Eyelid Surgery (Blepharoplasty)
Age: 54 Blepharoplasty
This is a 54 year old woman who underwent a “standard” blepharoplasty (eye lift). A small amount of fat was removed from her lower lids and placed in the hollows. Skin was removed from both the upper and lower eyelids. The results are natural. She looks more “bright eyed”, younger and more alert. The scars in the upper and lower eyelids are almost invisible and cover easily with makeup if needed (the scars are in the natural creases of the eyelids).
Blepharoplasty
This patient was interested in an upper lid lift or blepharoplasty to manage excess skin. She is seen here after a “standard” upper lid blepharoplasty with skin removal only. You can see that her skin excess is gone, her eyes appear more “awake and alert” and that she appears more youthful. The eyes are your contact with the world around you. If they look good, you look good. If they are puffy, full of skin excess, wrinkled and tired looking, this is unflattering.
A upper skin blepharoplasty is one of the “simplest” and most rejuvenating plastic surgery procedures that I perform. I often recommend that you consider Botox treatments if you haven’t already because this is the only way to treat the crow’s feet on the sides of the eyes and the deep creases between your eyes. Often, it all about B n B–blepharoplasty and Botox for optimal periorbital rejuvenation that is simple and relatively risk free in expert hands.
The photo with her eyes closed shows the location of the scar and how well it has healed only at seven months after her procedure.
In the patient’s own words:
“My name is Vida and I had upper eyelid surgery. I love the results and I wish I would have done it ten years ago. Not only do I look better, I feel better and from feeling better, I am inspired to take care of my body more. I eat smaller portions at each meal and I take more walks and dance more. It is hard to believe that a change on the outside can make such a change on the inside. Dr. Caridi is a combination of an expert plastic surgeon and a master human body sculptor and I am very grateful for all he did for me.”
Age: 49 Blepharoplasty
This is a 49 year old patient who was interested in an upper blepharoplasty (eye lift). As you can see from the pre-operative photos, she has very asymmetrical upper lids. The right upper eyelid is full and the left side is not. This is an asymmetry that is probably related to normal variations that occur in the people.
She is seen here after a removal of a small amount of skin excess and a procedure to secure the upper eyelid crease on the left at the same level as that on the right. You can see the symmetry that has been created. It’s rare to find any anatomic feature of a human that is perfectly symmetrical–we are quite crooked more often than not!
Age: 43 Blepharoplasty
This patient was interested in rejuvenation of her eyes. You can see from her pre-operative photographs that she has “puffy” upper and lower eyelids. The fullness of her upper eyelids actually touches her upper eyelid lashes. She has some excess skin of the uppers, less so on the lowers.
She is seen here after a “simple” blepharoplasty. I removed skin and fat of the upper eyelids. On the lowers, I removed a small amount of skin as well as some of the muscle on the lower eyelids. No fat was removed from the lower eyelids. It turned out that the small horizontal bulge on the lower lid was actually excess muscle.
She is seen here about six months from her procedure. Her eyes look more refreshed and less puffy. The appearance of dark circles about her eyes is considerably less.
Age: 66 Blepharoplasty
This gentleman presented to me for treatment options for bulging fat on his lower eyelids. On examination, he has fat herniation (bulging) of all three fat compartments of his lower eyelids. He has some skin laxity and only fair tone to the lower eyelid (tone refers to the strength of the lower eyelid support structures).
We discussed options at length. We elected to perform a reduction of the fat compartments from and incision on the inside of the lower lid (transconjuntival approach). This does not remove skin or “tighten” the lower eyelid. It only removes the excess bulging fat.
He is seen here six months after his procedure. There is a very significant change in his appearance. He looks less “tired” for sure and doesn’t look like he has full pillows beneath his lower eyelids. The “blue” shadowing associated with fat herniation is improved. His results appear natural–not “perfect”. Probably most importantly, he doesn’t have any of the complications associated with lower eyelid surgery like lower eyelid malposition (the lower eyelid appears pulled down and there is more white showing below the pupil of the eye). This can be associated with dry and irritated eyes.
Lessons to learn:
1. Lower eyelid procedures are to be respected because they are fraught with potential problems. I have clearly learned over twenty five years’ experience that less is more. The lower eyelids are delicate structures.
2. Photos don’t reveal the whole truth because it makes the shadows go away which hides some of the best benefits that you would see if the patient is sitting before you. Reducing lower eyelid bulging fat improves the shadows and makes the eyes appear more youthful and less tired.
3. In order to make sure you stay safe after lower eyelid surgery, you must have realistic expectations and completely understand the limits of the various procedures on the lids. If you “want it all” you may be setting yourself up for some issues.
4. Anyone who tells you that lower eyelids are “simple” either has figured it out or doesn’t understand the issues at hand because of lack of experience. Keep this in mind on your consultation.
Age: 51 Blepharoplasty
This patient is seen after a simple upper lid blepharoplasty. This procedure only removed a modest amount of skin excess that she has on her upper lids. I did not remove fat. You can clearly see the tremendous improvement from a simple skin excision! This is a very powerful tool to enhance your appearance, particularly since we communicate with the world through our eyes and if our eyes look youthful and “bright eyed”, this conveys very positive feedback.
When it comes to blepharoplasty, less can be more. Over the years I have become more conservative when it comes to the treatment of the eyes. They are delicate structures, particularly the lower lids. I remove less fat than before as I want to avoid the “hollow” eyed appearance that we get as we get older. Normal amounts of fat provide for a more full, youthful appearance than a hollowed out, aged eye. Pound for pound, it’s hard to beat a simple upper lid blepharoplasty when it comes to looking more youthful. It is, by far, one of the most commonly performed procedures in my office. It can be done under local anesthesia in less than 25 minutes. Sutures are out in five days. Makeup can then be worn to cover the scar. The scar fades very nicely in most patients after about 8-10 weeks. Patient satisfaction is very high.
Age: 58 Blepharoplasty
This is a 58 year old women who desired improvement around her eyes. On examination she was found to have the typical issues related to her age. She had excess skin of the upper lids and creases on the skin of the lower lids. She has eyebrow ptosis (her eyebrows are a bit lower than is ideal). She is seen in the side by side photos after an endoscopic brow lift and a conservative upper and lower blepharoplasty. There is a nice improvement overall with results that certainly qualify as appearing natural and elegant.
A blepharoplasty is a wonderful procedure when done well. I have concerns mostly with the lower eyelid as there is usually very little support in this area and the treatment of this area can result in a malposition of the lower eyelids resulting in an “operated” appearance and the rounding of the lower eyelid (or a lot worse). A canthopexy technique is a procedure that tightens the lower eyelid support structures so that eyelid malposition is less likely. This would be a recommendation to anyone who has particularly lax structures often associated with aging.
A conservative blepharoplasty means that the amount of fat and skin removed is less than an aggressive blepharoplasty. What is quite clearly associated with a youthful eye is FULLNESS. Removing all the fat and skin can only produce a hollow, skelatinized appearance that is not particularly flattering. Sometimes less is more and in terms of blepharoplasty this adage rings true more often than not.
Age: 50 Blepharoplasty
This patient has had a bilateral upper and lower blepharoplasty. This includes skin and fat reduction in the upper and lower lids. Because her brows are in a good position, a brow lift was not recommended. It’s important that your surgeon perform a conservative lower blepharoplasty in order to minimize the potential for lower lid malposition (drooping of the lower lid).
Age: 61 Blepharoplasty
This woman desired improvements around her eyes. She complains of bulging fat and excess skin and that it makes her “look tired”. We performed a typical upper and lower blepharoplasty which consists of the conservative removal of excess fat and skin.
Although a blepharoplasty seems like a straight forward procedure, it requires a fair amount of skill and judgment on your surgeons behalf in order to minimize the potential for lower eyelid malposition (pulling down of the lower lid with eyeball exposure) and the appearance that your eyes are too open.
Age: 69 Blepharoplasty
This woman desired correction of aging features around her eyes. We performed an upper and lower blepharoplasty (removing of skin and a small amount of fat).
Age: 60 Facial Rejuvenation
This woman desired facial rejuvenation. She wanted a natural result. She was very attractive for her age and she had very good facial bone structure. We felt that most of the improvement could be made in her eyes.
We performed an endoscopic brow lift and an upper and lower eye lift as well as dermabrasion of her upper lip. She has also been treating her skin with our medical grade skin care products. Note the dramatic, yet natural improvement in her appearance.
Age: 52 Blepharoplasty
This woman desired a blepharoplasty (eye lift) because of excess skin and bulging fat around her eyes. She also had dark circles. We performed an upper and lower lid blepharoplasty with the removal of excess skin and fat. I also performed an acid peel around her eyes and forehead to soften fine lines and improve the appearance of her skin (minimizing the splotchy appearance).
