyelid surgery. Dr. Renata evaluates each patient’s anatomy to determine whether a canthopexy (a minimally invasive tightening of the existing tendon) or a canthoplasty (a more involved restructuring of the eyelid’s supporting tendon) is appropriate. Canthopexy is often used for mild laxity or as a preventative measure to maintain eyelid position, while canthoplasty is reserved for more significant laxity or in revision cases. Both techniques aim to protect the eye shape and prevent complications such as eyelid droop or malposition. Dr. Renata’s decision is guided by the patient’s unique eyelid tone, eye shape, and surgical goals, ensuring both safety and aesthetic balance. This marks the final and fourth layer of consideration in all of Dr. Renata’s surgical approaches to lower eyelid rejuvenation.
Lower eyelid surgery offers more than a cosmetic change—it helps patients look less tired and more like themselves. Many report that their appearance finally matches how they feel day-to-day. With the right surgical plan, this procedure can significantly improve visible signs of aging in the lower eyelid area and contribute to a more rested, alert look.
Key benefits of lower blepharoplasty include:
Many patients report improved self-esteem, particularly in social or professional settings where appearance plays a role in how they are perceived. For those who have tried make-up, tightening creams, and even dermal fillers with minimal success—or who wish to avoid repeated injections—surgical correction offers a more permanent and effective solution.
Lower blepharoplasty, or lower eyelid lift surgery, is appropriate for adults of many ages who are concerned with the appearance of their lower eyelids. While the procedure is often associated with aging, younger patients may also seek treatment for inherited overly-visible fat pockets or under-eye hollows that cause puffiness or deep shadows, respectively.
You may be a good candidate for lower eyelid surgery if you have concerns relating to:
As with most cosmetic procedures, candidates for lower eyelid surgery should be in good overall health and free of any conditions that could impair healing. It’s essential to refrain from smoking before and after surgery, as smoking can significantly affect recovery and surgical outcomes. Patients should also have realistic expectations—lower blepharoplasty can improve under-eye anatomy due to genetics or aging, but it won't completely change your overall facial structure or stop the natural aging process. A thorough consultation is important to determine whether the procedure is appropriate for your anatomy, goals, and lifestyle.
While lower eyelid blepharoplasty can significantly improve under-eye contours, it’s important to understand what the procedure does not address. In some cases, additional treatments may be recommended to meet your aesthetic goals more fully.
The Consultation Process
The first step is a thorough consultation with Dr. Renata in her New York City clinic. During this appointment, your facial and eyelid anatomy, medical history, and aesthetic goals will be discussed in depth. Detailed professional photographs are taken from multiple angles to assess eyelid position, skin quality, and fat distribution.
Dr. Renata will evaluate the multiple layers of your lower eyelids and explain how each contributes to your specific concerns and clinical presentation. She will carefully assess the fat, skin, muscle, and supporting ligaments to determine their condition and degree of aging. This thorough analysis helps guide whether fat preservation or removal is more appropriate for your anatomy. In most cases, fat repositioning is preferred over excision, as it allows for a smoother eyelid-cheek transition and supports longer-lasting, more natural-looking results.
A patient coordinator will facilitate the consultation, providing personalized assistance by gathering necessary information, addressing inquiries, and offering detailed cost estimates.
Before your surgery, you will have a comprehensive pre-operative appointment with Dr. Renata and her team. During this meeting, you will review and sign consent forms, go over prescriptions, and discuss both pre- and post-operative care instructions in detail. A personalized packet of printed information will be provided, ensuring you and your caregiver are fully prepared for the procedure and recovery.
In preparation for cosmetic facial surgery, patients are commonly asked to:
Precision in Practice
Lower blepharoplasty is an outpatient procedure performed under general anesthesia for patient safety and comfort. The surgery typically lasts one to two hours, depending on the complexity, and is often combined with upper eyelid lifts or full face rejuvenation surgeries, which may extend the procedure time.
Dr. Renata commonly uses a fat-repositioning technique to smooth the transition between the lower lid and cheek, helping avoid the hollow appearance caused by excessive fat removal or unfavorable baseline cheek anatomy. Incisions are usually made inside the eyelid (transconjunctival), ensuring no visible scarring while addressing puffiness and under-eye bags, making this approach ideal for younger patients.
For more advanced aging, when excess, sagging skin is present, an additional incision below the lash line may be required to remove crepey, sagging skin, lift the muscle layer, and tighten the ligaments contributing to lower eyelid drooping. This incision heals well within the natural skin folds and shadows created by the lower eyelid lashes.
The goal of any lower blepharoplasty surgery is to achieve a natural, refreshed look, avoiding an overdone appearance. Results begin to show almost immediately, although swelling and bruising will temporarily obscure the final outcome. Most patients see their true results within weeks, with full benefits becoming apparent after several months.
Lower Blepharoplasty Recovery
Recovery from lower blepharoplasty is typically associated with mild to minimal discomfort, which can be managed with over-the-counter pain relievers.
Swelling and bruising usually peak within the first 24–72 hours, gradually subsiding by the end of the first week. Cold compresses and sleeping with the head elevated are recommended to support the healing process. During recovery, patients may experience typical symptoms such as mild discomfort, eye sensitivity, and a temporary period of increased tearing. To promote healing, it’s important to minimize sun exposure, use lubricating eye care, and avoid strenuous activities.
Most patients can return to desk work and light social activities within 10 to 14 days. By two weeks, many are able to resume normal activities, though some may choose to wear sunglasses to conceal minor bruising and swelling. Strenuous exercise, contact lens use, and heavy lifting should be avoided for at least three to four weeks, depending on the complexity of the surgery. Each patient’s recovery is unique, and personalized instructions may be provided to ensure safety and optimal healing.
As a general guideline, we recommend scheduling facial cosmetic surgery at least three to four months in advance of any special event to ensure you’re well healed and looking your best. Long-term results continue to improve gradually over the first year of healing, with subtle refinements in shape and contour. In many cases, the benefits of lower blepharoplasty can last well over a decade.
Caring for Your Results
Any surgery involving a skin incision will result in some degree of scarring at the biological level. However, with attentive care and proper technique, these scars are typically managed so well that they become socially imperceptible—even from a conversational, lunch-table distance. The goal is for the incision to blend seamlessly into natural skin folds rather than appear obvious or raised. This process takes time, and final scar refinement may take up to one full year.
For patients with external skin incisions, Dr. Renata provides a customized scar care protocol that may include:
For patients undergoing transconjunctival blepharoplasty, where no skin incision is made, there are no visible scars to manage. Regardless of the technique, all patients receive a clear and supportive roadmap for healing, along with personalized follow-up care to ensure the best possible results.
We offer surgeon-based care focused on highlighting your unique beauty. Possessing a keen eye, gentle touch, and deft technical skill, Dr. Renata stays at the forefront of aesthetic medicine to bring you the highest level of care available, tailoring every service to your unique needs.
Our state-of-the-art facial aesthetic clinic is located in DUMBO, Brooklyn, in New York City. We cater to the local areas, including Downtown Brooklyn, Brooklyn Heights, Park Slope, Williamsburg, Long Island City, and Cobble Hill, as well as Manhattan and New York City at large. Patients can expect a premium experience in our luxury office setting, where attention to privacy and one-on-one care create a professionally tranquil and high-quality visit.
A double-board-certified facial cosmetic and reconstructive surgeon, Dr. Renata Khelemsky specializes in enhancing natural beauty. A Fellow of the American Academy of Cosmetic Surgery and diplomate of the American Board of Facial Cosmetic Surgery, her personalized approach begins with a comprehensive analysis of your facial features, ensuring each transformation celebrates your unique individuality.
Learn More About Dr. Renata
For those considering lower blepharoplasty in New York City, RENATA Facial Cosmetic Surgery offers personalized care and expert surgical technique to address under-eye bags, excess skin, and a tired or aged appearance. Our approach focuses on natural refinement—restoring a rested, smooth contour without altering your unique features. Lower eyelid surgery pricing varies based on individual anatomy and surgical complexity, so a private consultation is essential to determine your personalized plan. Schedule your consultation today to discover how lower blepharoplasty can help you look like a more refreshed, more vibrant version of yourself.
Dr. Renata determines whether fat should be repositioned or removed based on a thorough evaluation of your lower eyelid anatomy during consultation. She assesses the amount and position of fat, skin quality, muscle tone, and the integrity of supporting ligaments. In most cases, fat repositioning is preferred because it preserves volume and creates a smooth, natural transition between the lower eyelid and cheek. As the cheeks naturally descend with age, the under-eye area can appear hollow or shadowed—making preserved fat especially valuable for restoring a more youthful contour. However, if there is significant bulging or displaced fat that cannot be artistically redistributed, selective fat removal may be recommended. The ultimate goal is to achieve a rested, balanced appearance that harmonizes with the rest of your facial features.
Yes, lower blepharoplasty can improve the appearance of “tear troughs”. Many patients initially try dermal fillers or makeup to conceal the hollow ridge of the tear trough, but this can be challenging due to the presence of a strong ligament creating the depression. During lower blepharoplasty surgery, this anatomy is altered, and fat is repositioned into the tear trough area, softening the appearance of the under-eye hollow in a long-lasting way. Unlike fat grafting procedures, the repositioned fat has its own blood supply, making it more predictable in healing. Dr. Renata will assess your unique needs and customize the approach to achieve natural, rejuvenated results.
Yes, fat repositioning and fat grafting can sometimes be performed together with lower blepharoplasty. Fat grafting is typically used to address volume loss, often in the lower midface and lateral cheek area, especially in patients who have a recessive cheek or insufficient volume in the lateral face. Some surgeons prefer to combine fat grafting with lower eyelid fat-removal blepharoplasty, as this approach aligns with their preferred technique for achieving facial rejuvenation.
However, Dr. Renata’s approach prioritizes preserving as much of the natural fat in the lower eyelid as possible, as this often reduces the need for autologous fat from another part of the body. For full facial rejuvenation cases, fat grafting can complement the procedure by softening and balancing contours, particularly in the lower eyelid and upper cheek junction, creating a natural and harmonious result. Each surgeon brings their own expertise and preferred techniques, which is why a personalized consultation is essential to determine the best approach for your unique needs.
Lower eyelid surgery is typically performed under deep sedation, which is a form of general anesthesia. This ensures the patient remains completely still and comfortable during the procedure while having no recollection of the surgery. In some cases, when combined with other facial rejuvenation procedures, general anesthesia may be preferred, especially for more extensive surgeries. Dr. Renata will assess your medical history and specific treatment plan to determine the safest and most appropriate anesthesia option for your procedure.
As with any surgical procedure, lower blepharoplasty carries potential risks and complications. Common, temporary side effects include mild discomfort, mild smiling upward of the outer corner of the eye, swelling, and bruising, which typically resolve within one to two weeks. Rarely, more serious complications such as infection, bleeding, prolonged eye irritation, blurry vision, or impaired healing may arise, among others. To minimize these risks and achieve the best possible results, it is essential to choose a highly qualified and experienced facial cosmetic surgeon with extensive expertise in various types and complexities of eyelid surgery. A thorough consultation will help assess potential risks and ensure that the treatment plan is tailored to your specific needs and goals.
Swelling is a normal part of the healing process, but several strategies can reduce its severity and duration. Patients are advised to use cold compresses for the first 48-72 hours, sleep with their head elevated, and limit any exertional physical activity to maintain a normal blood pressure. Use of all recommended post-operative medications is essential to promote healing and comfort, which also will help lessen swelling. Dr. Renata also provides customized recovery protocols that may include specific ointments, oral supplements, and gentle lymphatic massage to encourage faster healing and minimize swelling.
Yes, many patients choose to combine upper and lower blepharoplasty to achieve a more comprehensive eye rejuvenation. When only one set of eyelids is treated, patients often notice and become concerned with the untreated lids, leading them to seek further enhancement. Combining both procedures helps create a harmonious, balanced result. Dr. Renata will evaluate your unique anatomy and goals during your consultation to determine the best approach for you.
To maintain the results of lower blepharoplasty, it’s essential to care for the delicate skin around the eyes and proactively manage the factors that contribute to aging. Regular use of neuromodulators (such as Botox) helps relax the muscles responsible for crow’s feet and dynamic wrinkling, minimizing repetitive motion that leads to skin laxity and fine lines. A high-quality skincare regimen—including nourishing ingredients, antioxidants, and daily SPF—is critical to protect against environmental damage and maintain healthy skin.
Ongoing maintenance treatments like microneedling, CO₂ laser resurfacing, and chemical peels can further stimulate collagen production and improve skin texture and elasticity. These non-surgical treatments enhance and extend your surgical results.
It’s also important to understand that all facial rejuvenation procedures are ultimately subject to the natural effects of aging and gravity. Over time—typically after 10 to 15 years—a secondary touch-up or refinement procedure may be desired to maintain your refreshed appearance.
The professional surgeon’s fee for a lower eyelid blepharoplasty in NYC typically ranges from $6,000 to $15,000. However, pricing can vary significantly due to factors such as the surgeon’s sub-specialty and fellowship training in facial aesthetic surgery, the complexity of the procedure, and the urban geographical location. These elements often contribute to higher costs.
It’s important to verify whether the quoted price includes anesthesia, facility fees, and post-operative care in addition to the surgeon’s fees. During your consultation, Dr. Renata and a dedicated patient care specialist will provide a detailed, personalized cost estimate based on your unique needs and overall surgical plan. While the investment may seem significant, the lasting, natural results typically make it a worthwhile decision. Some practices also offer financing options to make the procedure more accessible.
At RENATA Facial Cosmetic Surgery, we prioritize privacy. While many Before & After photos are featured on our social media channels, we understand not everyone wishes to share them publicly. To respect our patients’ unique preferences, we invite you to explore a more comprehensive Before & After gallery during your consultation in our office.
Life can be demanding, and we understand. For patients who may be traveling, preparing for a last-minute occasion, or simply looking for a more exclusive experience without any inconvenience or delays, we are pleased to offer preferred patient scheduling. Patients may undergo a personal consultation as well as tailored cosmetic treatments during evening hours or weekends. Appointments are required and premium rates apply. Please call our office to inquire about preferred patient scheduling and allow us to create an exceptional experience just for you.
Request a ConsultationAt RENATA Facial Cosmetic Surgery, patients receive excellent customer service, communication, personal attention, and scheduling flexibility. Located in the historical and breathtaking waterfront neighborhood of DUMBO, Brooklyn in New York City, our office serves local neighborhoods including Brooklyn Heights, Park Slope, Williamsburg, and Cobble Hill, as well as Manhattan and New York City at large.
Our office location is:
58 Prospect Street, Brooklyn, NY 11201
Monday - Friday: 8:30AM to 4:30PM Saturday (by appointment only): 9:30 to 2:30PM
