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Blepharoplasty of Upper Eyelids. Is fat and muscle removed or just skin?

asked 1 year ago by July4 in USA
Latest answer by William Portuese, MD
Question viewed 877 times
Tags: excess skin, removal

Do most surgeons remove fat and muscle in the upper eye lids during blepharoplasty? Or is just the excess skin removed?

34 answers to Blepharoplasty of Upper Eyelids. Is fat and muscle removed or just skin?

+3

Each eyelid surgery should be tailored to your unique needs.

Dear Cerro Classically upper blepharoplasty involved removal of skin, muscle, and fat. However, it is the details that separate a beautiful upper blepharoplasty from a butchery. Generally surgeons go wrong with these surgeries by removing too much of everything. Skeletonizing an eyelid only makes the eye look like it had surgery. It does not make for a rejuvenated look. It is not enough to make someone look different. It is essential to make them look... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+3

Blepharoplasty of Upper Eyelids. Is fat and muscle removed or just skin?

In my practice, I find that fat removal is often necessary in older patients. In younger patients, typically skin alone needs to be removed. Obviously, the surgical steps are tailored to each individual patient.
Maurice M. Khosh, MD

New York Facial Plastic Surgeon
+2

Upper Blepharoplasty

Hello, Mostly skin is removed. Sometimes a small amount of fat, but rarely muscle. Thank you, and I hope this helps answer your question. Dr. Nassif
Paul S. Nassif, MD

Beverly Hills Facial Plastic Surgeon
+2

Upper blepharoplasty surgery involves removing excess skin, and sometimes muscle and fat.

Most of my patients that undergo upper blepharoplasty have excess skin and hooding of their upper eyelids. The goal of upper blepharoplasty is to rejuvenate the upper eyelids, recreate youthful eyelid creases, and maintain an unoperated appearance. Unless thare is unsightly bulging of the "medial fat pads" near your nose, I rarely remove orbital fat during upper blepharoplasty. Removing orbital fat may increase your risk of complications, and may lead to orbital hollowing. The... more
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon
+2

Upper Eyelid Surgery with Skin, Muscle, and Fat Modification

Upper eyelid surgery to rejuvenate the eyes is tailored to suit the needs of each particular patient. Generally, excess skin is removed. Occasionally, excess fat is removed. Sometimes eyelid muscle is tightened too. Lastly, the specific tissue modification on one eye may be different in the other eye due to inherent asymmetry present in most patients. Eyelid plastic surgeons will explain what will occur during your procedure. Best of luck. Dr. Chaboki
Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon

www.potomacplasticsurgery.com

+2

Blepharoplasty Focuses On Rejuvenation Not Radical Excision

How an upper blepharoplasty is performed should be based on what the patient needs, not a standard operation for everyone. Blepharoplasty most certainly removes upper eyelid skin, the only variable is what is done with the fat. Is the fat removed, left completely alone, or transposed to a different location? That will depend on the patient's individual anatomy, aesthetic goals and their age. Today's blepharoplasty techniques are based on more preservation of natural eyelid... more
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon
+2

Upper Lid Blepharoplasty: What's Involved

Upper Eyelid Blepharoplasty is primarily a procedure performed to remove excess skin from the upper eyelid crease, like removing a pleat from a trouser leg. There are certain circumstances where I remove medial (inner) upper eyelid fat, but I I almost never remove central fat. Likewise, I never remove upper eyelid muscle. The reason for preserving central upper lid fat and muscle is to avoid a "hollowed out look", which is characteristic of a poorly performed... more
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

+2

Blepharoplasty Technique

Good question. There is not a one-size-fits-all procedure for belpharoplasty. Your surgeon should customize the procedure for your particular anatomy. A combination of fat excision, replacement or repositioning and excess skin removal is usually performed. If you post pictures, we may be able to give you more specific advice. Good luck.
David Shafer, MD

New York Plastic Surgeon
+2

Fat and muscle very rarely removed in upper blepharoplasty.

Hi. The range of different answers is surprising. We now realize that the appearance of the aging face is caused in good part by atrophy in the upper face. So fillers or fat injections need to be actually added at times to the upper eyelids. A young looking upper eyelid is quite full. We usually just remove a strip of skin, and leave the fullness.
George J. Beraka, MD

Manhattan Plastic Surgeon
+2

It depends!

In an upper eyelid blepharoplasty, skin is almost always removed. The muscle and fat may be thinned judiciously as necessary. It really depends on what your specific goals and concerns are, so try and be as specific as possible with your surgeon in describing what bothers you. A lot of it also depends on how you are made, for example, if you already have a very hollow eyelid, than fat excision would not necessarily be a good idea. However, if you had lots of fatty prolapse,... more
Jasmine Mohadjer, MD

Clearwater Oculoplastic Surgeon
+2

Upper blepharoplasty-skin/fat/muscle

Upper blepharoplasty is a term used to describe removal of upper eyelid tissue to improve eyelid appearance. During blepharoplasty, skin removal is the rule. Skin removal allows for the formation of an eyelid crease and greatly improved eyelid definition. In some cases prominent areas of fat may need to be removed. When indicated, removal of fat is most often needed in the area of the eyelid closest to the nose. The surgeon should be careful not... more
Adam J. Cohen, MD

Skokie Oculoplastic Surgeon
+2

What is removed during upper eyelid blepharoplasty

Skin is always removed during upper eyelid blepharoplasty in my practice, but muscle and fat are not always removed as this is tailored to the patient's specific needs. Realizing that a youthful eye general has more fullness, not less, I refrain from removing fat except in very specific circumstances (e.g. excess fat medially near the inner corner of the eye). Similarly, maintaining the eyelid muscles also helps with creating a more youthful lid, rather than an overly sculpted... more
Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon
+2

Blepharoplasty

Blepharoplasty is a generic term and refers to surgical changes to the eyelids. It should be specifically tailored to the individual anatomy and goals of each patient. Sometimes it is skin that is removed, sometime fat and some muscle. But it can also mean doing fat grafts, or muscle tightening, or moving the fold. What an operation is called is less important that what is specifically done. Robin T.W. Yuan, M.D.
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+2

Upper eyelid blepharoplasty

Upper eyelid blepharoplasty almost always removes excess upper eyelid skin. Removal of underlying muscle and / or fat should be tailored to the needs of the individual patient, but in general has become more conservative, to prevent creating a "hollowed-out" appearance. My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board-certified plastic surgeon... more
Craig S. Rock, MD

Houston Plastic Surgeon
+2

What is done during an upper blepharoplasty

Some skin is always removed but whether muscle or fat is removed or not depends on the patient and the kind of look desired. In older patients, if the inner fat pad is very prominent, it is either removed or repositioned laterally to improve an A-shaped lid crease deformity.
Peter T. Truong, MD

Fresno Oculoplastic Surgeon

www.facialsurgerydr.com

+2

Upper lid rejuvenation, skin, muscle or fat

It can be hard to say what most surgeons do during upper blepharoplasty and you will see a variety of responses. Generally our trend has been a preservation of muscle and fat with lid rejuvenation to reduce future hollowing which can be aging. Older patients may need fat reduced, often in the inner corner of the lid, while younger patients do not. Be certain to ask your surgeon specifically what plan is in mind before surgery. Best of luck, peterejohnsonmd
Peter E. Johnson, MD

Chicago Plastic Surgeon
+2

Upper eyelid blepharoplasty

There are different techniques to address upper eyelid rejuvenation. Your surgeon will review your individual findings and recommend which technique is best for you. Skin is removed but muscle and fat manipulation will be dictated by your presentation. The upper lid has 2 fat compartments which create a fullness adjacent to the nose. I limit fat and muscle resection in the upper lid as I feel a youthful upper lid has a characteristic fullness. Ask your surgeon at the time of your... more
Robert W. Kessler, MD

Orange County Plastic Surgeon
+2

Upper lid blepharoplasty

During upper lid blepharoplasty, skin is almost always removed and often, fat will be removed as well. Whether fat is removed depends on each patient. I most commonly remove a small amount of fat when performing upper lid blepharoplasty.
P. Daniel Ward, MD

Salt Lake City Facial Plastic Surgeon
+1

Upper blepharoplasty and what it removes

The primary goal of the blepharoplasty procedure is to remove excess skin from the upper eyelids. Additionally, fat is usually removed from the medial compartment closest to the nose. On rare occasions middle fat is also removed in the central component of the eyelid if it is very heavy. If there is also excess orbicularis oculi muscle folded over upon itself, a small strip of muscle can be removed which will also deepen the crease. This is all customized depending... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Upper Blepharoplasty typically involves removal of excess skin, muscle and fat

Blepharoplasty is a three dimensional operation. If you only remove skin and leave lax muscle and fat behind you will not see a nice result. I always remove a strip of muscle beneath the skin during Upper Eyelid Blepharoplasty. My opinion is that the healing of the muscle and skin create a more defined Supra tarsal Fold-the nice aesthetic crease above the eye lashes. In younger patients who have hollow upper eyelids or who have no excess aft, only skin and muscle is excised more
Brooke R. Seckel, MD

Boston Plastic Surgeon

www.drseckel.com

+1

Upper lid blepharoplasty

In perforning an upper lid blepharoplasty, I usually try to conserve most muscle and take a small strip of skin. I will often just remove medial fat as well. I think over-treated eyes make patients look old.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Blepharoplasty technique depends on the result you need.

Blepharoplasty technique depends on the result you need. If you only have excess skin then only skin needs to be removed although usually some of the muscle is also removed. If you have excess "bags" of fat then some of the fat can be removed as well.
Richard H. Fryer, MD

Salt Lake City Plastic Surgeon
+1

What is removed in upper blepharoplasty

The classic upper blepharoplasty involves skin removal, limited muscle removal, and fat removal or contouring. When I perform upper blepharoplasty I tailor the procedure to the patient's goals and their anatomy. For example, patient's with thin or skeletonized looking upper eyelids to begin with certainly don't have any fat removal done during the procedure.
James C. Marotta, MD

Long Island Facial Plastic Surgeon

www.marottamd.com

+1

West Palm Beach Blepharoplasty

While more than half of the time, i find that i am removing fat along with skin when it comes to the upper eyelids, i have many patients who require only skin removal and many who seem to require removal of skin along with a little fat pocket in the inner corner of their upper eyelid for the best results. The decision fo whether to just remove skin or excise fat with skin is often determined by what will give the best aesthetic result without compromising... more
Anita Mandal, MD

Palm Beach Facial Plastic Surgeon
+1

Upper eyelid skin

Upper blepharoplasty removes the excess or " hooding ' of skin. Often the inner portion of the upper eyelid is puffy due to excess fat and can be removed at the same time. Removal of muscle or strip of muscle can also be performed to tighten and define the crease. It is important not to remove too much fat of the upper eyelid and cause an aged hollowed out look of the patient. Each patient undergoing surgical rejuvenation of the upper eyelids is evaluated to meet their... more
Andrew Turk, MD

Naples Plastic Surgeon
+1

What is removed during blepharoplasty...

Blepharoplasty of the upper eyelids is a very effective procedure to remove excess skin and fat above the eye. During the procedure, the excess skin and a small amount of fat is removed carefully from each upper eyelid. Usually a small strip of muscle is removed to decrease the bulkiness of the upper eyelid. If only skin is removed, then some bagginess of the upper eyelid may remain. When meeting with a board certified facial plastic surgeon, he or she will be able to... more
Andrew Miller, MD

Edison Facial Plastic Surgeon

www.associatesinplasticsurgery.com

+1

Is fat removed with eyelid aurgery

Fat, muscle and skin can all be removed with upper eyelid surgery depending on the amount of loose skin, excess fat and how shallow or deep set they eyes are.
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Removal of fat, skin and/or muscle with blepharoplasty.

Removal of fat, skin and/or muscle with blepharoplasty can be done and is done according to the problem that the patient has. This is sometimes done differently for each eyelid.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

Upper Eyelid Surgery: Not always just skin

Upper eyelid surgery, or "blepharoplasty", when performed for cosmetic reasons, serves to remove heavy skin of the upper lids. Occasionally this involves removal of a small strip of muscle and may also include the removal of fat that has herniated out from behind the muscle. Usually, the decision about what to remove and how much to remove is made by your surgeon.
Theda C. Kontis, MD

Baltimore Facial Plastic Surgeon
+1

Options for Upper Eyelids

Eyelid surgery has become one of my most popular procedures. If excess upper eyelid skin is hooding the eye and needs to be eliminated, an incision is made in the crease at the top of the lid and excess fat and skin are removed. The incisions are closed and sutured on the underside of the skin leaving minimal scarring. The great thing about this procedure is that it can be performed as an outpatient procedure without the need for general anesthesia. An effective non-surgical... more
Michelle Copeland, MD, DMD

New York Plastic Surgeon
+1

Lid surgery

Skin, fat and muscle can be removed in a blepharoplasty. Removal of these tissues is tailored to each patient's needs.
Keshini Parbhu, MD

Orlando Oculoplastic Surgeon

www.orlandoeyeopener.com

+1

What I do

What is important is what does your surgeon does. I remove skin, muscle and some fat most of the time. But again, this is individualized depending on what the patient needs.
William B. Rosenblatt, MD

New York Plastic Surgeon
+1

In eyelid surgery each operation is customized

As time goes on we realize that fuller upper eyelids give you a more youthful appearance. However some patients have too much tissue in their upper eyelids and look better if some is removed. You can have extra skin or extra fullness (muscle and fat) or both. Your surgeon will have an opinion on what tissue should be removed and I would discuss this with him/her.
Marc Cohen, MD

Philadelphia Oculoplastic Surgeon
+1

Upper lid Blepharoplasty

Typical upper eyelid blepharoplasty involves removing of all 3 elements, although the muscle and fat excision is significantly less than with lower eyelid surgery. Muscle removal is done to help define the upper lid crease. Fat excision is usually limited to the central portion of the upper eyelid, just next to the nose. Skin excision is often significant. However, the big mistake can be to remove too much skin, rather than treating a low lying forehead/eyebrow. As noted,... more
Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon

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