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Lower Lid: SOOF Lift Blepharoplasty

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Lower Lid:  SOOF Lift Blepharoplasty

Surgical rejuvenation of the lower lid was a problem in need of a good solution for many years. Dr. Sean Freeman invented the Lower Lid: SOOF Lift Blepharoplasty and published his technique in 2000 in the Archives of Facial Plastic Surgery. The SOOF lift Blepharoplasty is the best surgical approach for the rejuvenation of this area.

The SOOF Lift is now “The Gold Standard” for lower lid blepharoplasty. The procedure gives more natural-looking results, is longer-lasting, and has fewer risks than the old ways of doing lower lid surgery.

Dr. Freeman’s early adoption of minimal facial aesthetic surgery, and innovative surgical techniques, along with his years of experience have made him a sought-after teacher and lecturer to his peers, all over the world. He introduced the “Transconjunctival Lower Lid Blepharoplasty with SOOF,” which described a new technique for improving the results of lower eyelid surgery, in 2000. 

Patients fly in from all over the United States, and from around the world, to experience his excellent surgical results.  His procedure, the SOOF Lift blepharoplasty, lifts the SOOF, which stands for suborbicularis oculi fat. By lifting this, he is able to correct the hollowness underneath the lower lid, which is due to the inferior migration of the SOOF that occurs as we age. During the Lower Lid:  SOOF Lift Blepharoplasty procedure, he is also able to tighten a layer of tissue known as the orbital septum and push the bulging orbital fat back to where it was when the patient was young.  The combination of lifting the SOOF and correcting the bulging orbital fat restores the youthful anatomy of the lower lid all via a hidden incision inside the eyelid. The Lower Lid:  SOOF Lift Blepharoplasty is safe, effective, and long-lasting.

Patients who choose Dr. Freeman at The Center for Facial Plastic and Laser Surgery, in Charlotte, are choosing a physician who has specialized in facial cosmetic surgery since 1988. You can request your consultation online to receive $25 off your consultation fee, or call Dr. Freeman’s office at(704) 543-1110.


Many physicians in the facial plastic surgery world operate on the lower lid using approaches that do not work as well as the Lower Lid/SOOF Lift Blepharoplasty. Many use an open approach, with an incision beneath the eyelashes of the lower lid (known as a subciliary incision). They lift the skin and muscle of the lower lid and remove fat from each of the 3 compartments underneath and behind the orbit. The problem with this approach is that we don’t grow fat in the lower lid as we age. The fat simply protrudes because of the relaxation of a fascia layer that holds the fat in check when we are younger.

Removing this fat simply takes a bulging lower lid and makes it look hollow. Neither of these looks is pleasing. The other important point that this procedure ignores is the hollowness that occurs under the puffy area, commonly known as the tear trough.
Fat Herniation

Some surgeons will take fat from either the lower lids (which creates hollowness) or other areas of the body and try to “graft” this area to fill it in. While this may occasionally help, it is prone to failure due to clumping, resorption, or migration of the fat, among other concerns. In addition, using an open approach puts pressure on the support structure of the lower lid and can lead to a change in lower eyelid position, known as scleral show or frank ectropion (the lower lid is pulled away from the orbit). Dr. Freeman does find a subciliary incision to be necessary in the rare patient, and if you are in that category, he will discuss this approach during your office consultation.

Dr. Freeman’s SOOF Technique

At his Charlotte practice, Dr. Freeman performs blepharoplasty for the lower lids using an incision inside the eyelid, known as a transconjunctival incision, for the vast majority of his patients.

Lower Eyelid

He has devised a way to tighten the structure that contains the protruding orbital fat, returning this area of the eye to its smooth, youthful position and appearance. That means improving puffiness without causing a hollow appearance. He lifts the mid-face fat that used to be under the lower lid, called the “SOOF”. This corrects the hollow appearance under the eye.

You can view more photos of  SOOF Lift blepharoplasty here.

Results from this approach look very natural because the surgery puts the lower eyelid anatomy back in its youthful position.  Dr. Freeman has been using this approach for over 20 years and can say that it is safe and long-lasting. This combination of attributes makes the SOOF Lift Blepharoplasty the “Gold Standard” for lower lid rejuvenation.