The eyes are among the most noticeable and impressionable features of the face. Unfortunately, they also tend to show the first signs of aging. As we get older, excess skin forms on the eyelids and bulging of fat develops around the eyes. This can project a sad, tired or even angry appearance. Fat pseudoherniation in the lower eyelid is what causes under eye bags to form, and the redundant skin that accumulates in the upper eyelid is known as dermatocholasis.
Skilled Eye Lift Surgeon
Blepharoplasty, also known as an eye lift or eyelid lift, is the surgical procedure that can restore beauty and youth to the eyes by removing sagging, loose skin around the eyes and eliminating the excess fat that cause puffiness in the eyelids. Dr. Stong is an elite double board certified facial plastic surgeon who is highly regarded in his field. When it comes to blepharoplasty, he employs the latest and most advanced techniques available, including those that prevent visible scarring.
Blepharoplasty is among the most popular cosmetic procedures, primarily due to its profound improvements it can make using conservative surgical techniques, hidden incisions and minimal downtime. In fact, many eye lid lift surgeries can be performed in the office under local anesthesia, which can significantly quicken recovery time.
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What is Blepharoplasty?
Blepharoplasty, also known as an eyelid lift or eye lift, is a surgical procedure to improve the appearance of the eyelids. This procedure can be performed on the upper lids, lower lids, or both. Upper blepharoplasty targets sagging skin that overhangs the upper lid, removing mostly skin and a small amount of fat from the inner corner of the eye. Lower blepharoplasty is designed to correct the ” bags” that form underneath the eye. Patients commonly choose to have their upper and lower lids done at the same time to avoid multiple downtimes and to have the eyelid aesthetic subunit match and be evenly rejuvenated. Dr. Stong will evaluate your specific needs and determine which procedures will give you the most natural and refreshed look.
Who is a candidate for blepharoplasty?
Patients who are experiencing signs of aging around the eyes, such as excess eyelid skin or puffiness underneath the eyes, can take advantage of blepharoplasty to restore youth and beauty. Eyelid surgery is an excellent solution for those that want to reverse the signs of aging around the eyes and rejuvenate the eyelids.
Blepharoplasty can specifically treat:
- Loose or sagging skin in the upper eyelid, that creates hooding
- Excess fat or puffiness in the upper and lower eyelids
- Bags underneath the eyes
- Excess skin and fine wrinkles of the lower eyelid
How is blepharoplasty performed?
There are varied techniques to a blepharoplasty, which distinguish how it is performed. In an upper blepharoplasty, incisions are placed in the supratarsal crease in the upper eyelid with a gentle curve upwards at the outer corner of the eye to blend in with existing creases in this area. In a lower blepharoplasty, the incision is placed just below the lash line with a gentle curve downwards at the outer corner to naturally blend in with the creases and wrinkles in this area. Blepharoplasty can be done safely in the office under local anesthesia or in the operating room with sedation. It typically takes about 1 to 2 hours to perform.
What is an upper eyelid lift?
Excess skin and fat in the upper eyelids contribute to a tired appearance. An Upper Eyelid Lift is designed to correct this aging effect by removing precise amounts of fat, muscle and loose skin of the upper eyelid. The incisions are well concealed within the natural creases of the eyelid.
What is a lower eyelid lift?
Lower Blepharoplasty is used to address under eye bags caused by excess fat in the lower lids. These incisions are also inconspicuous since they are placed just below the lower lash line and within the smile creases of the lower eyes. Just like an upper eyelid lift, Dr. Stong will carefully remove the right amount of skin and muscle within the lower eyelids to give patients a more refreshed and youthful appearance. Dr. Stong believes in fat preservation in lower eyelid blepharoplasty and therefore uses a fat transposition technique to restore a natural youthful contour to the lower eyelid and upper cheek junction. In general, lower eyelid blepharoplasty is more technically challenging and complex than an upper blepharoplasty, which is why there are multiple approaches.
What is a fat transposition?
The lower eyelid fat can be an ideal filler to restore age-related deformities under the eyes. The excess lower eyelid fat is essentially repositioned or transposed into the “tear trough” area of the eyes, which creates a smooth natural transition from the lower eyelid to the cheek. It also helps improve dark circles under the eyes. Dr. Stong uses a fat transposition technique to help patients avoid a hollowed sunken appearance and improve the natural transition from the lower eyelid to the cheek or midface. Some doctors lift the SOOF (sub orbicularis oculi fat) pad to try and achieve a similar result, but this technique is not as effective as repositioning the fat pads from around the eye.
What is a transconjunctival lower blepharoplasty?
If a patient has lower eyelid puffiness caused by excess fat yet does not have much excess eyelid skin, a transconjunctival blepharoplasty eye lift can be performed. This approach removes the bulging lower eyelid fat using an incision on the inside of the eyelid through the pink “conjunctival” layer. A transconjunctival lower blepharoplasty is favorable to patients who want to eliminate any external scars and only need fat removal. It is ideal in patients who are much younger. Because this technique removes fat from the lower eyelid and is not a fat preservation technique, if too much fat is removed, it can lead to a sunken or hollowed appearance to the lower eyelid.
What is a skin pinch technique?
The “skin pinch” technique is best suited for younger patients who have minor amounts of excess lower eyelid skin. The skin pinch technique uses a minor excision of a small amount of excess skin in the lower eyelids. It is does not involve muscle removal and is often combined with transconjunctival blepharoplasty to remove minor amounts of skin at the same time that fat is removed.
What is a skin/muscle flap lower blepharoplasty?
The Skin Muscle Flap Lower Blepharoplasty is among the most time tested methods of eyelid surgeries. This procedure, when performed alone, can address excess skin and muscle, and bulging fat, in the lower eyelid. Incisions are made underneath the lower eyelash line so that the skin and underlying muscle layer can be elevated creating optimal exposure to the eyelid fat pads allowing for more precise shaping. Excess skin and muscle are removed with this technique to get rid of fine lines and wrinkles. Dr. Stong combines this approach with the fat transposition technique to create a natural youthful contour to the lower eyelid.
What is the advantage of a skin/muscle flap lower blepharoplasty over a transconjunctival blepharoplasty?
The skin muscle flap blepharoplasty when combined with a fat transposition technique allows for better exposure to the eyelid fat pads and more precise contouring of the fat pads, resulting in a more natural outcome. It also allows for more precise control of skin removal as well as removal of excess muscle in the lower eyelid. Because the fat transposition technique is a fat preservation procedure there is almost no chance of a sunken or hollowed appearance after lower eyelid blepharoplasty. Fat transposition is performed almost exclusively through as skin muscle flap blepharoplasty technique.
What is expected during recovery from a blepharoplasty?
Blepharoplasty incisions heal remarkably well and are virtually imperceptible. The eyelid skin is the thinnest skin on the body and heals with minimal scarring. The incisions are placed in the same orientation as the naturally existing creases around the eye. Sutures are removed around 4 to 5 days after the surgery, with bruising subsiding shortly thereafter. Swelling resolves last, but the eyes appear much more rested and youthful within 10 to 14 days after surgery. Makeup and cover up may be used in the postoperative period to camouflage any residual bruising. Patients can typically return to work within 5 to 7 days following surgery.
What factors may limit the results of blepharoplasty?
For patients that have descending brows, a thorough, comprehensive consultation must be performed to ensure that a brow lift procedure isn’t indicated instead of or in combination with an upper eyelid blepharoplasty. If not identified during consultation and prior to the procedure, the patient is at long-term risk of a shortened eyelid or lagopthalmos during a future brow lift procedure.
Additionally, patients with dry eyes should be careful when undergoing blepharoplasty as it can worsen dry eyes, particularly in the short term following a blepharoplasty. Finally, patients with excessively loose lower eyelids are at risk for lower eyelid drooping and chronic tearing following blepharoplasty if not identified properly before surgery, treated with a conservative amount of skin removal at the time of surgery and possibly tightened during the lower eyelid procedure with a canthopexy or canthoplasty.
Before & After Eyelid blepharoplasty (eyelid lifts)
Before & After Eyelid blepharoplasty (eyelid lifts)