Now this is a real work of art! Here I combined upper lid blepharoplasty with lower lid blepharoplasty and lower lid bilateral cheek lift.
In the lower lids, I remove very little fat, instead, I release the three fat bags completely, take out the fat, preserve most of it still attached to its blood supply, remove some excess, release the tissues over the lower orbital rim (bone), tuck the lower eyelid fat bags down over the lower rim, then elevate the cheek pad back over the transposed fat. Finally, then remove the excess skin. The results are light years ahead of average eyelid surgery – a youthful face with preserved almond-shaped eyes! A beautiful result!