A Modern, Multi-Layered Approach to the Eyes

Traditional lower eyelid surgery typically targets only one aspect, such as removing excess fat or tightening skin, which can lead to hollowing or altered eyelid shape. Dr. Roy takes a different approach to lower blepharoplasty at our Los Gatos, CA, practice. The lower blepharoplasty trifecta rejuvenates the eyes at every level—structure, volume, and surface—during a procedure that takes less than 90 minutes.

I chose Dr Roy at RefineMD to do my lower bleph because of how nice and welcoming he was during my consultation. He answered all my questions and I immediately felt assured that everything would go well. I had my surgery on 1/20, I’m 3 months post op now and I love my results.

Megan P. 5-Star Yelp review

View Before & After Photos

Dr. Sudeep Roy
Dr. Sudeep Roy
Double Board-Certified Facial Plastic Surgeon

Dr. Roy's personable bedside manner inspires the confidence and trust of our facial plastic surgery patients. A graduate of Stanford University, Dr. Roy completed a rigorous 5-year otolaryngology—head and neck surgery residency focused on facial plastic surgery and fellowship training with the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). He performs one case per surgical day, personally handles every procedure from the first incision to the final closure, attends every post-operative appointment, and remains available to every patient through recovery.

Meet Dr. Sudeep Roy
Facial Plastic Surgeon
Double Board-Certified Facial Plastic Surgeon

Understanding the Aging Lower Eyelid

Aging around the eyes occurs in three dimensions, and each layer contributes to an aged or tired look.

  • Structural: Fat pads that once supported the lower eyelid begin to protrude, forming puffy under-eye bags.
  • Volume: Soft tissue and fat loss in the tear troughs and midface deepen shadows, creating the look of dark circles.
  • Surface: Skin laxity and fine wrinkles dull the texture and reduce the light-reflective quality of youthful skin.

Dr. Roy’s Lower Blepharoplasty Trifecta addresses all 3 in one procedure to restore smoothness, balance, and vitality.

The Lower Blepharoplasty Trifecta

Each step of Dr. Roy’s approach targets a different aspect of lower eyelid aging, and together they restore smooth, youthful contours without changing your natural expression.

1. Transconjunctival Lower Blepharoplasty

Dr. Roy makes incisions inside the eyelid (transconjunctival), preserving external skin and muscle without a visible scar. He repositions or conservatively removes fat to smooth contours while maintaining natural support. The goal is to restore continuity between the lower eyelid and cheek without creating under-eye hollows.

2. Microfat Injections

Using a patient’s own purified microfat, Dr. Roy restores youthful volume to the tear troughs, cheeks, and temples. He is a pioneer of fat grafting in the periocular region, having refined microfat processing and injection techniques that overcome the lumpiness concerns that have historically made surgeons reluctant to transfer fat to the lower eyelid. He uses the Dermapose™ autologous fat processing system to maximize fat quality and graft survival in one of the most delicate anatomical areas of the face. Injecting microfat creates gentle transitions between the eyelid and midface, and introduces regenerative stem-cell effects that enhance tone and elasticity over time.

3. Laser Resurfacing

Fractional laser skin resurfacing refines the skin’s surface by softening wrinkles and tightening laxity. The result is smoother texture, more even tone, and the subtle glow associated with healthy, youthful skin.

“I started evolving my lower blepharoplasty technique to address multiple factors relevant to achieving a great outcome, reducing eyelid bags, restoring volume, and improving skin, all without introducing a visible scar. That is how the Lower Blepharoplasty Trifecta was born. It combines a transconjunctival incision, fat transfer, and CO2 laser, addressing fat pads, volume loss, and skin all in one fell swoop in less than 90 minutes.” 

—Dr. Sudeep Roy
Dr. Roy examines woman's jawline while she holds a mirror

Benefits of Lower Blepharoplasty Trifecta

Dr. Roy’s 3-step approach delivers comprehensive correction through natural, minimally invasive means.

  • Efficient recovery: Coordinated healing leads to less bruising, swelling, and downtime.
  • Comprehensive correction: Structural, volumetric, and surface aging are all addressed in one procedure.
  • No visible scars: Internal incisions and gentle laser resurfacing avoid external stitches.
  • Natural results: Preserves eyelid shape and character for an authentic look.
  • Longevity: Regenerative fat grafting and collagen remodeling extend the lifespan of results.

A Reputation Built on Results

Dr Roy does amazing work. He is a true artist. He thoroughly explained the procedure, very helpful with...
Fabulous polite, professional and highly skilled Doctors and staff. Have had several Halo laser treatments...
Refined MD has been my go-to destination for aesthetic treatments for nearly four years, and I couldn't...
RefinedMD has been my go-to for all things skincare for years! They have top-of-the-line equipment,...

Ideal Candidates

The lower blepharoplasty trifecta is ideal for patients who notice under-eye bags, hollows, or fine wrinkling and want subtle, natural rejuvenation without external incisions. The lower blepharoplasty trifecta is a modern, comprehensive solution suitable for adult patients of all ages and nearly all skin types. Even though many patients have concerns caused by aging, approximately 60 to 70% of trifecta patients are between 25 and 35, and have hereditary rather than age-related under eye concerns. This reflects a patient demographic that is unusual for a facial plastic surgery practice and one that the trifecta procedure is uniquely positioned to serve. 

Results and Longevity

Patients see changes within 1 to 2 weeks as swelling subsides and the eyes appear smoother and brighter. Over the following months, the transferred microfat integrates naturally, and the skin texture continues to improve. Results are durable so you’ll age gracefully, supported by the regenerative effects of the treatment.

Dr. Roy’s Expertise and Recognition

Dr. Roy has refined the lower blepharoplasty trifecta through years of specialized surgical experience and ongoing innovation. The Trifecta has generated a self-sustaining national and international patient pipeline driven entirely by organic peer recommendation, with demand continuing to grow since a patient’s experience went viral on TikTok. His approach attracts eyelid surgery patients from Saratoga, Campbell, San Jose, and nationwide, seeking advanced, scarless eyelid rejuvenation. His artistry, meticulous technique, and commitment to natural-looking outcomes have made him one of the region’s most sought-after facial plastic surgeons.

 

Dr. Roy in a suit, smiling, while seated in office lounge

Why Patients Choose RefinedMD

At RefinedMD, every treatment plan combines precision surgery with regenerative science. Patients appreciate the practice’s warm, attentive environment and Dr. Roy’s dedication to subtle and harmonious enhancements.

Refresh your eyes. Restore your confidence.

Request a consultation using the online form to meet personally with Dr. Roy to discuss your concerns and goals.

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Santa, But Make It Refined: A Holiday Night Out

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Reviewed for clinical accuracy by a RefinedMD Medical Editor on September 7th, 2026.

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