Since “the eyes reveal the soul,” what do yours say about you? Do they convey your inner emotion and vitality, or do they make you look sad, tired or both? As we age:
Some of us inherit excess fat that further hides our normal sparkle. Whether from congenital excess fat or the result of aging, blepharoplasty can rejuvenate your puffy, sagging or tired-looking eyes by:
Upper blepharoplasty is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of your field of vision. Older techniques removed significant fat from the upper lid. Today, we rarely do this since it creates a defect that later requires fat grafting. Both blepharoplasty and fat grafting are almost always done as an outpatient and frequently can be done in the office. If you have surrounding problems, we can occasionally:
If you have obstucted upper vision, this can be corrected by the blepharoplasty procedure if the problem is caused by the weight of the excess skin on the upper lid (mechanical ptosis) as the extra skin is removed. If instead you have droop of the upper lid caused by laxity of the levator muscle that raises the lid (muscular ptosis), the muscle can be shortened through the blepharoplasaty incision. This markedly corrects the “tired” look of the upper lids.
Lower blepharoplasty will usually correct the dark circles under your eyes allowing you to look younger and more vibrant. Newer techniques give you better results that last longer and avoid many of the problems of the older methods. Today we rarely remove any of the lower lid fat, as loss of fat in the area is one of the main reasons the cosmetic problem exists. Fat removal, in fact, leads to worse problems in a few years that are harder to correct. The most effective purely surgical method to treat severe “bags” requires significant manipulation of the tissues of the lid. This is usually done under significant sedation or general anesthesia. Since this has a high rate of problems, we now do a less extensive but very safe and effective office procedure and treat any residual deformity with fat grafting. This not only provides superior cosmetic results but markedly reduces problems. You can combine this procedure with others such as a Today’s Liquid Lift, forehead lift and/or BOTOX® Cosmetic treatments to achieve other desired results. When done alone, we usually perform the procedure as an outpatient. You should be able to wear makeup and return to the public in 4-5 days. The fine incisions usually virtually disappear within several months.
While many people will require full surgical correction to achieve rejuvenation of the upper and/or the lower eyelids, others may obtain excellent correction using fillers like Juvéderm™Voluma and other Injectables, including fat. These are also excellent in correcting post surgical deformities in both the upper and lower eyelids from previous blepharoplasty, especially in those where fat has been removed.
Before and After – 49 Year Old with Lower Blepharoplasty
Before and After – 69 Year Old with Upper and Lower Blepharoplasty
Before and After – Early 60’s with Upper and Lower Blepharoplasty
Before and After – Blepharoplasty with correction of Ptosis
Blepharoplasty is a term for a procedure to improve the cosmetic appearance of the eye area. Therefore, the time that it takes depends on exactly what procedure is done. A simple upper blepharoplasty that corrects excess skin and, occasionally, fat of the upper lids, takes about 1.5 – 2 hours total in the office. Extra time is required to remove the muscles between the eyebrows so you no longer need Botos there or to tack the eyebrows up to prevent their descent. Lower eyelid lift takes a similar time. Both are done under local anesthesia, though mild oral sedation can be used if desired, in the office.
Recovery also varies depending on what is done. Sutures are usually removed in 3-5 days. Swelling usually also resolves in about that time. Bruising can take longer but can be covered with camouflage make-up so you can return to normal activities.
Most people require only Tylenol to control the minor discomfort most have. If required, something stronger but, generally, not an opioid can be prescribed.
The incision for upper blepharoplasty, including reduction of the glabella muscles and tacking the brow up, is in the crease where the skin folds from the flat of the lid margin to the upper soft tissue as the eye is opened. The scar is, therefore, only visible when the lid is closed. The lower lid incision is just under the margin of the lid to the lateral lid margin and then in a natural smile crease.
Scars result from any surgery. However, within 2-6 months, the scars from this procedure become almost invisible.
There are possible risks and complications to any procedure. However, over the years I have modified the blepharoplasty procedures to make them as simple as possible to allow them to be done in the office under local anesthesia. This has also made them safer by eliminating or reducing most of the major risks. It has also markedly reduced the recovery time. The most common, though still unusual post-op problem, is residual though significantly reduced tear trough. This, however, can be corrected by use of a filler or fat injection.