Wrinkles and sagging skin around the eyes can make a person look more tired and older than they are. Puffy pouches of fat in the upper or lower lids create an exhausted appearance, and excessive skin in the upper eyelid can even interfere with vision. Our Riverside, CA board-certified plastic surgeon, Dr. Childers, can help patients look dramatically younger and more rested through eyelid lift surgery, or blepharoplasty. If sagging eyelids are interfering with vision, then an eyelid lift can widen the visual field, creating less strain on the eyes. The incisions are made where the natural crease should be in the upper lids and below the lash line of the lower lids. Excess fat and skin are then removed. If only excess fat is present in the lower lids, it may be removed through an incision inside the lower lids with no external incision or scar (called a transconjunctival blepharoplasty).
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Upper Eyelid Surgery
During upper eyelid surgery, an incision is made within the natural fold of the lid and extended outward. The incision will go out as wide as possible so that additional skin folds on the outside of the upper eye can also be addressed. Once the incision is made, excess skin, tissue and, in some cases, a small portion of the orbicularis occuli muscle are removed. The incision is closed with absorbable sutures and the scar remains almost completely hidden because of where it resides in the natural crease.
Lower Eyelid Surgery
During lower eyelid surgery, an incision is made along the bottom of the lash line. This allows the surgeon to remove excess fat and tissue. In patients who have puffy lower eyelids but good skin tone, an approach known as a transconjunctival blepharoplasty can be performed. This technique puts the incision inside the lower eyelid rather than outside. Patients who have dark circles under their eyes will sometimes have a deficiency of fat in these areas. Injectables can be used to help fill these soft-tissue deficiencies and can improve the appearance of these circles.
Eyelid surgery is performed under general anesthesia as an outpatient procedure in an accredited surgical facility. It generally takes up to 2 hours for both the upper and lower eyelids to be addressed. Following surgery, the area around the eyes will be bruised and swollen. Patients should apply ice packs, keep their heads elevated, and apply medicated eye ointment for a few days. Patients comment on the fact that friends and family tell them they look great, but often can’t put a finger on what is different. These subtle, yet dramatic results restore a softer, more youthful appearance.
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Eyelid Surgery FAQs
After surgery, scarring will not be visible because of where the incisions are placed. In the upper eyelid, the incision follows the natural crease of the eye. The lower eyelid incision will run just under the eyelashes or inside the eyelid. Scarring will be inconspicuous.
Eyelid surgery will reduce puffy bags and excess skin and may help contribute to some minimization of crow’s feet. However, to truly treat crow’s feet, one will need a different approach. BOTOX® injections and procedures such as a browlift, are better options to help eliminate crow’s feet.
Irritation After Surgery?
Some patients will experience dryness and minimal irritation following surgery. If these occur, we can recommend ointments and eye drops to assist during the healing phase. Patients should protect their eyes against wind and sun irritation for the first several months by wearing dark sunglasses.
If anything, eyelid surgery actually helps improve the vision for many patients. Not only does it restore a fresh, younger look from a cosmetic standpoint, it eliminates the excess skin that may have been impairing vision. It is important to select a skilled surgeon who has expertise with eyelid surgery. We take great care during this surgery so that the eyes themselves are left untouched and unharmed.