Eyelid Surgery: Q&A

Ask a Question

Is a Lower Bleph Usually Done with a Mid-face Lift?

I had a consult with two surgeons.

Two facial surgeons have recommended lower facelift, mid facelift and brow lift. One insist that the lower eyelid has to be done in that combination because of the excess skin being pulled up and doesn't do mid face and brow lift w/o lower eyes. The other says the lower lids not necessary in that combination. I had lower lids done over 20 years ago and they aren't real bad. Does anyone have opinion on this situation?

Tags:

same time second opinion

Comment on this

18 Doctor Answers | Asked by 1554anon in Syracuse, NY

Doctor Answers (18)
Community Comments (0)

Is a Lower Bleph Usually Done with a Mid-face Lift?

The goal of any plastic & cosmetic surgery should be to make one more naturally attractive. How the surgeon accomplishes this goal can and does vary with every surgeon. Understanding that allows the prospective patient to concentrate on what is the "end result"...ie. how is the face going to be made to look more youthful and naturally attractive instead on the mechanics. With Face Lifts, IMHO, it's imperative to create more aesthetically attractive cheeks as well... more

Lower eyelids and Midface often worked on together

The lower eyelids & cheeks are 2 facial areas that are often worked upon independently or together, to achieve a great rejuvenation. It really just depends on your anatomy AND your goals. Undoubtedly, there are many options for the these 2 cosmetic units: under eye skin pinch excision, fat bag removal, under eye peel, midface lift, cheek lift, fat transfer, and malar implants among the most common. Any of these listed can also be performed with a facelift or brow... more

Yes, Lower Bleph and Mid-facelifts are commonly combined, but There are Exceptions.

Hi 1554anon, You stated the reason why mid-facelifts and lower eyelid surgery are often performed together, because of the potential for the lower eyelid skin bunching and causing more wrinkles under the eyes than prior to the mid-facelift. Just because they are often performed together for good reason, ultimately each person's face is different and their past surgical history is also different. If a surgeon follows a cookie cutter approach to all... more

George Yang, MD

13 reviews

New York Facial Plastic Surgeon

www.GeorgeYangMD.com

A Lower Blepharoplasty Is Done With a Midface Lift If It Needs To Be

As with many situations in facial plastic surgery there is not one answer that applies to all situations. The issue here is that when the tissues of the mid face are lifted upwards they tend to push the lower eyelid skin towards the lid margin, causing some wrinkling of the lower lid skin. Whether or not you need a lower lid blepharoplasty with your mid face lift depends on how much wrinkling of the lower eyelid skin you get. If you have had your lower lids done before, you may not get... more

Mid facelift and lower eyelid surgery

The issue with mid-face lifts and lower blepharoplasty is that at surgery the cheek lifting can cause some bunching of lower eyelid skin. The surgeon then removes this skin. The problem is the patient is lying down not standing and some of the cheek lifting is also lost after surgery. The end result then is too much lower eyelid skin was removed at surgery. You have to be very conservative with this type of surgical combination to avoid future problems. Without photos or a face to face... more

Lower and midfacial surgery surely will need lower bleph correction but uncomplete/si ya has sido operada de parpados infs

If you have been operated on years ago of lower bleph, and you are going to get a mid, lower and upper lifting you surely will need an uncomplete lower bleph correcting only skin and muscles without touching the palpebral fat sacs. si tu ya has sido operada previamente de los parpados infs y te vas a someter a una riti medial, inferior y superior seguramente vas a requerir tocar los parpados infs, pero en forma incompleta es ... more

Lowwer blepharoplasty and mid face lift

I am not a big fan of mid face lifts alone. I usually elevate the cheek from a full facelift. The midface lift has a significant complication rate in many studies. One problem is when too much skin is removed from the lower lid.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Midface Life is Not Always Necessary

There has been a trend moving away from midface lifting towards more conservative (and therefore, more safe) lower eyelid surgery. While some limited fat and skin removal may be required (not always), many physicians are relying on resurfacing (e.g. fractionated resurfacing lasers) and fillers (e.g. hyaluronic acid fillers such as Juvederm and Restylane, or fat injections) either with or without surgery. In my experience, and seemingly the experience of many other facial... more

Facial cosmetic surgery is customized to patient needs

There is no usual in facial rejuvenation surgery. Every case is unique and based on the patient's needs and concerns. Photos would certainly be helpful. I also agree with others that there is a difference between a little "nip/tuck" in the lower lids and a full blepharoplasty so you may want to get a clarification on this point. Good luck!

Is a Lower Bleph Usually Done with a Mid-face Lift?

Each cosmetic procedure in my practice is customized for the individual patient. Without seeing your face, it is impossible to give any opinion.

Lower bleph with mid face lift

Yes. This requires surgical judgement at the time of surgery. It isn't really a question of a true blepharoplasty. It is a question of whether or not to trim excess skin that bunches under the eyes from the cheek lift. I trim the excess skin if the skin is loose before surgery and the skin fold will clearly bother the patient afterwards. I don't trim the skin if the eyelid skin is taut before surgery or if there is only a little excess. When in... more

Lower lids and midface lift

No, lower blepharoplasty is not ALWAYS indicated with midface surgery. However, it is true that the subperiosteal midface lift creates a powerful lift of the cheek and can create excess skin that needs to be addressed through lower blepharoplasty. Also, depending on the amount of excess lower lid fat that is present, blepharoplasty may or may not be indicated. If you've had a lower bleph in the past, chances are, no lower bleph or a minimal lower bleph is necessary. more

Caution Necessary with Lower Eyelid Surgery and Midface Lift

Generally speaking, No, you don't need to do lower eyelid surgery BECAUSE you are having a midface lift. In fact, a great number of complications result when a midface lift is done and then the surgeon removes "excess" skin that is discovered as a result of the midface lift. The problem is that some of the skin movement you see right after the midface lift is temporary. As the cheek descends, it takes the skin back down with it. If that skin was removed, then the... more

Gosh, Sean is not the only surgeon who has been doing "SOOF lift with blepharoplasty."

1554Anon Sean has contributed many articles on this subject. However, in his article, transconjunctival sub-orbicularis oculi fat (SOOF) pad lift blepharoplasty which appeared in the Archives of Facial Plastic Surgery in 2000, he stated: "The transconjunvtival suborbicularis oculi fat (SOOF) pad lift blepharoplasty is a new approach that I have used for more than 18 months in 64 patients." However, many surgeons have been working on these techniques really over the past... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Lower Bleph with Midface Lift.

Hi, Its very difficult to give you an honest opinion without seeing your face. You can have both procedures at the same time or alone. See video link below that describes midface lift. Best, Dr.S. see video

Mid face lift

There is not one procedure that is applicable to all patients. The procedure needs to be customized to the individual patient. Without seeing pictures of you or examining you in person, it is impossible to give you specific or individualized advice. There are many different techniques for lifting the face, the mid face and addressing the lower eyelids. Good luck.

Mid-face lift and lower blepharoplasty

I will offer a midface lift concomitantly with a lower blepharoplasty if the patient has significant malar descent in conjunction with steatoblepharon (fat pads) in the lower lid region. Not all patients with excess skin and bulging fat pads of the lower lids warrant a midface lift. Part of the answer to your question depends on your aesthetic goals and the other on your particular anatomy. I will rarely perform a midface lift in isolation.

The answer lies in your exam!

I’ve been doing nothing but facial aesthetic surgery since 1988 and I'm the originator of the "SOOF lift blepharoplasty" so I have some experience when it comes to this question. Mid-face surgery helps improve the depth of the nasolabial fold and should rotate the malar fat pad toward the lateral cheek bone, improving this area. That's about it. The vast majority of patients that I see that have mid-face laxity also have other areas of concern such as neck and jowl laxity... more