Is a Lower Eyelid Surgery Painful?

Most patients are pleasantly surprised to find that discomfort after lower blepharoplasty is minimal. You may experience mild tightness, swelling, or tenderness around the eyes during the first few days, but significant pain is uncommon. Any mild discomfort after surgery can easily be managed with prescribed or over-the-counter medications, cold compresses, and rest.

How Many Appointments Will I Need?

You can expect a few visits for your lower eyelid surgery, beginning with your initial consultation and continuing through your post-operative care. Your follow-up appointments are essential for monitoring healing, removing sutures if needed, and ensuring that your results are developing as expected. If your case involves combination procedures or a more complex surgical plan, Dr. Harley may recommend additional follow-ups to support continued evaluation and recovery.

How Long Until I See Results?

While you’ll notice immediate improvement once swelling begins to subside, most patients see their final results at around two to three months post-surgery. Early swelling and bruising will fade significantly within the first two weeks, and over time, your results will continue to refine, offering long-lasting rejuvenation that can last 10 years or more, depending on lifestyle, genetics, and skincare. Many patients find that their eyes remain youthful and bright for well over a decade, making this one of the most rewarding facial rejuvenation procedures available.

Can I Combine a Lower Eyelid Surgery With Other Procedures?

Yes, combining lower eyelid surgery with other facial procedures can often enhance overall balance, which is why many patients choose to add upper eyelid surgery, a brow lift, or a facelift to smooth fine lines further and tighten surrounding tissue. Fat grafting is also very commonly added. Combining procedures can also streamline recovery time, allowing for more comprehensive results in a single surgical session.

What Are the Risks Associated With a Lower Eyelid Surgery?

Like all surgical procedures, lower eyelid surgery carries potential risks, including temporary swelling, bruising, dryness, or asymmetry. In rare cases, patients may experience delayed healing, minor irritation, or temporary sensitivity to light. However, these side effects are typically short-lived and manageable with proper aftercare.

Cashiers, North Carolina

Lower Eyelid Surgery

Introduction

Introduction to Lower Eyelid Lift Surgery
(Lower Blepharoplasty)

Puffiness, dark circles, and sagging skin beneath the eyes are among the most common signs of aging, and whether caused by genetics, volume loss, or the natural weakening of tissue over time, these changes can dramatically affect your appearance and self-confidence. Lower eyelid surgery, or lower blepharoplasty, offers a long-lasting solution by restoring smoothness and definition to the under-eye area. At our Cashiers, NC, office, which serves patients from Asheville, NC, and Greenville, SC, as well as across the country, Dr. David Harley can remove or reposition excess fat, tighten skin, and rejuvenate the lower eyelids for a brighter, more rested appearance that looks natural and balanced with the rest of your face.

What is a Lower Eyelid Surgery?

Lower eyelid surgery (lower blepharoplasty) is a delicate cosmetic procedure that corrects under-eye bags, puffiness, and sagging skin. During surgery, Dr. Harley makes discreet incisions either inside the lower eyelid or just beneath the lash line, depending on your anatomy and cosmetic goals. Through these incisions, he can remove or reposition excess fat and tighten loose muscles to restore a smooth appearance beneath the eyes. Unlike over-the-counter creams or non-surgical treatments, lower eyelid surgery directly targets the structural causes of puffiness and drooping, providing permanent improvement.

Who Are the Best Candidates For a Lower Eyelid Surgery?

Lower eyelid surgery is an excellent option for individuals who struggle with under-eye puffiness, sagging skin, dark circles, or visible fat deposits that don’t improve with sleep, skincare, or fillers. Ideal candidates are in good general health, non-smokers (or willing to quit before surgery), and have realistic expectations about what surgery can achieve. Many patients seeking this procedure are in their 40s to 60s, though age alone is not a limiting factor, as genetics and lifestyle play equally large roles.

What Are the Benefits of a Lower Eyelid Surgery?

The benefits of lower eyelid surgery go far beyond aesthetic enhancement, often including an emotional and psychological lift. Patients frequently describe feeling more confident, alert, and comfortable in their own skin following their procedure. Cosmetically, lower blepharoplasty reduces under-eye bags, fine wrinkles, and sagging, restoring a smooth and firm under-eye contour. It can also significantly improve skin texture and tone, especially when combined with skin resurfacing or laser treatments. Through lower blepharoplasty, Dr. Harley can restore youthful fullness while avoiding the hollow or “sunken” look that older techniques sometimes cause.

Functionally, this procedure helps the eyes appear more open and balanced, complementing the shape of your cheeks and upper lids. For many, the change is subtle yet highly transformative.

What’s the First Step?

You will need to start with a private in-person or virtual consultation with Dr. Harley. This one-on-one process will allow the doctor to carefully analyze your facial anatomy, discuss your aesthetic goals, and review all surgical options, including incision placement, anesthesia, and expected outcomes. The consultation and discussion with Dr. Harley helps ensure that your surgical plan is personalized, safe, and aligned with your vision for natural, long-lasting rejuvenation.

For nearly 20 years, the practice of Dr. David Harley has been a destination practice. As a patient, you will be fully supported and fully connected throughout the process and beyond. Your journey will begin with a consultation, whether virtual, via telephone, or in person, followed by a trip to Cashiers, NC, for the procedure. Our concierge-type practice provides white glove service from beginning to end. You will be assisted with any questions you might have regarding travel arrangements and accommodations.

What to Expect on the Day of Lower Eyelid Surgery

On the day of your procedure, Dr. Harley and his team will welcome you into their state-of-the-art facility and help you settle into a comfortable surgical suite, answering any last-minute questions and reviewing your individualized care plan. You will then receive oral sedation combined with local anesthesia, which helps keep you asleep and numb throughout your procedure.

The procedure will go by quickly for you, since you will be relaxed and asleep, and you will have no pain. Once the procedure is completed, you will be awakened and a soft elastic dressing will be applied. Your caregiver, hopefully a friend or family member, will transport you to your local accomodations, where you will relax comfortably and rest until your follow-up appointment the following day.

A faded, high-exposure landscape painting in soft white and grey tones, depicting a river, trees, and a distant figure with sheep.

Lower Eyelid Surgery Recovery

Your Guide to Post-Lower Eyelid Surgery Care

Recovery from lower eyelid surgery is generally well-tolerated and easier than most patients expect. You can expect mild swelling, bruising, or tightness for the first week, which gradually subsides with rest, cold compresses, and medication as prescribed.

Dr. Harley recommends keeping your head elevated and avoiding strenuous activity for about 10 to 14 days. Sutures (if external) are typically removed within the first week, and most patients feel comfortable returning to work or social events within 10 days to two weeks.

How Much Does a Lower Eyelid Surgery Cost?

The cost of a Lower Eyelid Surgery varies depending on the complexity of your case, the surgical technique used, and whether you choose to combine it with other procedures. In particular, fat grafting and resurfacing are often combined with lower eyelid blepharoplasty.

Because every patient’s anatomy and goals are unique, Dr. Harley will provide an exact quote following your consultation, which includes all surgical fees, anesthesia, and facility costs.

Why Choose Dr. Harley?

Dr. David Harley brings an unmatched level of experience to facial rejuvenation. Double board-certified by the American Board of Otolaryngology-Head and Neck Surgery (ABO-HNS) and Reconstructive Surgery and the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS), he specializes exclusively in surgical procedures of the face and neck. His deep understanding of facial anatomy, combined with a refined aesthetic sense, allows him to achieve results that look youthful yet completely natural.

Dr. Harley believes that successful cosmetic surgery is about more than tightening skin; it’s about restoring balance, confidence, and harmony. His patients come from the Asheville, NC, and Greenville, SC, areas, and from across the country to visit Cashiers, NC, trusting him for his meticulous technique, compassionate communication, and commitment to patient safety.

Dr. Harley, wearing a black surgical cap and face mask, adjusts a pair of specialized surgical loupes with integrated lighting on his head.

Lower Eyelid Surgery FAQ’S

Most patients are pleasantly surprised to find that discomfort after lower blepharoplasty is minimal. You may experience mild tightness, swelling, or tenderness around the eyes during the first few days, but significant pain is uncommon. Any mild discomfort after surgery can easily be managed with prescribed or over-the-counter medications, cold compresses, and rest.
You can expect a few visits for your lower eyelid surgery, beginning with your initial consultation and continuing through your post-operative care. Your follow-up appointments are essential for monitoring healing, removing sutures if needed, and ensuring that your results are developing as expected. If your case involves combination procedures or a more complex surgical plan, Dr. Harley may recommend additional follow-ups to support continued evaluation and recovery.
While you’ll notice immediate improvement once swelling begins to subside, most patients see their final results at around two to three months post-surgery. Early swelling and bruising will fade significantly within the first two weeks, and over time, your results will continue to refine, offering long-lasting rejuvenation that can last 10 years or more, depending on lifestyle, genetics, and skincare. Many patients find that their eyes remain youthful and bright for well over a decade, making this one of the most rewarding facial rejuvenation procedures available.
Yes, combining lower eyelid surgery with other facial procedures can often enhance overall balance, which is why many patients choose to add upper eyelid surgery, a brow lift, or a facelift to smooth fine lines further and tighten surrounding tissue. Fat grafting is also very commonly added. Combining procedures can also streamline recovery time, allowing for more comprehensive results in a single surgical session.

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