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Upper and Lower Blepharoplasty

Upper Eyelid Blepharoplasty

The upper eyelid blepharoplasty is the most commonly performed facial cosmetic surgery for several reasons; extra or puffy upper eyelid skin is a very common problem, the surgery is relatively straightforward involving minimal risk and recovery time, and most patients will have an excellent outcome with a very natural and non-surgical appearance.

With age, the thin skin of the eyelid stretches and hangs down over the eyelid. Additionally fat underneath the skin can protrude (especially fat pads in the inner upper eyelid) causing an abnormal puffiness to the upper eyelid. These changes may occur as early as the late twenties or early thirties. This droopy eyelid skin can lead to a sad, tired, or angry appearance.

The upper eyelid blepharoplasty is a surgery designed to remove the extra skin and fat in the upper eyelid. Surgery involves removal of skin, muscle, and fat via an incision hidden in the upper eyelid crease that becomes virtually undetectable after healing is complete. Each patient’s eyebrows, eye sockets, and eyelid shape (and position of the eyelid crease) are unique and influenced by age, sex, and ethnicity. For patients with droopy or low brows, a brow lift may be recommended to enhance the results of an upper eyelid blepharoplasty. Surgery is individually tailored based on each patients ethnicity, age, sex, and unique anatomy to give a natural appearance.

Cosmetic Surgery is typically performed as an outpatient under intravenous sedation. Minor bruising and swelling typically resolve within the first two weeks.

Lower Eyelid Blepharoplasty

The lower eyelid blepharoplasty is a surgery designed to correct puffiness, bags, and fine wrinkles in the lower eyelids. Whereas the upper eyelid blepharoplasty is performed in a relatively similar fashion in most patients there are hundreds of different techniques to lower eyelid blepharoplasty. Why? The anatomy of the lower eyelids and the associated aging changes presents several challenges that must be addressed to achieve an excellent outcome.

Lower eyelids may have a component of looseness (laxity) or be pulled down away from the eye (retraction and ectropion). The very thin eyelid skin may become finely wrinkled like crepe paper. The cheek fat pads that create high cheeks, and contribute to a smooth transition between the lower eyelid and cheek when we are young, lose fat and volume with age. This leads to a longer lower eyelid and the appearance of a natural valley in the lower eyelid near the nose (the tear trough). The tear trough can give a heavy shadow and the appearance of dark circles to the lower eyelid. The fat underneath the eye can bulge forward above the tear trough, leading to the appearance of puffy eyes. Some people develop fluid in the lower eyelids (festoons) as well.

Each surgery is tailored to the patient in an effort to best address the aging changes of the lower eyelid. Fat may be removed from the lower eyelid but some patients may benefit from the addition of fat transferred from other areas of the body (autologous fat transfer or fat grafting) in an effort to restore the volume and fullness of the cheek as it blends with the lower eyelids. Cosmetic Surgery is typically performed as an outpatient under intravenous sedation. Minor bruising and swelling typically resolve within the first two weeks.

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