Many of us notice that as we get older the skin of the upper eyelids begins to droop obstructing the natural eyelid crease. We also notice the lower eyelids become progressively more puffy, along with the development of fine wrinkles and increasing laxity of the eyelid skin. These changes often have the effect of making one appear drowsy or tired. The eyes may feel more easily fatigued by the weight of the drooping skin and occasionally even interfere with one’s vision.
The upper and lower eyelids may contain wrinkles, loose skin and bulges due either to hereditary factors or the aging process. Pouches or bags of the upper and lower eyelids are generally due to herniations of the fat normally located in the eye socket. These fatty hernias may be removed along with excess skin in the eyelid plastic surgery procedure known as blepharoplasty. This condition is often first seen in the 20-30 year age group, sometimes younger, and can often be corrected at that time. There is little rationale to wait for some arbitrary age before having surgery. When the problem exists, it should be corrected.
Upper lid surgery is usually done at the same time as lower lid surgery, but either can be done as an isolated procedure. Upper and lower eyelid surgery plastic surgery may be done alone or in conjunction with facelift , brow lift or other surgery.
At times the curtain of skin hanging from the upper eyelid may be partially due to sagging of the eyebrows. In such cases, it may be necessary to advice elevation and support to those structures at the same time the upper lid plastic surgery is performed.
In the upper lid blepharoplasty a determination is made about the excess or overlapping skin, which frequently obliterates the natural skin crease above the lashes. After the area has been anesthetized the excess skin and fat are removed and the incision site closed with delicate sutures.
Making an incision below the lower lashes and elevating the skin so that the fatty pouches or “hernias” can be identified perform the lower eyelid procedure. Once they are removed the excess skin is trimmed. Small delicate sutures are used to close the lower lid incisions.
For most patients, there is little or no pain in the post-operative period. Each operation is followed by varying degrees of swelling and discoloration most of which usually subsides within 7-10 days. By this time, too, the incision line can be camouflaged by make-up. These incision lines gradually blend in with the surrounding skin and after several months have passed generally become perceptible only upon close scrutiny.
As a rule, the operation is associated with minor disability and allows one to return to routine living after a few days using cosmetics and sunglasses.
Several weeks after lower lid surgery, we frequently recommend a light peeling to cause further tightening of the skin and improve fine wrinkle or “crow’s feet.” This is done in the Center and causes minimal incapacitation, but the healing period is 10-14 days with any peeling procedure.
Insurance may not cover surgical fees and hospitalization expenses for cosmetic surgery. However, in patients who have extreme amount of overhanging tissues producing “hooding,” we may request a consultation from any eye specialist. If the examination demonstrates any visual impairment from such a problem, a portion of the fees for the upper lid surgery may be covered by medical insurance.
We have yet to encounter a case where excess skin and fat in the lower lid impaired one’s vision; however, if we need to do a procedure to support a lax or drooping lower lid, insurance may pay some of the costs for this portion of the lower lid operation.
We recommend you have an eye examination prior to eyelid surgery. Ask your eye doctor to send a report of his findings. We can help you obtain an appointment if you should have a problem.
Eyelid surgery done for the proper indications can be a rewarding experience providing a more youthful appearance to the eyes, as well as, a welcome relief to some symptoms caused by the excess fat and skin that has accumulated.
For free information regarding this and other procedures please contact our office.
