Eyelid/Lower Lid Surgery
Eyelid surgery ( blepharoplasty) is a procedure to remove fat, usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes, features that make you look older and more tired than you feel and may even interfere with your vision. However, it will not remove crow’s feet or other wrinkles, eliminate dark circles under your eyes or lift sagging eyebrows. While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage.
The eyes being “the windows of the soul” are one of the most important facial features. While many patients concentrate on excess eyelid skin, eyelid opening, eyelid position and angulation of the lateral portion of the eyelid are all a part in our preoperative planning. Lower eyelid fullness can often be relieved with behind the eyelid fat removal. Dark circles involving the lower eyelids are improved with elevation of the midface or with the use of soft facial implants, customized to fill in the furrows.
The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.
A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease and diabetes. A detached retina or glaucoma is also reason for caution. Check with your ophthalmologist before you have surgery.
Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you are having all four eyelids done, Dr. Fisher will probably work on the upper lids first, then the lower ones.
In a typical procedure, Dr. Fisher makes incisions following the natural lines of your eyelids; in the creases of your upper lids and just below the lashes in the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, Dr. Fisher separates the skin from underlying fatty tissue and muscle, removes excess fat and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.
If you have a pocket of fat beneath your lower eyelids, but do not need to have any skin removed, Dr. Fisher may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.
Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift.