What does a blepharoplasty do?

Blepharoplasties usually remove excess skin, especially from the lower eyelids, and reduce or remodel excess fat from around the eyelids.

For the upper eyelids, removing skin and focal pockets of fat is the most common procedure. For revisional upper eyelid procedures, we often perform scar revisions and restoration of fat with LiveFill to the upper eyelid.

For the lower eyelids, conventional lower eyelid surgery (subciliary incision) involves removal of fat and sometimes skin. Sometimes the procedure is performed from inside the eyelid (laser blepharoplasty or transconjunctival blepharoplasty). The subciliary procedure is falling out of favor among doctors who perform a great deal of revision eyelid surgery because of the characteristic problems it can cause, namely pulling down of the eyelid, alteration in eyelid shape, hollowing out of the eyes. Revisions to the lower eyelid usually involve cheek advancement (cheeklift) techniques, canthal reconstruction, eyelid reconstruction and eye volume restoration with LiveFill.

Definitely educate yourself to these issues and make sure your doctor is skilled with revision procedures, a good indication that the primary problems will be avoided!

Upper lid blepharoplasty is the single most rejuvinating surgery for the face that there is. It removes extra skin and sometimes extra fat and produces a rested refreshed look. It does not lift the eyebrows however.

Lower lid surgery is more complex and carries more risk. It is primarily good for the removal or redistribution of buldgy fat bags. It is not for significant skin excision. Often the main problem is tear trough formation which can be effectively treated with Restylane without surgery.

Loose lower lids are particularly risky with surgery as are lids in patients whose cheek bones are underdeveloped. Sometimes in these cases a canthopexy is recommended to tighten the lower lid to minimize the risk of it pulling down during healing. But the canthopexy can make the lids look asian and decrease the width of the eye. Patients often complain, "I wanted to look better, not different."

Excessive or 'redundant' upper eyelid skin is a very typical aging change that leads people to seek eyelid surgery. In many patients, this surgery can be performed under light sedation with local anesthesia as an outpatient office procedure. In a few cases, protruding fat behind the eyelids is also removed. As with most facial aging changes, no two people present with exactly the same eyelid concerns. Surgical treatment is therefore individualized to the needs of each individual patient.

My approach to upper eyelid surgery is to be conservative with skin excision, and to reserve excision of fat for patients with significant fat excess. In my opinion, aggressive removal of upper eyelid skin and fat is a 'skeletonizing' procedure which risks making eyes appear more deep-set and aged, rather than younger. In fact, in many patients I perform structural fat grafting (using the patient's own fat, from the abdomen or hips) to help restore soft tissue volume around the eyes.

Cosmetic Eyelid Surgery (blepharoplasty) removes the excess fat and wrinkled drooping skin of the upper eyelids that can make you look sad or tired. It also eliminates bags under your eyes and tightens your lower eyelid skin. The result is a more rested and alert appearance.

If you don't have the time, energy, or resources for a full facelift, a blepharoplasty can frequently provide you a cost-effective and quick spark.

Blepharoplasty makes a patient’s eyes look well rested and open without looking like a “deer caught in the headlights.”

During an upper blepharoplasty, extra skin from the upper eyelids is excised and fat in the area of the upper eyelid closest to the nose is removed to decrease puffiness. The goal for the lower eyelids is to remove the puffiness and bags on the lower lids.

Blepharoplasty is a common operation that creates a restorative and youthful look to the eyes.

Blepharoplasty refers to any surgery which is used to correct a cosmetic deformity of the area around the eye. It may be used to remove excess skin of the upper eyelid which can result in vision improvement or simply remove the bags around the lower eye. Blepharoplasty can be performed on either the upper or lower eyelids or both at the same time and either the left or the right side or both at the same time.

Indications for upper eyelid blepharoplasty are several. Excess upper eyelid skin can produce a cosmetic deformity or can sometimes interfere with vision. To determine if excess upper eyelid skin interferes with vision, a test is done which measures a person’s ability to see objects in their peripheral vision in a natural position and with the excess skin taped out of the way.

Excess upper eyelid skin can also be causing a cosmetic problem and for women this often leaves them without a platform to put makeup on. Upper eyelid blepharoplasty involves removing the excess skin of the upper eyelid, possibly with some muscle, and closing the incision in a natural skin crease. Once healed, the incision is imperceptible.

During the procedure, fat may be removed from the middle part of the eyelid to produce a less full look. Care must be taken as sometimes a low brow may be causing excess upper eyelid skin and the correct procedure to fix excess upper eyelid skin is actually putting the brow back into its correct position.

Lower eyelid blepharoplasty is usually a cosmetic procedure. It involves removing the fat from the around the lower portion of the eye which generally causes bulges around the eyes as we age. The procedure can be done from inside of the eyelid or possibly through a small incision in the skin just below the eyelash line. In either case, once the incision heals, it too is imperceptible.

There are risks associated with blepharoplasty procedures and it is always important to seek a trained and experienced surgeon for any surgery. An experienced surgeon can sit and talk with you about the risks and benefits of the procedure.

It is important to share with your surgeon all of your medical problems and any medications that you may be taking. This includes herbal supplements and over the counter medications as some of these can interfere with blood clotting and increase the risks associated with the procedure. The surgeon may ask that you cease using some medications for a time period before and after surgery to ensure the best possible outcome.

Blepharoplasty surgery is generally performed as an outpatient procedure. Recovery times vary though most people can return to normal, non-strenuous activities within a week. Again, an experienced surgeon can better inform you as to the expected outcomes and return to normal activity schedule.

If you are contemplating blepharoplasty surgery, be sure to research the procedure and find a qualified and experienced surgeon. Additional research will help you to be a well informed and thoughtful patient.

Blepharoplasty helps improve the shape of aging eyelids by trimming of excess skin and by sculpting of the deeper layers (fat and muscle).

It is important to realize that blepharoplasty does not help with the following:

• Droopy eyebrows
• Wrinkles caused by smiling or squinting
• Thin and sun-damaged skin
• Dark circles under the eyes
• Volume loss in the tear trough area