“Under-eye bags are caused by herniated orbital fat — fat that has prolapsed forward through a weakened orbital septum. No eye cream, no filler sequence, no radiofrequency device can permanently address this. Transconjunctival lower blepharoplasty removes or repositions the fat through an incision hidden inside the lower eyelid. There is no external scar. The bags are gone. It is, in my view, one of the most elegant procedures in all of facial plastic surgery.”
What lower blepharoplasty
can do for you
Lower blepharoplasty corrects the herniated fat pads that create under-eye bags and the hollows beneath them. The result is a smoother, brighter under-eye that reflects how rested you actually feel.
- Under-eye bags permanently gone — herniated fat is repositioned or removed — once corrected, the bags do not return.
- No external scar — incision placed inside the lower lid (transconjunctival) so the skin surface is untouched.
- Makeup looks great (if you even want to wear it at all) — the structural cause is gone, so makeup finally sits flat and even — and most patients find they reach for it far less often.
- Smooth transition to the cheek — the abrupt bag-to-cheek step is flattened into a single rested curve.
- You stop looking tired in photos — the under-eye area finally reads the way you feel on a good night of sleep.
Ready to discuss your lower blepharoplasty goals?
Understanding the lower blepharoplasty
What the lower blepharoplasty is
Lower blepharoplasty corrects the herniated fat pads that create under-eye bags, as well as the hollows that can sit beneath them. The result is a smoother, brighter under-eye that reflects how rested you actually feel.
Who the lower blepharoplasty is for
If any of the following describes you, the lower blepharoplasty may be worth exploring:
What makes Dr. Truesdale’s approach different
Dr. Truesdale’s approach to every procedure reflects a consistent set of principles — the same standards that inform every consultation, every surgical plan, and every post-operative follow-up.
Restraint, Not Over-Correction
The most over-done procedures in facial aesthetics are over-done because someone kept going past the right stopping point. Dr. Truesdale's rule: when the result is right, stop — even if more could technically be done. For lower blepharoplasty, that means correcting fat herniation without over-resection — preserving lower-lid support and avoiding the hollow that comes from aggressive surgery.
The Artist's Eye
Before becoming a surgeon, Dr. Truesdale was a trained portrait artist. That lens shapes every decision — proportion, light, shadow, the relationship between every feature — in a way purely clinical training alone does not. For the lower lid, that lens informs the transition from lid to cheek so the under-eye reads as one continuous, rested curve.
Personal, Start to Finish
Every consultation, every surgical plan, every procedure — performed personally by Dr. Truesdale. No delegation to coordinators, PAs, or residents. Dr. Truesdale is personally involved every step of the way. Every lower-bleph incision is placed and the contour judged by Dr. Truesdale at the operating table — never delegated.
Natural Is Non-Negotiable
The only acceptable outcome is one that no one can identify as a procedure — a result that reads as a better version of you. No pulled look, no frozen expression, no obvious work. The lower-bleph goal: under-eye smoothness, not a sunken or pulled appearance.
“The under-eye should never be pulled tight or hollowed out. Conservative is always right.”
— Dr. Carl Truesdale, MD
Lower blepharoplasty before & afters
Real lower blepharoplasty patients of Dr. Truesdale. Under-eye correction is performed through a hidden incision so there is no visible scar.
Your transformation starts with a conversation.
From first consultation to final reveal
We always tell our patients to ‘trust the process.’ You are in good hands on every step of the journey to your unique masterpiece.
Consultation
Personal session with Dr. Truesdale — facial analysis, honest assessment of candidacy, and a clear plan for what the procedure can and cannot achieve.
Planning
Medical clearance, pre-operative instructions, and a personalized plan Dr. Truesdale reviews with you before the day of the procedure.
Procedure Day
Performed personally by Dr. Truesdale under MAC (Monitored Anesthesia Care) with IV sedation — gentle, deep sedation comparable to a colonoscopy, administered and monitored throughout by a hand-selected, board-certified anesthesiologist. Transconjunctival approach (no external incision) for most cases; occasionally combined with skin pinch.
Initial Healing
Sutures (if any) removed at Day 5. Bruising and discoloration over 10–14 days. Lubricating ointment used in the first several days; mild blurry vision is expected and resolves quickly. Contact lenses may resume at Day 10. For under-eye darkness related to hemosiderin staining, a lightening cream may be prescribed; pigment typically resolves over 3–6 months.
Discoloration Resolves
Bruising and most swelling resolved. Under-eye area appears smoother and more rested.
Look and Feel Like a Masterpiece
Smooth under-eye contour with no visible external incision.
Individual timelines vary. Dr. Truesdale sets realistic, patient-specific expectations during your consultation — not exaggerated claims.
See if a Lower Blepharoplasty is right for you.
See the work in motion
Dr. Truesdale on technique, philosophy, and patient stories — from his self-produced Beyond the Surface docuseries and his educational content library.
Lower Blepharoplasty FAQs
Bring your own questions to consultation — Dr. Truesdale personally answers every one. Below are the questions patients ask most often about lower blepharoplasty.
The strongest candidates have persistent under-eye bags or hollows that are making your face look tired regardless of how rested you are. Dr. Truesdale evaluates you personally in consultation and only recommends the procedure when it will genuinely help. If a different approach would serve you better, he’ll tell you that too.
Filler can camouflage under-eye hollows temporarily. It cannot remove fat bags — it merely pads around them and can actually worsen their appearance. If fat bags are your primary issue, surgery is the only real answer. If you have hollows without bags, filler or fat transfer may be appropriate. Dr. Truesdale evaluates the anatomy carefully before recommending either.
Most patients describe the discomfort as mild to moderate. Dr. Truesdale’s team is available throughout recovery — you are not managing discomfort on your own. See “What kind of anesthesia is used?” for details on intra-operative comfort. Dr. Truesdale’s team is available throughout recovery — you are not managing discomfort on your own.
Our surgical procedures utilize a patient-focused anesthesia technique known as MAC (Monitored Anesthesia Care) and IV Sedation, ensuring your maximum comfort and safety. This method provides a level of gentle, deep sedation comparable to the comfortable experience many patients have during a colonoscopy, which we have found helps make patients less fearful. The anesthesia is administered intravenously and meticulously monitored by a hand-picked group of board-certified anesthesiologists, who are dedicated to your well-being throughout your entire procedure.
Plan on 7–10 days of social downtime. Expect mild swelling and occasional under-eye bruising. Light cardio resumes at 2 weeks; most patients are cleared for strenuous exercise at about three weeks, at a follow-up visit. Your follow-up appointments along the way are conducted by Dr. Truesdale and our physician assistant, with Dr. Truesdale seeing you personally at the key milestones.
That’s the entire standard Dr. Truesdale designs for. Under-eyes should never look pulled tight or hollowed out — conservative is always right here. Every patient is evaluated in a seated, relaxed state beforehand so the target is based on your real anatomy — never on an idealized template.
Yes. Lower-lid anatomy varies meaningfully across ethnicities — fat compartment volume, skin thickness, melanin density, and the relationship to the cheek all differ. Dr. Truesdale’s practice is one of the most diverse in the world, and he designs every lower blepharoplasty around your specific anatomy. East Asian, African, Latin, Middle Eastern, South Asian, and European patients each have distinct lower-eyelid characteristics that should be preserved — never erased. The goal is a smoother, rested lower lid that still looks unmistakably like yours.
Permanent. Once fat bags are removed or repositioned, they do not return.
Yes. A significant portion of Dr. Truesdale’s patients travel from across the United States and internationally. The process begins with a virtual consultation with Dr. Truesdale himself (not a coordinator), followed by in-person pre-procedure evaluation. Our patient-care coordinators help arrange travel, accommodations, and local transportation, and Dr. Truesdale’s team conducts virtual follow-ups after you return home.
Request a consultation through the form at the bottom of this page, email contact@doctortruesdale.com, or call (424) 363-4112. Our team responds within one business day to schedule either an in-person consultation at 150 S. Rodeo Drive, Suite 360, Beverly Hills, or a virtual consultation worldwide. Every consultation is conducted personally by Dr. Truesdale.
Most lower blepharoplasty patients are between 40 and 65. Dr. Truesdale operates on younger patients with genetic under-eye bags and on patients into their 70s with significant festooning or hollowing. The ideal moment is when you consistently look more tired than you feel.
The cost of lower blepharoplasty can vary based on the patient’s situation, including if it is a revision surgery and if this surgery will be combined with other surgeries or treatments. The total cost may include the surgeon’s fee, operating room fees, and anesthesia fees. At Truesdale Facial Plastic Surgery, we believe the surgeon’s philosophy and experience, and your comfort with him, are just as important as the final cost of the surgery. We can provide an approximate range for this procedure over the phone, and your patient care coordinator (PCC) will confirm the pricing for you after your consultation with Dr. Truesdale.
This procedure is performed by Dr. Truesdale or his hand-picked associate Dr. Sajjadi — discuss the right path on your free Surgery Discovery Call.
Schedule your lower blepharoplasty consultation
Permanently eliminate under-eye bags — with no external scarring. We respond same-day, Monday-Friday.
Book a Surgical Discovery Call online
After clicking the booking link, select “new patient” under Schedule Your Appointment and fill out the form to see our current availability for a Surgical Discovery Call with a Patient Care Coordinator and book immediately. Call us (424) 363-4112 for additional appointment times and information.All times are based on Los Angeles, Pacific Time (PT).
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