Is lower blepharoplasty covered by insurance?

Lower eyelid blepharoplasty is performed for cosmetic reasons in nearly all cases and is therefore not covered by insurance.

What is the difference between the transconjunctival and transcutaneous approaches?

Transconjunctival surgery is done through the inner surface of the lid with no external scar, preferred when fat is the main issue. The transcutaneous approach uses an incision just below the lashes to also remove excess skin.

What is fat repositioning?

Instead of simply removing orbital fat, it is draped over the orbital rim to fill the tear-trough hollow — producing a smoother lid-cheek junction and a more natural result than excision alone.

What is the main risk specific to lower blepharoplasty?

Lower-lid malposition (retraction or ectropion). Tension-free technique and careful patient selection minimize it; pre-existing lid laxity may warrant a tightening procedure at the same time.

Will lower blepharoplasty get rid of my dark circles?

Partly. Dark circles caused by the shadow of under-eye bags or a tear-trough hollow improve when those are corrected. Circles from skin pigmentation or thin skin showing underlying vessels are treated differently (resurfacing, fillers, or topical therapy).

Will there be a visible scar?

Usually not. The transconjunctival approach (inside the lid) leaves no external scar; the transcutaneous approach hides the incision just under the lash line, where it typically heals to a nearly invisible line.

Eyelid

Lower Eyelid Blepharoplasty

Lower eyelid (eye-bag) surgery to reduce herniated fat and crepey skin — transconjunctival or transcutaneous, often with fat repositioning.

Medically reviewed by Tamara R. Fountain, MDOculoplastic SurgeonLast updated June 2026

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Part of our complete guide to Blepharoplasty (Eyelid Surgery) — this page covers lower eyelid blepharoplasty in depth.