Under Eye Lift: Before & After, Surgery vs Thread Lift

Under eye lift before and after results depend on the method. Lower blepharoplasty removes or repositions bulging fat and, when needed, extra skin, giving the most lasting change to under-eye bags. Filler can soften hollows for up to about a year. Thread lifts under the eye have little published evidence. Surgery suits true bags; filler suits mild hollows.

This comparison belongs to our eye lift overview. It helps you match the treatment to the cause of your under-eye concern.

Lower blepharoplasty

Lower blepharoplasty treats bags by removing or repositioning fat, through an incision inside the lid or just below the lashes.

The American Society of Plastic Surgeons (ASPS, US) describes two approaches:

• Inside the lid (transconjunctival): fat is redistributed or removed with no outer scar, but no skin is removed. It suits younger people with good skin tone and puffy bags.
• Below the lashes: excess skin is removed and fat repositioned. It suits people with loose, crepey lower-lid skin.

Moving fat into the hollow below the bag, rather than only removing it, can smooth the lid-cheek junction and avoid a sunken look. In my practice, I prefer to keep and reposition fat where I can, because over-removed fat is hard to replace.

ASPS lists risks including lower-lid pulling down (lid lag), the lid rolling outward (ectropion), dry eyes and, very rarely, vision changes. The National Health Service (NHS, UK) adds rare bleeding into the eye socket.

Under eye thread lift

Thread lifts are used mostly for the cheeks and brows; evidence for threads under the eye is thin, and the skin there is very delicate.

A 2021 systematic review in Aesthetic Plastic Surgery, covering 26 facial thread-lift studies, found swelling in 35% of patients, dimpling in 10% and altered sensation in 6%. None of the included data focused on the lower eyelid. Lower-lid skin is among the thinnest on the body, so visible or palpable threads and dimpling are a concern.

Some clinics use cheek threads to lift the mid-face, which can soften the lid-cheek junction indirectly. That’s different from placing threads in the eyelid. For a fuller comparison of non-surgical choices, see our non-surgical eye lift guide.

What about filler?

The US Food and Drug Administration (FDA) approved Restylane Eyelight in May 2023 for under-eye hollows in adults 21 and over. In a study of 333 participants, one or two treatments were needed, with results lasting up to 12 months. Other fillers are not FDA-approved for the area around the eyes.

Under eye lift before and after

Typical surgical results show flatter lower lids and a smoother lid-cheek junction, visible after two weeks and settling over a few months.

According to ASPS, most people look presentable within 10 to 14 days, and final healing takes a few months. The NHS says bruising and redness may take several weeks to fade and that scars become barely noticeable over time. ASPS notes a laser or chemical peel may be suggested for lower-lid discoloration, which surgery alone doesn’t remove.

When you compare photos, look at the lid position as well as the bags. A lower lid that sits lower or looks rounder after surgery is a warning sign. Our eye lift before and after guide lists other things to check, and the upper eye lift guide covers combining both lids.

If you’d like to find out whether bags, hollows or both are behind your tired look, you can book a consultation with Metropole Clinic by ABmedi. For more on types and costs, return to the eye lift hub.

This article is for general education and does not replace a personal medical consultation.

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