Upper & Lower Blepharoplasty (Eyelid Surgery)

When we meet someone we are looking at their eyes. Eyes are the first thing we see of people, and that can determine how we think of them. Do they look bright and happy, or tired and sad? Much of these feelings are expressed in the way our eyes, or really our eyelids, are viewed.

For instance, puffy lower eyelids, or “bags under the eyes”, make a person seem tired, old, worn out, or a party person who doesn’t get enough sleep. Whereas the opposite, tight, flat, lower eyelids are typical of a young person or one who is smiling.

For puffy lower lids I do not like to remove skin because it gives a tight, drawn look, which makes a person look different, as though there is not sufficient eyelid to support the eye. By taking out the excess fat pads, the skin-muscle eyelid is able to tighten and flatten out. It is important to realize that the wrinkles will still be present, only the puffiness will be gone. The incision is placed on the inside of the eyelid, so there will be no visible scar. The operation is usually done under a local anesthetic in the office operating room. You will need to have someone drive you. The bruising and swelling can last about two weeks, often only a week.

The upper eyelid is not only puffy, but has excess skin, because of descent of the brow. A decision has to be made whether to accept a browlift, which by elevating the brow also tightens the skin, or if that is not acceptable for whatever reason, then the excess fat can be removed and the skin redraped. If then there is any remaining extra skin, it can be trimmed, with the scar being in the fold of the lid. I much prefer to remove skin after the swelling has gone down, however. Again, the swelling and bruising will last about two weeks.

It must be accepted that the brow elevation is the best operation for excess skin of the upper lid. To have just the skin excised is to lead to a shortness of skin and further descent of the brow. As with the lower eyelid, the wrinkles, or “crows feet”, are not going to be cured by upper eyelid surgery, and it needs the browlift to tighten the skin on the outside of the eyelid, over the temple area.

I believe eyelid surgery is the most effective surgery we do, as judged by the improvement as against what is involved with the surgery. Lower eyelid surgery in particular, makes a person look better and younger and more rested, than any other surgery.