What is eyelid surgery?

More than any other facial feature, your eyes reveal the most about how you feel. When your eyes are bright and alert, you appear energized, well-rested, and in control. However, if you have lower-eyelid puffiness, dark circles or drooping upper lids, others may assume that you are fatigued, angry or unhappy.

Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat — usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes — features that make you look older and more tired than you feel, and may even interfere with your vision.

After weight loss, there can be excess skin around the eyes that is not accompanied by fat, but the surgery still serves to correct this drooping skin.

Is cosmetic eyelid surgery right for you?

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, or if you've sustained a large weight loss resulting in excess skin around your eyes, you may decide to have eyelid surgery at a younger age. Many people in their 20s or 30s may benefit from the procedure.

A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery.

Eyelid surgery is performed on men and women of all ages who want to improve their self-image. You may be a good candidate for eyelid surgery if you have any of the following conditions:

Upper eyelids:

    • excess skin that hides the natural fold of the upper eyelids

    • loose skin that hangs down from the upper eyelids

    • puffiness in the upper eyelids that creates a tired look

As part of the consultation, your surgeon will assess the amount of excess fat and skin in your eyelid areas, the position of your eyebrows, and the condition of the muscles around your eyelids.

Your plastic surgeon may suggest other cosmetic treatments to meet your appearance goals. For example:

    • A sagging brow can be tightened and smoothed with a forehead lift.

    • Crow's feet near the eyes can be minimized with a chemical peel
      or laser resurfacing.

    • Dark circles beneath the eyes that can't be helped by blepharoplasty can
      be treated with a bleaching medication, chemical peel or laser treatment.

How is cosmetic eyelid surgery performed?

             
The specific method used for your eyelid surgery will be determined by your features and your surgeon's preferences.

Upper eyelids:

Typically, the incision begins within the natural crease of the eye's inside corner and extends slightly beyond the outside corner into the crow's feet or laugh lines. Through this incision, excess skin and fatty tissue are removed. The incision line follows the natural contour of the upper eyelid, and is camouflaged when healed.

Lower eyelids:

Usually the incision is concealed just below the lower lashes. Through this incision, excess skin, muscle and fat are removed. Your surgeon may also make special adjustments. For example, the fat beneath the eye can be redistributed to eliminate puffiness or bulges.

In some patients, the underlying muscle will be tightened. Your surgeon may decide that the best approach for removing fat from the lower eyelid is with a transconjunctival blepharoplasty. In this procedure, an incision is placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin.

Laser resurfacing or chemical peel is sometimes used in conjunction with this procedure to minimize fine wrinkles near the eyes.

In our next issue, through our interview with Dr. Mendelsohn, we'll explain what you'll need to do in order to prepare for surgery, how to find the right surgeon for you, follow-up care, and recovery & results!

This new year just might be the right time for you to consider a new you!