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Eyelid Surgery (Blepharoplasty)

What Is It?

The purpose of an eyelid lift is to remove excess loose eyelid skin, possibly tightening the muscle, and to remove or redistribute excess pockets of fat. Sagginess of eyelid skin is frequently the earliest sign of facial aging. It makes people look older than they feel. Others perceive it as a sign of fatigue or disinterest, and sometimes patients appear to look unhappy. Younger patients may have the surgery done to reduce excess deposits of fat that develop on a familial or ethnic basis. The procedure can add an upper eyelid crease in Asian eyelids. Occasionally, upper eyelid surgery is indicated when there is impairment of vision due to skin hanging over the eyelashes.

The surgery usually includes an incision along the crease fold of the upper eyelid. In the lower eyelid, the incision either follows a line just below the eyelashes, or is a hidden incision inside and below the lower eyelid itself. The skin incisions may extend into the "crow's feet" areas to the sides of the eyelids if there is loose skin.

Patient Examples

Click on any photo for larger version and more views of that patient.

Before Surgery Consultation

During the initial consultation, Dr. Neu will take a detailed history of the patient’s past health, focusing particularly on conditions that may affect the eyes or eyelids. Thyroid conditions, diabetes and elevated blood pressure need to be examined. Patients with dry eye conditions may be asked to see an ophthalmologist first, as the condition may be aggravated by an eyelid lift.

The amount of skin, fat and muscle in each lid is carefully assessed and documented. Occasionally, the aged look to the eyelids is caused by eyebrow ptosis or advanced aging of the face around the eyelids. In such cases, a brow lift or facelift may have to be considered for the most optimum result. Dr. Neu may suggest fat injection around the eyelids when there is a deficiency of fat, particularly in the lower lids.

The Surgery

An eyelid lift is typically done by Dr. Neu as a day surgery procedure, either under local anesthesia with an anesthetist present to provide sedation, or under general anesthetic. No effort is spared in obtaining the most optimum, natural-looking aesthetic result. The amount of skin to be excised is carefully measured out with calibration instruments, recognizing that there is a fine balance between taking too little and too much skin. Eyelid surgery has become more sophisticated in terms of the handling of the fat. The fat that used to be removed today is more likely to be redistributed to areas of hollowness. Muscle tightening is also done judiciously to achieve the correct balance.

Resumption of Activity

Most patients after an eyelid lift return to sedentary work and social activities two to three weeks after surgery. Some residual swelling or redness to the scars may be hidden by the use of tinted glasses or makeup. Vigorous sports can be resumed at three weeks.