Eyes: Blepharoplasty (eyelid surgery or eyelift)
 

Lower Blepharoplasty

Upper Blepharoplasty

Those Aging Eyes

The eyes are generally the first area of the face to show the signs of aging. Although one might think that facial plastic surgery and rejuvenation is only necessary for individuals over the age of 50, individuals in their thirties and forties are excellent candidates for a number of particular rejuvenation therapies, specifically eye rejuvenation. It is not unusual to see hooded upper eyelids, sagging lower eyelids and baggy eyes in individuals in their thirties.

Important Anatomy

Generally, dark circles underneath the eyes are due to a shadow affect caused by protruding fat in and around the eyeball socket. There is also an increase in pigmentation to the lower eyelid that accentuates the tired/baggy appearance. There are a number of factors that predispose baggy eyelids, including persistent allergies, genetic predisposition, sinusitis and recurrent swelling to the lower eyelid. In and around the eyes themselves is a layer and coating of fatty tissue called adipose tissue. This fatty layer is kept in place by a membrane. The fatty layer is important because it supports and protects the eye and associated neurovascular structures and muscles. As time passes the fatty tissue bulges forward through the support membrane, causing herniation and protrusion of the fat and this is due to the laxity of the lower eyelid septum.

There are many factors that may increase lower eyelid swelling. The most significant is the swelling that occurs during a woman’s monthly cycle. Allergies also contribute greatly to increased swelling in and around the eyes. Exacerbation of allergic rhinitis, particularly during the spring allergy season, tends to increase lower eyelid swelling. For most individuals, the contributing factor for baggy eyes and lower puffy eyelids is protruding fat in the lower eyelid area, which is unrelated to any specific medical problem.

The Blepharoplasty Procedure

Blepharoplasty surgery is performed in an outpatient setting. Local anesthesia with intravenous sedation is employed. General anesthesia is sometimes used if underlying medical conditions exist. The procedure lasts approximately 30 minutes for upper eyelid surgery and 30 minutes for lower eyelid surgery. Endoscopic brow lift surgery generally requires approximately one hour. Again, different procedures may be done dependent upon the desires and anatomical characteristics of each individual patient. 

Inherent Risks of Blepharoplasty Surgery

The incisions are well concealed, however, they tend to be moderately pink in color for the first few weeks. The pink coloration will dissipate and will hide quite nicely underneath the eyelashes in the lower lid incision and along the crow’s feet for the lower and upper blepharoplasty procedures. Scar formation that is permanently noticeable is rare. But, as with any surgical procedure, there are always potential risks such as bleeding and infection. Generally, with blepharoplasty, the risk is not as significant.

Eyebrow Considerations

The blepharoplasty procedure addresses the upper and lower eyelids, but does not address the eyebrow proper. Eyebrow ptosis (or laxity) is a common occurrence and is usually associated with the upper and lower eyelid blepharochalasia palpebra. The eyebrows may descend and encroach upon the upper eyelids, worsening the weary and/or tired appearance of the upper eyelids. The specific procedure designed to restore a youthful appearance and restore aesthetic harmony to the upper eyebrows is known as the endoscopic brow lift.

Once performed, endoscopic brow lift will negate the need for an upper blepharoplasty procedure. Each individual is unique and anatomy can dictate which procedure(s) will be most beneficial. Oftentimes, an endoscopic brow lift and a lower blepharoplasty are all that is required for eye rejuvenation. Other times, both upper and lower blepharoplasty is a more suitable option. It is quite rare for upper and/or lower blepharoplasty to be required after an upper brow lift. The endoscopic brow lift usually satisfactorily addresses rejuvenation of the entire upper forehead and face and has become one of the most highly desirable procedures today in facial plastic and reconstructive surgery.

Before Blepharoplasty	After Blepharoplasty

Also See: Botox and Endoscopic Brow Lift