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EYELID LIFT (BLEPHAROPLASTY)
The area of the eyes is the first on the face to show aging. Since the ravages of time and the sun can present in many ways, eyelid lift surgery is one of the most varied of all cosmetic surgery. The eyelids are an important area for not only appearance, but function as well. And because the tissues are so very delicate, there are extreme demands upon the surgeon for precision and good judgment. Aging of the upper lid can present with excess skin or excess fat or a lowered level of the actual eyelid.
All of these separate aspects of the aging process are addressed in different ways and thus the surgery is very much individualized to the patient's needs. Lower lid aging can present with excess skin whether it be fine wrinkles or larger wrinkles, excess fat, rolls of muscle, or a sagging or drooping of the lower lid lash margin. Again, all of these aspects are addressed in different ways surgically whether it be a tightening, a removal of some skin or fat, laser resurfacing, or a combination of all these procedures. The surgical plan must be very much uniquely designed for the individual patient's needs. As Dr. Hubbard completed an oculoplastic fellowship following his cosmetic surgery training, he is very much attuned to the specific demands of eyelid surgery.
Indications for an Eyelid Lift: Sagging or excessively wrinkled upper or lower eyelid skin. Loss of the natural eyelid crease. Bulges or puffy pouches of fat in the upper or lower lids that give a tired or aged appearance. Creation of an eyelid crease.
Intended Results: More youthful, rested appearance of the eyes. Improved vision if hanging skin has interfered with field of vision. More freedom with make-up application for women.
Procedure Description: This surgery is done on an outpatient basis usually under sedation and local anesthesia. The upper lid incision is made where the natural crease should be. Often, the lower lid incision is made on the inside of the lower lid with no visible scar (transconjunctival). Other times the incision is also or instead made just beneath the lower lid lashes. Appropriate excess fat and skin is removed. Sometimes laser resurfacing is performed at the same time.
Recuperation and Healing: All sutures are usually removed in 3-5 days. Initial mild discomfort is easily controlled with oral medications. Bruising and swelling progressively disappears in 1-2 weeks in the majority of patients. Once the sutures are removed, we encourage our patients to visit our skin care clinic for a complimentary make-up session designed to camouflage any remaining discoloration. Contact lenses can be worn when comfortable, usually within 7-10 days.
Other Options: Browlift can enhance the upper lid alone or with a blepharoplasty. Fat Injections alone or in combination with other facial procedures are a great way to correct gaunting or hollowing under the eyes.Facelift and cheek implants also can enhance the lower lid area in more subtle ways.
Make Sure You Are Getting Everything You Can Out of Your Blepharoplasty: State-of-the-art lower eyelid surgery is accomplishing more exciting changes these days with recently advanced surgical techniques. Blepharoplasty has undergone great advances from even five to ten years ago. It is more involved than removing skin and fat. In fact, no two blepharoplasties are exactly the same since the process must begin with very careful analysis. In this particular patient (below), there was excess fat that was removed with transconjunctival technique for maintaining safe long-term lid position. Fat grafting was done in the hollow area to greatly improve contour. Skin removal helps with some excess skin but the low wrinkled skin of the eye could not be touched with traditional techniques. This was addressed with the muscle hitch procedure for a more dramatic result. Recovery varies with the techniques used. Some blepharoplasty patients can still return to work in 3 or 4 days. Some techniques such as correcting a bulge or fold lower on the cheek will require a long recovery.
We need to be careful comparing before and after photos. Shown below are special shadow views, intended to simulate the everyday light that we live in. Care was taken not to use artificial bright frontal light, used in most medical photography, since that would blanch out or hide many wrinkles and shadows. The dramatic rejuvenation shown here is a direct result of careful surgical planning and implementation of many different techniques to achieve our best possible outcome.
 Before Lower Eyelid Bleph with Fat Injection |
 After Lower Eyelid Bleph with Fat Injection |
 Before Lower Eyelid Bleph with Fat Injection |
 After Lower Eyelid Bleph with Fat Injection |
Extreme Importance of Fat to the Lower Lid: Modern lower lid blepharoplasty or eyelid tuck procedures have taken quite a step forward in effectiveness and degree of rejuvenation with the addition of fat injections. So much of aging of the lower lid area is due to a hollowing and in fact, in some individuals, the only sign of aging in the lower lid is hollowing and no excess skin or bulging fat. In the patient below, (also see Patient Two in Gallery 1) most of the rejuvenation of the lower lid area was accomplished with fat injections that filled out hollowing that occurred with age. She did have a small amount of fat removed above the area of hollowing and a small amount of skin removed but these had a minor impact compared to the fat injections taken from her own fat and placed at the time of her lower lid surgery with micro injection needles.
More Information: Eyelid surgery is of particular interest to Dr. Hubbard. His double board certification attests to two formal training programs that involved extensive experience in eyelid surgery. Further, his interest in this area led to even more advanced training emphasizing the eyelids, a fellowship in oculoplastic and cosmetic surgery. Modern oculoplastic surgery involves removing or tightening skin, repositioning or removing fat and adjusting the levels of either or both upper and lower eyelids.
Please visit our Photo Gallery Page to see examples of Eyelid Lift or click on the following links for information on other procedures.
 Before Blepharoplasty with Fat Injection |
 After Blepharoplasty with Fat Injection |
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