Lower Blepharoplasty at 79: Resolving Severe Under-Eye Swelling Without Visible Scars

Many patients assume that oculoplastic surgery is strictly for aesthetic enhancement or suited only for younger individuals. In reality, targeted procedures can resolve significant physical discomfort at any stage of life. Recently, I had the pleasure of treating a 79-year-old patient who suffered from continuous and severe swelling in the periocular area, directly caused by prominent under-eye bags. For him, the primary motivation was not cosmetic: the constant swelling made him feel genuinely unwell and noticeably affected his daily comfort.


To address this issue effectively, we performed a Lower Blepharoplasty. The defining feature of his surgery—and the main reason behind his swift recovery and entirely natural-looking outcome—was the transconjunctival approach. In simple terms, the excess fat bags were removed entirely from the inside of the eyelid. By choosing this internal route, we successfully avoided making any incisions on the external skin of the lower eyelid. The complete absence of visible scars is one of the most significant advantages of this advanced technique, as it preserves the structural integrity of the orbicularis muscle and maintains the natural shape of the eye.

As the patient’s testimony clearly shows, the clinical results were exceptional. Even when looking up, there is no longer a single trace of the fat bags that once caused him so much distress. His overall facial appearance is immediately more rested and revitalized, leading him to jokingly exclaim that the procedure “took twenty years off” his face. This beautifully illustrates how restoring harmony to the eye area can profoundly impact self-perception and significantly improve overall quality of life, without artificially altering one’s natural features.

Hearing that a patient is “one hundred percent” happy is the ultimate reward for any surgeon. Age should never be viewed as a barrier to seeking relief from physical discomfort, especially when modern, minimally invasive oculoplastic techniques allow for safe and customized solutions. If you are experiencing persistent under-eye bags or eyelid swelling, please do not hesitate to contact us to book a consultation for a comprehensive evaluation.

About the author

Ophthalmologist and oculofacial plastic surgeon. He completed a two-year surgical fellowship at the University of Cincinnati (Ohio, USA). He is a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), AICPE and the Orbital Society. He is an adjunct professor at the Ophthalmology Residency Program of IRCCS San Raffaele Hospital in Milan and a member of the Editorial Board of the journal Ophthalmic Plastic and Reconstructive Surgery (OPRS). He sees patients in Milan and Genoa and operates in Genoa at Villa Montallegro.