Current concepts in cosmetic eyelid surgery

Hisham Seify, MD, PhD, FACS

Article by
Orange County Plastic Surgeon

Rejuvenation of the eyes remains one of the most thought after procedure in plastic surgery. In the majority of my patients, the early signs of aging start around the eyes. The brow starts to sag giving a tired appearance. The upper eye lid becomes heavier and droopier. In some patients this could lead to obstruction of vision. The lower lids tend to be baggy and with the effect of gravity the cheek droops leaving behind deep tear trough and cheek lines.

Reversal of the facial aging could be done in two different ways:

1.Non-Surgical:  Lasers, peels etc. can provide skin tightening and could help with discoloration. Skin care products will maintain this effect and will help avoiding further skin aging.

Fillers e.g. fat, Restylane, Juvederm etc. will help to fill the tear trough and soften the eye lid cheek junction. Botox could be used to relax the frowning muscles and raise the eye brow. The combination of all these modalities is sometimes called the liquid face lift. It works for mild to moderate aging.

2. Surgical: Upper blepharoplasty will remove the excess skin and fat and gives a youthful shape for the upper lid.

A combination of lower blepharoplasty and a cheek lift will rejuvenate the whole mid face and will soften the lower lid junction. The fat of the lower eye lid is redraped to cover the cheek bones. Support of the delicate eye lid structures is important technically. 

Surgery around the eye is a delicate surgery that requires special expertise, a board certified plastic surgeon with special Occuloplastic training and interest would be the gold standard. The final goal is to achieve a natural look with a healthy recovery.