• Transconjunctival approach (no external scar): ideal for younger patients with isolated fat pads. Fat can be removed, repositioned onto the tear trough (fat transposition) or supplemented with lipofilling.
• Subciliary approach (scar just beneath the lashes): suitable when excess skin must be resected. Often combined with canthopexy to support the lower lid.

Surgery takes 60 to 90 minutes under local anaesthesia with sedation or light general anaesthesia. Social return is possible in 10 to 14 days. The result stabilises after 2 to 3 months.

Lower blepharoplasty is often combined with periorbital lipofilling or fractional resurfacing (Erbium/CO₂) to address volume, fine lines and skin quality together.