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Which Blepharoplasty Type is Better?

asked 3 years ago by AshleyDallas in Dallas, Texas
Latest answer by William Portuese, MD
Question viewed 756 times

I was looking into getting a blepharoplasty and there are two kinds: the one that involves an incision, and the one that is just string. The string procedure is known to "undo" itself over time and it less reliable than the incision. However, if the patient is not happy with the results of the incision procedure you cannot undo it. Which procedure would you recommend? How long is the recovery time for each procedure? I want my results to be natural looking and I want to be out in public within 2 weeks of the surgery.

14 answers to Which Blepharoplasty Type is Better?

String surgery vs. real surgery

Blepharoplasty is rejuvenation of the eye area. Upper or lower eyelids can be rejuvenated. That's where the standardization in periorbital surgery ends. In recent years, focus has shifted toward fat preservation, microadjustment in eye shape, and considering the face as a whole, rather than just the "do the eyes approach" with a standard removal of skin and fat. There is no one single technique that is right for every patient. A skilled plastic surgeon will rely on many... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Forget the string, have a transconjunctival blepharoplasty

Strings pull out and can distort your skin if not placed correctly-these techniques have caused terrible results and are usually offered by doctors who do not know how to or have not been trained in eyelid surgery, in my opinion. Blepharoplasty surgery can provide a beautiful result when done by an experienced board certified plastic surgeon. There is no non-surgical substitute when a blepharoplasty is truly indicated. The more modern transconjunctival blepharoplasty with arcus release and... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Go with the tried and true procedure

To be honest, your description of a string-only procedure sounds like something not used very often. If you go to an experienced plastic surgeon there should be little concern about being able to "reverse" the procedure.

Richard Baxter, MD
Seattle Plastic Surgeon

Traditional blepharoplasty is the gold standard

The “string” blepharoplasty has not been time-tested and is not universally accepted amongst facial plastic surgeons. Traditional blepharoplasty has been performed for many, many years and continues to be the gold standard. The swelling and bruising which occurs after a blepharoplasty should be subsided at two weeks so that patients can return to their normal social and daily functions including exercise.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

String Procedure not recommended for eyelid rejuvenation

I too am not sure about what procedure you are talking about regarding the placement of a string but I can tell you it will not produce natural long lasting results. Eyelid rejuvenation is best accomplished with surgery (blepharoplasty), volume replacement (fat or fillers), or skin rejuvenation. Which of these modalities would be best for you would be determined by your board certified plastic, occuloplastic, or facial plastic surgeon.

Richard Gentile, MD
Cleveland Facial Plastic Surgeon

www.facialplastics.org

Incisional surgery more reliable

String procedures are primarily suspension procedures that pull tissue upward but do not correct the underlying problem. Most patients excess skin on the upper lids with a small amount of fat herniation and on the lower lids more fat herniation with less excess skin The lower lids are usually more of a problem to treat. That's why there are so many different approaches and techniques described. Fat can be repositioned, removed, or reset and the excess skin is usually pulled slightly... more

Joseph M. Perlman, MD
Houston Plastic Surgeon

doctorperlman.com

If you have a real issue get REAL surgery

I've never been a fan of "fly by night" surgery that can be done by anyone who claims to have a medical backround. If you have a real, diagnosible issue, then get real gold standard surgery. With these other procedures you'll spend money now then again in a year to get the real surgery. If it sound too good to be true...

Christopher L. Hess, MD
Fairfax Plastic Surgeon

Strung up in Dallas?

Ashley, In cosmetic surgery in general, the less invasive you are, the less dramatic and shorter lasting your results are. The benefit is that the recovery time and expense are usually less. String lift recovery is maybe 5 days and eyelid surgery 7-10 days. Although string lift procedures for elevating the eyebrow do have some lifting effect on the upper eyelid, they do not directly address the eyelid. They are also considered less invasive than open eyelid surgery and thus the results... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Stick with the gold standard

You should stick with the gold standard. There are many tricks and gimmicks, however the best procedure is the traditional blepharoplasty. If you post pictures, we may be able to give you more specific advice. Two weeks should be plenty of time for your recovery. You may have trace swelling and/or resolving minimal bruising. Most patients are ready to go out in public without sunglasses within a week of surgery.

David Shafer, MD
New York Plastic Surgeon

Not clear what you're referring to for Blepharoplasty

Dear Ashley, It is not clear what you are talking about and I am not sure that the general plastic surgeons who are answering your question really know either. When you are talking about string procedures for eyelid surgery, generally what is meant is the vast array of upper eyelid crease forming procedures done to make a double fold in the upper eyelid. These are primarily for asians lacking a well-defined upper eyelid fold. There are numerous procedures for threading the eyelid with... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

The string procedure is just a gimmick.

Hi! There are different ways to make the eyelids look better, but the string procedure is not one of them. Some good techniques use skin incisions and some don't. It depends on your anatomy. Find a board certified plastic surgeon who does a lot of eyelids. Ask to see a lot of before and after pictures. Ask to talk to a patient. Then get a second opinion.

George J. Beraka, MD
Manhattan Plastic Surgeon

Don't get strung along by an inferior procedure.

As it gets harder and harder to earn a living in medicine, more non plastic surgeons are trying to hone in on a lucrative field. They have little if no surgical experience, so try to do things that are easy. This may be a quick fix, but it will not last long and should be avoided. Talk to a board certified Plastic Surgeon with a good reputation before getting hung up on string.

William B. Rosenblatt, MD
New York Plastic Surgeon

Keep researching, but don't be fooled by gimmicks.

Make sure you get opinions from Board Certified Plastic Surgeons with lots of experience doing lower eyelid surgery. As you have already found, most of the plastic surgeons will not recommend anything other than the standard lower eyelid surgery. It is the best way we learned how to give the best, most permanent results. As with any surgery, see lots of pictures, ask lots of questions, and get references. Good Luck!

Thomas T. Nguyen, MD
Orange County Plastic Surgeon

Lower lid options

The techniques in lower blepharoplasty have expanded dramatically over the last few years. this si because we have developed a much greater appreciation of the anatomy and function of the tissues around the eye. Today we appreciate the value of retaining fat and repositioning it to preserve the youthful appearance of the eyelid and cheek. Maintaining or improving the shape of the eye is also a key apsect of lower lid surgery. Procedures which rely on sutures and strings without manipulation... more