Hi. Is the so called "hollywood blepharoplasty" where you remove orbital fat to make the eyelid crease look higher, like many did in the 60s safe? And what is the reason it is out of fashion now and called sunken eyes? I think it's beautiful and have always wished to get the look. Can someone tell me more about this and the differences between "modern" blespharoplasty and this one? Thank you very much.
The Hollywood Blepharoplasty? (photo)
Doctor Answers (9)
The Hollywood Blepharoplasty?
Some of the periorbital anatomy is individual and genetic, but all upper blepharoplasties can be tailored to the individual. More of the fat pads can be removed if that is what the patient would like. Find a plastic surgeon with ELITE credentials who performs hundreds of eyelid surgeries each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA
I was always a conservative upper bleph surgeon becuase I felt that many patients looked too hollow and therefore older or sik. A young eye has fullness that is my goal.
This is a great question. As the concepts of aesthtic surgery have evolved, so have the surgical techniques. If you look at younger people, they tend to have more volume in their faces. Volumetric analysis has shown that one loses volume as one ages, and thus to try and restore a youthful appearance we add volume with fillers. We also try and preserve volume when appropriate with surgery. The goal of aesthetic surgery is to make the patient look rejuvinated, not different. Creating a high lid crease in a patient who never had this will often make them look different and unnatural. Also, aggressively removing fat aroung the eyes can make them look gaunt.
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The Hollywood Blepharoplasty?
Just to mores of the time period we are in. The "new" look is a fuller less skeletonized empty look.
Modern vs old "Hollywood" blepharoplasty
It is true that upper blepharoplasty used to include significant fat removal, creating a high eyelid crease, with hollow appearance. However, it is that hollow appearance that makes someone appear older and the hollowness is something that gets worse with age as one loses more fat around the eyes with age. The goal of modern upper blepharoplasty is to make someone more youthful without making them look unnatural and older. Therefore, fat is usually not removed any longer (except for medial fat pad) unless the person has very puffy upper eyelids.
current aesthetic concepts in blepharoplasty
In the 60s and 70s it is very common to remove a significant amount of fat in the upper eyelids to give that hollowed eye look. That look is now fallen out of favor, and we are much more conservative on the amount of fat and muscle taken in an upper lid blepharoplasty. The more fat and muscle strip is taken, the deeper and higher the crease becomes. Current aesthetic concepts today leave behind muscle and a little bit of fat to give a more full look which is a sign of youthfullness. Excellent communication with your surgeon is imperative to give you the results you desire
Hollow look in eyelids is not youthful or attractive.
If you look at a lot of beautiful young women, you will see that they have full eyelids. We have learned over the decades that removing a lot of orbital fat can give you a "clean" look, but doesn't make you look better. Now we tend to reposition fat, and even add fat with fat injections. A real evolution.
Trends in surgery change due to the long term follow up.The newer techniques use the eyelid fat to fill defects in the lower lids as the fat stays attatched to the face keeping its blood supply. This was not done many years ago. In my experience, I only performed modern style surgery once the peer review process took place.Sunken eyes come from fat atrophy with age or excessive fat removal from previous surgery.All the best
The shift to less aggresive upper and lower lid bleph. has a lot to do with long term follow-up of these patients.As we age most patients loss even more fat leaving eyes emerging from hollow orbits. looking bad enough to inject the orbits with their own fat or one of the fillers. The other problem is the lacrimal gland can be damaged or removed leaving the patient with serious dry eyes. one can always touch up a result ,removing residual fat or skin, but adding tissue back to treat dry eyes or the lids wont close at nite is more difficult.