The eye area is one of the first places to show aging. You may notice your eyes look tired, sad, or older than you feel. Blepharoplasty removes fat and drooping skin of the upper eyelid, minimizes bags under the eyes, and tightens the skin of the lower eyelid. It will help “open up” the eye so the upper lid’s natural crease is visible and remove loose skin and wrinkles of both lids.
For the upper lid, I do remove some fat during blepharoplasty, but only fat which protrudes. A youthful eye has fullness; it does not look skeletonized. To remove lower lid puffiness, I perform a fat sparing eyelid surgery technique to preserve the fullness and youthfulness of the lower eye. There are two techniques for this area, an open technique and a pinch blepharoplasty technique. I choose the technique depending on your anatomy and your risk of dry eyes. I usually combine the lower lid surgery with fat transfer to the eyelid cheek junction to help with under eye shadowing and the “tired” look. I am a big fan of micro fat transfer, and with the lower eyelid, the cheek usually is a big component of aging.
When assessing your eye aging, the position of your eyebrow is important. Frequently your brow has fallen and is contributing to the upper eyelid fullness, so for a full correction you may need a browlift or endobrowlift. In addition to skin removal, skin resurfacing with a chemical peel is sometimes needed to help “iron” the skin around the eye for an optimal, smoother result.
I chose Dr. Greenberg because of her honesty and her amazing results focused on keeping her patients looking natural.
Other problems with the eyelid can also be improved.
The scars hide in the natural creases of the upper eyelid. For the lower eye, incisions are made immediately under the lash line. When fat is removed from the lower lid, the incision can be made inside the lower eyelid through a “transconjunctival” approach.
Eyelid surgery is easily done under local anesthesia. Scars heal beautifully. The procedure lasts about two hours for all four lids. The surgery is done in an operating suite nearby, in either the Palo Alto or Menlo Park surgery center, to maintain strict sterile technique near the eye. Recovery time varies, but is about one week to 10 days.
Soft tissue fillers can provide a nonsurgical lower eye “lift.” It is a simple office procedure injection. You may have some bruising following the procedure. Try to avoid aspirin and nonsteroidal products for 2 weeks prior to injection. The common fillers I use in this area are HA fillers like Juvederm and Restylane, or longer term fillers like Sculptra.
Again for the lower eyelid area, I am a believer in adding volume to the lower eyelid cheek junction to help this area. This does not mean you have to look fake, over plumped, or plastic. There are many examples of poor technique in adding volume on TV and in magazines. When done well, you just look “good for your age.”
If you have done in office fillers and you like the look, consider a more lasting procedure like micro fat transfer to the cheek and eyelid junction. Not only does the fat last for a long time (I have patients out years with lasting results), many believe the stem cells in the fat help rejuvenate the overlying skin. I am in the camp of plastic surgeons who believe fat helps improve the skin quality. It is slow and subtle, but I think real. This is a surgical procedure, and will have 1-2 weeks of swelling and mild bruising.
To find out if you are a good candidate for cosmetic eyelid surgery, known as blepharoplasty, contact my Palo Alto practice to schedule an consultation.