Does Skin Excision Have to Be Combined With Muscle Manipulation?

Can skin only be done in Upper Blepharoplasty or does muscle (even if a little) always have to accompany the excision of skin? This is based on the patient wanting skin only (without any manipulating and/or removing muscle) and one who is "not" interested in the outcome resulting in the optimal of a cosmetic, aesthetic look. Thx.

Doctor Answers 10

Upper blepharoplasty to remove only excess skin

The upper blepharoplasty procedure can involve trimming excess skin, a very conservative strip of muscle, and removal of a portion of the 2 fat pads in the upper lids.  The results are quite variable and are tailored to each individual patient depending upon the needs, wishes, desires, and the physical anatomy of the eyelids.  Surgeons have become more conservative over the years about removing muscle and fat to prevent the hollow eye look.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Modern upper blepharoplasty (skin only)

In the past, upper blepharoplasty included removal of skin, muscle, and fat from the upper eyelids.  We have since recognized that we want to preserve the fat and muscle to provide more fullness to the upper eyelids, thereby creating more youthful appearance. Therefore, upper blepharoplasty now includes only skin removal, with some exceptions.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 74 reviews

Options in upper eyelid blepharoplasty

Many times I perform a skin only upper eyelid blepharoplasty.  A muscle excision is only needed when you are trying to deepen the supratarsal crease.  In a younger patient it is not unusual to leave the muscle alone and make small incisions through the muscle to remove bulging orbital fat.  This helps to preserve the youthful fullness of the eyelid.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Skin Only Blepharoplasty

Yes, a skin only blepharoplasty is certainly a possibility.  The best advice is to talk with your surgeon about your goals and objectives of the surgery and let them give you your surgical options.  That way, you can both come up with the best plan for your surgery.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Skin only upper lid excision

It is certainly possible to perform a skin only upper lid blepharoplasty especially if you have a very hollow upper lid.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Upper Lid Blepharoplasty Technique

Although both skin and muscle have both been excised together in the classical description of upper eyelid blepharoplasty, excising muscle is not a necessity.  In my opinion, preservation of orbicularis oculi muscle is preferable and leads to a more natural look, preventing an overly deep upper lid crease, preventing a superior migration of the upper eyelid crease, and preserving infrabrow fullness.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 95 reviews

Skin-only blepharoplasty

Skin-only blepharoplasty can always be done. The decision to remove muscle has to do with the preexisting amount of fullness in the eyelid. If this is not an issue, no muscle removal is required. One can always go back in later to trim the muscle.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 38 reviews

Skin only upper eyelid lift

For a select group of patients, skin is the only problem and there is no redundant muscle tissue.  For these patients a skin only excision is the perfect option.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 135 reviews

Blepharoplasty with only skin excision

Blepharoplasty can be performed with only excision of skin and not excision of muscle.  Every patient is different, so the procedure is not always done exactly the same in each person.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Skin Only Upper Blepharoplasty

  Skin Only upper blepharoplasty can definitely be performed instead of conventional bleph, and I do it every day (as do many, many other surgeons).

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.