Does the Muscle in Back of Lid Have to Be Cut During Eyelid Surgery?

i'm considering eyelid surgery but after hearing about cutting muscle i think i'll just have some trimmed off lids. Should I see a resonable result? Does the muscle have to be cut to have good results? my vision is not impaired so it will be cosmetic only. i'm 58 years old and think this will hold me for a while. won't care after 70+. is this a good decision? thanks for your time.

Doctor Answers 13

Muscles in eyelid surgery

When performing an upper lid Blepharoplasty it is rare that I will cut or remove any of the orbiculares muscle. If there is a fullness from fat herniation, I will will remove a minimal amount of fat and only from the medial side (closest to the nose). I believe that by leaving the muscle intact, you will achieve a natural fullness to the upper lid which is more youthful.

Medford Plastic Surgeon
4.8 out of 5 stars 40 reviews

Muscle excision with blepharoplasty

Sometimes surgeons trim some of the orbicularis muscle which is directly under the skin. This can help to sharpen the crease. I prefer in most cases to leave it intact to keep the fullness in the eye. which I feel is more youthful looking.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Eyelid muscle not always cut during eyelid surgery

No, the eyelid muscle is called the orbicularis oculi muscle and is occasionally trimmed of excess muscle. This is to deepen the upper lid fold when necessary. If your desire is to get a deeper fold of the upper lid, then sometimes this muscle can be trimmed. If you want more of a full look the muscle is not trimmed.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Eyelid Surgery Technique for Extra Skin

Cosmetic eyelid surgery (blepharoplasty) has many variations. Let's focus just on the cosmetic surgery of the upper eyelid. Most plastic surgeons generally remove a small strip of muscle in addition to excess skin for eyelid enhancement. Some eye plastic surgeons may remove the extra skin only. Less commonly, a small amount of fat is also removed from the upper eyelid area. Lastly, some patients have droopy eyelids (ptosis), usually from age, and require tightening of the eyelid. Each technique has its advantages and disadvantages.

Only after a comprehensive evaluation by a specialist can an appropriate upper eyelid surgery be determined for you. Best of luck.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Everybody is different

The answer is depends, your surgeon will examine you and determine what is the problem, based on his examination and experience he/she will recommend a plan of treatment. Some patient will required excision of skin, fat and muscle in different proportions depending on their individual characteristics. If you are one of those patient with increase amount of muscle and this is not resected, you will not have an optimum result from your surgery.

Good luck in your surgery

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 28 reviews

Some procedures only require removal of skin

Surgery for the upper lid usually requires removing skin and some fat. Some patients have a hollowed out upper eyelid so no fat is removed in them. As a matter of fact ,sometimes fat is placed into the recess in the upper eyelid immediately beneath the bone in the upper eye socket ,to correct the hollowed look.

For the lower eyelids, less skin is removed but more fat is either removed or repositioned. Since the fat lies beneath the both the upper and lower eyelids, if that is being removed or repositioned, it is necessary to at least cut through the muscleto get to the fat. It's not unusual to remove a small strip of the muscle, but this does not affect the eye muscle movement. This is an external muscle that is circular in shape and is responsible for winking.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 20 reviews

Eyelid surgery, blepharoplasty, involves a number of steps

Each person needs to be evaluated as in individual. Some only have extra skin in their eyelids to be removed. Some have extra fat,while others need their own extra "fat pads" moved to an adjacent area. Third, the muscles should be preserved but sometimes trimmed. The results should last 10 years or more and make you look more youthful and less tired. I suggest you seek out a specialist in facial surgery to determine what is best for you.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 125 reviews

Upper eyelid lift

No, the muscle does not always need to be cut. Many plastic surgeons take only skin and leave the muscle untouched. It is very dependant on what you truly need. My personal take on the matter is that patients can request what parts of their face get operated on but they probably shouldn't request what techniques are used. Your surgeon should make the recommendation as to what is best but an educated discussion on the matter will clarify your comfort with your plastic surgeon as he should know a very clear and distinct answer to your question.

Best Wishes.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 119 reviews

Droopy eyelid

You may be talking about performing muscle surgery from a posterior (back of eyelid) approach in order to correct droopy eyelid, which is different than just excising skin from the front (blepharoplasty). They are each done for a separate reason, depending on the need: do you have excess skin or is it droopy or both. I routinely perform both procedures, if needed.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Most patients will need muscle excision

Upper eyelid surgery usually involves excision of the orbicularis muscle. This is to remove the excess tissue that is sagging and prevent too much fullness .
The techniques for the eyelid surgery will vary from patient to patient also surgeons experience

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 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.