The standard technique of upper eyelid surgery has been practiced in the 1920s and it was taking out skin, some fat as needed. And they're taking a bit more skin to tighten it all up and that was the operation. And then within a few years that would start to relapse and so more skin was taken out and sometimes people have it the third time and that's the origin of the term "nip and tuck". Like you have a bit now and then you can make it have some more layer. Now there is another way of doing the eyelid surgery. It's not popular, it was introduced to the ‘80s and it's an evolution of the technique that is used by Asian eyelids. And because if you look at people who have really nice eyes, they don't age, they tend to stay nice and bright as people age and so they're always look lovely and then look young for their age.

And so what you do with the surgery is correct the deficiency that's allowing early aging permanently by defining the lid crease. So with the lid crease then you're not removing very much skin at all because you need skin to go it back in to give a nice firm definition. That the big advance and this is where fat is really useful because as we age, everyone loses some of the fat in the lid, it might have had too much when they're young and yet getting in their ‘40s and ‘50s and even people would have just the right amount of fat and bright eyes lose some fat and so fat injections in the upper lid is so important, so beneficial.

Upper Eyelid Surgery Defines the Eyelid Crease

Dr. Bryan Mendelson explains that upper eyelid surgery used to mean removing droopy skin and fat over a series of multiple surgeries, as needed, but today, we understand that defining the crease is the most effective method.