Eyelid Lift Procedures

Cosmetic eyelid surgery is what patients often request seeking facial rejuvenation [blepheroplasty]. According to the most recent statistics from the American Society of Aesthetic Plastic Surgery there were 290,000 cosmetic blepheroplasties performed by its surgeons in 2004 (up 82% from 1997). Eyelid-plasty was the third most popular procedure requested by patients. Our own statistics mirror this national trend. We have seen our blepharoplasty requests double over the past two years!

The eyelids are a combination of skin, underlying fascia, fat pads, and surprisingly large muscles overlying the bony contours. Aging is a complex combination of eyebrow droop (ptosis), skin damage, facial sagging, and laxity of the lower lids. The soft tissues of the eyes react to the life-long exposure of the sun, stress, orbital injuries, and disease in a relatively predictable pattern. As the eyelids age, the natural upper eyelid fold becomes hidden in loose skin that creates a “tired” look. In the lower lids puffy bags, dark circles, and fine wrinkling all combine to produce the appearance of aging [Figure 1a. Figure 1b.].

Several factors explain blepharoplasty’s popularity.

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Figure 1b

In a majority of cases, the surgery is usually straight forward when performed by a trained oculoplastic surgeon. Upper eyelid-plasty includes removal of excess skin and fat from the upper eyelids that produces an immediate and often striking result [Figure 1c. Figure 1d. Figure 2a. Figure 2b. Figure 3a. Figure 3b. Figure 4a. Figure 4b. Figure 5a. Figure 5b.].

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Figure 5a

Lower eyelid surgery assessed carefully before proceeding. What may look like an excess of lower lid skin may actually be herniated fat pads combined with lower lid laxity. Care is taken to conservatively remove fat and skin and re-suspend the lower lid margin. Fortunately, experienced plastic surgeons have surgical techniques for removing the lower eyelid herniated fat from the inside of the eyelid (trans-conjunctival blepharoplasty) and for elevating and reinforcing the laxity of the lower lid tendon (lateral canthoplasty). Trans-conjunctival blepharoplasty and lower lid canthoplasty is one of the most underrated operations in cosmetic surgery [Figure 1a. Figure 1b. Figure 1c. Figure 1d.].

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Although most eyelid surgery is straightforward, there may be hidden nuances that patients may not recognize before consulting with an oculoplastic surgeon. For example, what appears to be hooding of the upper eyelid with reduced vision, excess skin and irritation may actually be lowering (ptosis) of the eyebrows. In such a case a brow-lift (often combined with upper lid blepharoplasty) may be the wisest treatment choice to elevate the brows, “open” the upper orbit and minimize crow’s feet [Figure 6a. Figure 6b. Figure 7a. Figure 7b.].

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Figure 7b

During your first consultation in my office, we will assess your physical and emotional health and discuss your specific cosmetic goals. Any information that you can provide regarding previous surgery, allergies and medications is helpful in planning surgery. It is important to address any potential thyroid problems, multiple sclerosis, diabetes, facial palsy, myasthenia gravis, dry eye, glaucoma and high blood pressure when considering cosmetic eyelid surgery.

Following surgery, healing is rapid with minimal bruising. Four to six days after surgery, the sutures are removed and bruising will begin to fade within the first week. Makeup is applied to the eyelids to conceal discoloration following suture removal.

The surgery is performed under a local anesthesia with intravenous sedation (twilight sedation) or general anesthesia, in an outpatient setting.

To prepare for the surgery you must discontinue smoking, control your high blood pressure, avoid medications that may promote bleeding, and arranged for postoperative family or nursing care.

For patients who are unaccustomed to cosmetic surgery, eyelid-plasty is a way for them to “get your feet wet” before proceeding with a full-scale facial rejuvenation.

If you are interested in further information on eyelid plasty surgery, please:

Call my office at (757)-274-4000,
Fax my office at (757)-274-4001,
E-mail me at [email protected],