Eyelid Surgery

The eyelids are often the first facial feature to show signs of aging resulting in a sad, tired appearance even in the most energetic individual. Blepharoplasty, a surgical procedure designed to rejuvenate the eyelids, can return that youthful elegance to your face, making the eyes appear brighter and more refreshed. The eyelids can be considered separately, but it is usually most beneficial for patients to have both upper and lower eyelids treated simultaneously. When the entire area around the eyes is treated together, the transformation is truly dramatic.

Any one or combination of the following conditions may indicate that you are a good candidate for eyelid surgery:

Excess skin obscuring the natural fold of the upper eyelids.
Loose skin hanging down from the upper eyelids, perhaps impairing vision.
A puffy appearance to the upper eyelids, making the eyes look tired.
Excess skin and fine, crinkly wrinkles of the lower eyelids.
Bags and dark circles under the eyes, often with a depression along the bony border of the lower eyelids.
Droopiness of the lower eyelids, showing white below the iris, the round-eye look.

Upper Eyelid Blepharoplasty

Three major factors can contribute to the aged appearance of the upper eyelids; 1) aged eyelid skin looses its tone, causing droopiness and overhanging skin; 2) loss of the upper eyelid crease associated with youth; 3) and bulging or herniation of fat that is normally located in the orbit. To correct sagging in the upper eyelids an incision is made at the natural crease, excess skin is removed, and a lift of the remaining eyelid skin is performed. The underlying muscles will be tightened and bulging fat tissue is also removed. This procedure can give patients a much more youthful appearance by restoring a natural arch to the eyelids, tightening the skin and muscles and producing a crisp, youthful eyelid crease. In many cases an eyebrow lift is used in conjunction with an upper eyelid lift to establish a more youthful appearance for the entire upper third of the face. This combination of procedures will generally give the longest lasting result and happiest patients. This is especially true in individuals who notice the skin of the upper eyelids to be so lax and impart a hooded appearance to the upper eyelids and, in severe instances, even obscure your vision.

Lower Eyelid Blepharoplasty

Aging in the lower eyelids is also associated with sagging skin, but to a lesser degree. The lower eyelids do have a tendency to develop fine crinkly skin even when there is no excess. More important in this location is bulging of fat that is normally found inside the orbit. As the fat around the eye bulges forward, bags or dark circles under the eyes are seen making you appear aged, tired and sad. The dark circles under the eyes are due to double shadows that do not occur in youthful eyelids. In younger patients with bags under the eyes, but no excess skin, we can remove bulging fat using only incisions on the under surface of the eyelid and without incisions on your skin. A small amount of skin tightening and resurfacing can be accomplished with either laser or chemical peel, if needed. More mature individuals with excess and fine crinkly skin and fat bulges will benefit greatly from fat removal, excess skin excision and tightening of the lower eyelids. When incisions are placed in the creases of the lower eyelids these incisions usually heal well and are largely invisible after full healing. After lower eyelid surgery most patients enjoy smoother, more youthful looking eyes.

Upper Eyelid Blepharoplasty with Ptosis Repair

The words, eyelid ptosis, describe a situation in which the upper eyelid tissues become so droopy that vision can be severely affected. The cause of ptosis, in most cases, is an anatomic deficiency that occurs with aging when the lower part of the upper eyelid separates from the tendon that normally pulls the eyelid in an upward direction. This separation allows the eyelid to descend to a much lower level than normal and results in severe eyelid droopiness. The diagnosis of ptosis can be made on physical examination in patients who complain of upper visual field loss and is confirmed by specialized testing that is performed by your eye doctor. Many patients with ptosis also experience excessive skin in the upper eyelids and can benefit greatly from ptosis repair performed at the same time as an eyelid skin tuck.

Asian Eyelid Operation

Men and women of Asian descent seek out cosmetic eyelid surgery for the very same reasons that Caucasians seek out surgery: to look better and feel better about their appearance. Approximately half of all Asian people are born without an upper eyelid crease and in those who do develop a crease, it is usually different from the Caucasian eyelid. Patients without a well-formed crease often times appear more tired and have upper eyelids that appear “puffy” because the orbital fat pads slide down farther towards the lid margin. The vast majority of patients who seek out Asian eyelid surgery do so to develop a crease and establish a “double eyelid” appearance. With the formation of the crease, the eyelid appears younger, crisper and resembles the more widely accepted norms of aesthetics and balance, often times creating an ocular region which appears more open and brighter. The creation of an upper eyelid crease in no way detracts from the ethnic appearance of the individual and we find that patients often times seek this operation to look more like their Asian counterparts who have developed a crease on their own.

Individuals in whom the eyelid crease is developed or partially developed may also seek out surgery to obtain a more defined eyelid crease, which appears crisp and brighter. The operation is also used to lift the eyelid in more senior individuals who begin showing advanced signs of aging.

Canthopexy for Almond-Shaped Eyes

Another procedure which can rejuvenate the eyelids involves the repositioning of the tilt of the eyelids. As we age, the natural, youthful tilt of the eyelids, slightly upward from its central origin close to the nose to its end laterally, usually disappears due to gravity and aging. The beautiful almond-shaped eyelid appearance of youth turns into a lax, round-eye and aged look. The lower lid tilt can be restored when bulges and excess skin are treated with a procedure called, lateral canthopexy, in patients with the round-eye look. Restoration of the almond-shaped eyelid is an effective addition for bringing back a youthful look to the entire orbital region. We customize all of our surgical procedures around the eyelid region to fit the needs and desires of the individual.