What Is "Triple Lower Blepharoplasty"?

Triple Lower Blepharoplasty refers to a comprehensive, three-part surgical strategy for rejuvenating the lower eyelid and mid-face area. While not always labeled as such in clinical settings, this approach addresses three major layers of lower eyelid aging: fat, volume, and skin.

In essence, it is a highly customized combination procedure that blends fat management, skin refinement, and mid-face support to correct under-eye puffiness, tear-trough hollowness, and skin laxity in one cohesive plan. For patients with complex concerns, this layered approach can offer transformative results that are both natural-looking and long-lasting.

Unlike simpler blepharoplasty techniques that target only fat removal or excess skin, Triple Lower Blepharoplasty is ideal for individuals with multi-dimensional aging or inherited traits that require a more nuanced solution. It's particularly well-suited for patients who want to refresh their under-eye appearance without compromising facial harmony.

Why It Matters: What Each Step Achieves

1. Mid-Face and Lower Eyelid Augmentation

The first component addresses volume loss in the tear trough and upper cheek. With aging or genetic predisposition, this region can develop a deep crease or hollow appearance that makes individuals look perpetually tired or drawn.

Augmentation often involves fat grafting or strategic filler placement to restore volume where it's been depleted. This helps blend the lid-cheek junction, eliminating harsh shadows and creating a smoother, more youthful contour. At Arumline, this step is planned meticulously to avoid overfilling and maintain natural curvature.

2. Transconjunctival Eyebag Removal or Repositioning

The second component targets the fat pads that contribute to under-eye puffiness. Through a small incision on the inner side of the eyelid (transconjunctival), the surgeon can remove or reposition these fat pads without creating any visible external scars.

Repositioning rather than removing fat is often preferred to avoid a sunken or hollow look. By redistributing the fat into adjacent hollows, surgeons can smooth the transition from the lower eyelid to the cheek and maintain a more youthful facial structure.

This approach minimizes trauma to the delicate orbicularis muscle and helps preserve eyelid strength and tone—reducing the risk of postoperative complications like eyelid malposition.

3. Skin Pinch or Excision

The third step is designed for patients with excess or crepey lower eyelid skin. Even if the underlying fat and volume are corrected, redundant skin can still create a tired or aged appearance.

A conservative skin pinch or excision allows for tightening and refinement of the skin envelope. This can be done just below the lash line, hidden in natural folds, and is often combined with skin resurfacing or scar care for optimal healing.

This step must be performed with precision to avoid over-tightening, which could pull the eyelid downward (ectropion). At Arumline, Dr. Lee Joong-geun applies conservative techniques that prioritize skin integrity and maintain eyelid function.

Surgical Context & Techniques

Triple Lower Blepharoplasty is not a one-size-fits-all procedure. It requires an intimate understanding of lower eyelid anatomy and individualized planning to balance correction with preservation.

At the core of the technique is respect for the three primary components of lower eyelid aging:

• Fat protrusion: Due to orbital fat herniation

• Volume loss: In the tear trough and cheek junction

• Skin laxity: From collagen degradation or repetitive motion

To address these layers, surgeons at Arumline select from multiple surgical options:

Transconjunctival Approach

This approach is performed through the inner surface of the eyelid, making it scarless externally. It’s ideal for younger patients with puffiness but good skin tone. It's also preferred when repositioning fat to fill hollows and soften transitions without disrupting muscle or skin integrity.

Skin-Excision (Pinch or Extended)

For mature patients with noticeable skin laxity, a skin pinch or more extensive excision may be necessary. Incisions are placed just beneath the lash line to minimize visibility. This allows for subtle tightening and smoothing of fine wrinkles without creating an artificial or pulled appearance.

Fat Repositioning or Transposition

Rather than discarding fat, skilled surgeons reposition it into the tear trough or upper cheek to reduce hollowing and maintain fullness. This technique offers both aesthetic and structural benefits, avoiding the risk of post-surgical hollow eye syndrome.

Canthal Support or Canthopexy

In cases where lower eyelid tone is weak or the risk of drooping is high, additional support may be added through canthopexy. This strengthens the lateral canthus (outer eye corner), ensuring a stable, symmetric eyelid contour post-surgery.

Is Triple Lower Blepharoplasty Right for You?

If you’re noticing more than just puffiness—perhaps shadows, sagging, and loose skin—then a more layered approach like Triple Lower Blepharoplasty may be the right option. Ideal candidates include those with:

• Moderate to severe under-eye bags

• Hollow tear troughs or mid-face deflation

• Fine lines or loose lower eyelid skin

• A desire for a single, holistic procedure rather than piecemeal corrections

You may also benefit from this method if you've had previous lower eyelid procedures that addressed only one concern, leaving others unresolved or unbalanced.

At Arumline, we carefully assess each patient’s anatomy and goals to determine whether a three-part approach is suitable. Sometimes, only two steps may be needed. In other cases, all three may be necessary for optimal, lasting harmony.

How Arumline Approaches Tailored Lower Eyelid Surgery

At Arumline Plastic Surgery, Skin & Beauty Clinic, our philosophy is simple: precision meets personalization. Led by Dr. Lee Joong-geun, we specialize in lower eyelid rejuvenation that enhances natural beauty while maintaining structural integrity.

1. In-Depth Assessment

Our evaluation begins with a comprehensive examination of eyelid function, skin condition, fat distribution, and facial symmetry. We perform:

• Snap-back tests to assess lid tension

• Dynamic analysis of eyelid movement

• Shadow and light assessments to understand depth and volume loss

This detailed diagnostic process ensures that no contributing factor is overlooked and that every surgical plan is tailored to the individual.

2. Customized Surgical Blueprint

There are no templates at Arumline. Every lower eyelid surgery is designed based on your unique anatomy and goals. We combine techniques strategically to:

• Preserve youthful volume

• Soften puffiness

• Gently tighten skin

• Harmonize the lid-cheek junction

Some patients may need added volume in the mid-face, while others require only fat repositioning and skin refinement. Our planning ensures that the combination delivers a cohesive, natural result.

3. Dynamic Refinement

Intraoperatively, we continue to refine as we go. Eyelid height, contour, and fat placement are adjusted based on real-time tissue behavior. Dr. Lee’s 3-STEP surgical system guides every procedure, ensuring:

• Balanced tension and symmetry

• Controlled fat redistribution

• Preservation of muscle and support structures

This dynamic approach allows us to adapt to intraoperative findings and optimize outcomes.

4. Scar-Respectful Technique

Whenever possible, we favor transconjunctival approaches or minimal skin excisions. Incisions are placed with an eye toward invisibility, and postoperative care includes advanced scar management to ensure a discreet result.

Even in cases where external skin removal is necessary, we ensure the scars heal seamlessly into the natural contours of the eyelid.

5. Long-Term Harmony

Our goal is never a quick fix. We design every Triple Lower Blepharoplasty to hold up beautifully over time. That means preserving the structures that matter, educating patients on eye care, and guiding them through healing.

From post-surgical swelling management to sun protection and collagen support, our aftercare protocol is designed to help your results age as gracefully as you do.

What Many Patients Don’t Realize...

Lower eyelid aging is rarely caused by a single issue. Puffiness, volume loss, and skin laxity often coexist, creating a tired or imbalanced look. Treating just one layer may provide improvement, but can also expose or even worsen other issues.

That’s why a comprehensive solution like Triple Lower Blepharoplasty can be so effective. By targeting all contributing factors in one surgical setting, we reduce the need for repeat procedures and support a more natural outcome.

And while it may seem complex, when performed by an experienced surgeon, this technique is remarkably well-tolerated. Recovery times are similar to less comprehensive blepharoplasty procedures, and with proper care, patients return to daily life within a few weeks.

We often hear patients say they look more rested, younger, and even happier—not because they look "different," but because they look more like themselves again.

Is It the Right Choice?

You may be a strong candidate for Triple Lower Blepharoplasty if:

• You have a combination of under-eye bags, hollowness, and skin laxity

• You've had partial corrections in the past but still feel dissatisfied

• You want a balanced, single-session rejuvenation with minimal visible scarring

• You value natural results and long-term stability over drastic short-term change

At Arumline, we believe in gentle transformation—enhancing what makes you look like you, not changing it. Through surgical precision and a patient-first philosophy, we help restore clarity, softness, and vitality to the eyes.

If you’ve been hesitating or unsure where to begin, a consultation with Dr. Lee Joong-geun can offer clarity. Our priority is your comfort, confidence, and lasting satisfaction.

If natural beauty is your priority, consider a personalized consultation at a results-proven clinic like Arumline Plastic Surgery, Skin & Beauty Clinic. Don’t rush your decision—find a team that prioritizes safety, artistry, and honest results.