I live in the UK and am 61 years old, and I am thinking of consulting 3 Ocuoplastic surgeons regarding upper and lower Bleph surgery. I wondered what your recommendations would be? I have a very noticeable vein under my left eye since my early 20s, and it really bothers me (photo). I also have quite a few smaller veins which are not visible on the photo. Could anything be done about these during surgery? I also have what I think is Syringoma under my eyes, is this a contraindication? Thanks
Upper and Lower Eyelid Surgery? (photo)
Doctor Answers (9)
I live in the UK, and I am thinking of upper and lower Bleph (Eyelid Surgery).
The photos provided would indicate an Upper and Lower Eyelid Surgery could improve the aesthetic appearance of the eyes.
Brow lift or blepharoplasty- which is better for eyelid problems
An experienced plastic surgeon or maybe an oculoplastic surgeon should be able to evaluate your entire face and offer treatment options. It is very important to look beyond the lids and evaluate the brow position in situations such as yours because a browlift (forehead lift) may be the better way to deal with most of the excess skin and in addition treat low eyebrows as well as forehead wrinkles, loss of brow arch shape, and active frown lines. Excess bulging fat in the lids however requires a blepharoplasty. Sometimes both a brow lift and a blepharoplasty are needed to get maximum results.
Look in the mirror and use four fingers to raise your brow to a reasonable height (so you don't look surprised) and see how your eyelids look.
Lower lid surgery may or may not require skin removal but surgeons have become more conservative with skin removal and often wrinkled skin is better treated with a CO2 LASER rather than removal. The lower lid puffiness is usually treated by repositioning the fat down lower in the lid to fill in the hollowed/ shadowed area (tear trough) rather than removal. Sometime the entire cheek must also be lifted to further fill in the tear trough and redefine the cheek and the lid-cheek junction.
The veins can rarely be removed by laser but can be surgically stripped if they are large enough.
You can see that a full evaluation should include an overall look at your face and a discussion of these possibilities..
61 years upper and lower eyelids surgery
From the photo. it looks like your eyebrows are on the low side. performing upper eyelid surgery would bring your eyebrows lower. Consider a endoscopic forehead lift at the same time.
I have successfully used laser technology to get rid of all veins around eyes and present that in Italy.
Syringomas under eyes can be remove with radio frequency performed sequentially, bu do that after your eyelid surgery in case you need eyelid skin removed.
David Ellis MD FRCSC
Toronto Facial Plastic Surgeon
Art of facial surgery
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There are some safety things that should be done. A complete examination with regard to any dry eye. At age 61 you may have some of these issues and it is important to evaluation before surgery. Make sure you bring old photographs so you can discuss the way you have changed over time. These can be useful. There are many good oculoplastic surgeons in the UK. Go to the ASOPRS site and see
Upper and Lower Eyelid Surgery? (photo)
Your idea of seeing 3 Oculoplastic surgeons is sound. You will get several opinions of what will help you the most and then can decide. From the photo, I do not see any contraindications to blepharoplasty, but a full examination is needed.
Upper and lower eyelid blepharoplasty
The primary goal upper lid blepharoplasty is removing excess skin and a small amount of fat. The primary goal of lower eyelid surgery to remove fat bags (creating the puffiness) and a little bit of skin. The incision on the uppers is in upper eyelid crease while the lower fat pads are removed from a trans-conjunctival approach on the inside of the eyelid. When excess skin is removed on the lower lids, a small pinch technique is performed on the lower lid margin and closed with Histocryl tissue glue. The procedure takes approximately an hour under general anesthesia, and anticipate 2 weeks of bruising and swelling after the procedure to recuperate.
Upper and lower lid blepharoplasty would improve your appearance. Continue with you plan to consult with your 3 oculoplastic surgeons.
4 lid blepharoplasty
A 4 lid blepharoplasty sounds reasonable but an exam in person is key to appropriately evaluate you.
You wont need an oculoplastic you need a plastic surgeon/
you would need to lift both eyebrowns and correct cross feet plus lower palpebral, resecting a little fat and the possible syringomas, total recovery time 1 week.
local anesthesia plus sedation, ambulatory aproximately cost:between 2 and 3 thousand USD everything included more information on lower paragraphs