The eyes are the most important focal point in the face and are the keystone of facial beauty. They express our joy, sorrow and inner emotions. Aging causes sagging of the eyelid skin and stretching of internal tissues, which, in conjunction with the effect of gravity, produces the typical drooping of the upper lids and bulging bags in the lower lids. Overhanging upper eyelid skin and puffy lower lid bags make us look tired, aged and somewhat sad. Interestingly, lower eye bags are also seen in some families at a very young age giving them the "lack of sleep" appearance. There are other causes for baggy eyelids these include swelling from water retention, allergies, and thyroid conditions.
Blepharoplasty removes excessive upper eyelid skin and lower lid eye bags correcting the tired, dissipated and aging look of the eyelids. The overall effect of Blepharoplasty is wider, crisper, brighter and more youthful looking eyes.
In the Asian population, the upper eyelid typically lacks the natural fold that is commonly present in the Caucasian eyelid. Blepharoplasty can create the upper fold thus adding a different dimension of beauty to the naturally attractive Asian eye.
For many years Blepharoplasty has been based on the removal of excess skin and fat from both the upper and lower lids. Removing too much fat from the eyelids gives us an unnatural hollowness around the eyes later in life. I currently perform the newer techniques, which are based on fat preservation and push back rather than excessive removal. These new operations maintain the natural fullness and youthful appearance of the lids. Crows feet which are wrinkles at the outer corner of the eyes will not be improved by the Blepharoplasty procedure. Crows feet can be improved if not eliminated with Botox which is a safe and non invasive treatment. Similarly dark circles under the eyes will not be improved by Blepharoplasty. Treatment of choice for lower lid dark circle is Restylane. Wrinkled skin can be treated with Exoderm our unique Non-surgical Face Lift & Peel which can treat most of the remaining wrinkles of the eyelids as well as the face effectively. Presence of excessive upper eyelid skin can simply be the result of forehead and brow sagging which has to be differentiated from pure upper eyelid skin excess. As the forehead sags eyebrows are pulled down by gravity adding the skin under the brows to the upper eyelid skin. In other words excess upper eyelid skin may be partially due to forehead and brows sagging in which case a forehead lift may be necessary.
The procedure is commonly performed under local anesthesia and intravenous sedation. One should expect some swelling and bruising during the early stages of healing. Incisions in the upper eyelids are made along the natural fold and for the lower eyelids, along the lash line. Scars generally fade and become barely visible over time. On the average patients are advised to take off 7 days. Sutures are removed on the 4th day make-up can be applied 1 week after the surgery. I recommend my patients to obtain a general eye examination by an ophthalmologist prior to surgery. The examination should include visual acuity test and tearing test. Since inadequate tear production may cause dryness post-operatively, the surgical procedure will require some modifications to avoid such dryness. Exercises should be avoided for 2 to 3 weeks. Post operative discomfort is minimal and is easily controlled with prescribed pain medication.
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