Few would argue that the eyes are one of the most expressive features of the face. It stands to reason, therefore, that blepharoplasty (BLEF-AR-OH-PLASTY) can affect one's appearance as dramatically as any facial plastic surgery.


Blepharoplasty is a safe, effective procedure accomplished to restore a more youthful appearance and less fatigued look while maintaining or improving function. Performed to remove excessive skin and fat around the eyelids, blepharoplasty is one of the most common facial rejuvenation procedures. Once thought a beauty procedure sought by only wealthy women, men in today's competitive corporate workplace are increasingly seeking eyelid surgery to restore a younger look that more typifies their energy level.


When patients come to our office seeking facial plastic surgery, it's not uncommon for them to focus on a single aspect of their appearance rather than the overall picture. Blepharoplasty alone is not always the answer to redundant skin about the eyes. Premature aging and dropping of the brow can cause a tired, angry look with frown lines and sagging skin. It is not uncommon for patients who come to my office for evaluation of the eyelid area to simultaneously discuss an eyebrow lift. Read more about endoscopic browlift to see if this procedure is right for you.

 
Along with baggy eyelid skin, an additional source of concern is textural or surface changes (fine little lines) in the skin around the eyes. Although some improvement in facial wrinkles can be obtained from a blepharoplasty, it will not address all the superficial lines that come from premature aging, overexposure to weather and genetics. Blepharoplasty addresses "excess skin and fat; skin resurfacing such as chemical peels and laser surgery addresses textural wrinkles and imperfections.


A good surgeon, knows that his responsibility is to evaluate not only the areas of concern but also the motivation behind the requests. It goes without saying that blepharoplasty won't save a failing marriage. Similarly some patients not ready for cosmetic surgery are better served with conservative measures, such as Botox for fine lines and wrinkles or Collagen for crows feet. Patients who educate themselves about facial rejuvenation know when and if the time is right to proceed.

When discussing rejuvenation procedures the best place to start is by looking at before and after photos to see just what can be accomplished. As you will see in the photos, patients often ask to combine an eyelid lift with other cosmetic surgery. Facelifts, chin implants, cheek implants, rhinoplasty (nasal surgery), otoplasty (ear surgery) and lip surgery can also be performed in conjunction with blepharoplasty.
The illustration (left) shows the incision placement for upper and lower eyelid surgery. For traditional lower eyelid blepharoplasty, it is common that an incision is made in the lower eyelid skin with removal of excess skin and fat to achieve a refreshed look.
 

 

However, an advanced technique that has been performed successfully for the past ten years on lower eyelids is the transconjunctival blepharoplasty. (Wow! That's a big word! The conjunctiva (con junk tie vah) is the pink inner lining of the lower eyelid.) With this approach, the incision is made just inside the lower eyelid and no external incision is required. Ask your facial plastic surgeon if you are a candidate for this surgery.

 

Revision Eyelid Surgery


While we're on the subject of alternatives to traditional blepharoplasty, we would like to include a word about revision eyelid lift. It is not uncommon for patients to be referred to us for revision cosmetic surgery. The following instructions for eyelid tuck apply to all patients undergoing blepharoplasty. However, revision eyelid patients have their own set of challenges.


In revision blepharoplasty, the facial plastic surgeon is working on an area that has previously undergone changes. Correcting previous surgery by another plastic surgeon can be a bit more complex and, therefore, may take longer than the initial surgery. Also, swelling can be more pronounced with revision surgery as well as a slightly longer healing time. Please don't hesitate to contact us if you have questions about previous cosmetic surgery.


At your initial consultation, we evaluate the bony and soft tissue architecture as well as the form and function of the eyes. Assessment of the upper and lower eyelids along with the eyes themselves provides the basis for what one may expect from blepharoplasty. Skin type, ethnic background and age, along with the degree of deformity and function are important factors influencing the outcome of surgery.


As with all facial plastic surgery, a thorough health assessment and realistic expectations are prerequisites. Your understanding of procedures and routines is essential to a successful final result. Following your consultation, we continue our discussion at the preoperative appointment.