As we all know, the eyes are a prominent facial feature. They convey emotion and contribute to the wide array of expressions. Unfortunately, wrinkles and deep lines as well as puffiness under the lids develop as you age. In addition, exposure to the sun as well as hereditary factors, contribute to the aging process – all resulting in changes of expression. In many cases, people may look tired, somewhat angry, and older than their true age. The removal of a small amount of skin and very small amounts of the specialized fat; can dramatically enhance the appearance of this area. It is important to maintain fullness of these tissues such that fat repositioning techniques are often utilized. This is especially critical in the lower eyelid region.
The upper eyelids usually develop excess skin over time which is further accentuated with the sagging upper eyebrows. Small bulges of fat also interrupt the clean, consistent look of a youthful upper lid. Therefore, the blepharoplasty/eyelid surgery is often combined with a carefully positioned ‘brow lift’ to open up the eye and expose a softer, more contoured eyelid. In the female, this allows makeup placement on a wider region including the area just underneath the eyebrow. In the male, the eyebrows are normally left lower, with primary attention to the excess eyelid skin. The actual procedure is virtually painless and the primary recovery is a ‘cosmetic’ recovery – there is potential bruising, which typically resolves within a couple of weeks, if not sooner. Specific postoperative instructions should be followed for the most successful result.
Another reason for upper lid blepharoplasty is to alter the Asian eyelid. Some Asian upper lids do not have a ‘double lid’ or fold. A simple procedure under local anesthetic or sedation can help change the lid contours at the patient’s requiest. Dr Wittenberg has experience is this area and can ensure the look of the upper eyelid maintains a natural ethnic appearance commensurate with the natural bony shape of the eye.
Each person’s tissues are different and Dr .Wittenberg can review your anatomy during your consultation.
As one ages, the eyelids primarily appear to have bags under the eyes and also wrinkles with excess skin. A younger person can start to develop the fullness under the eyes first, and then progress to wrinkles over time. One of the most common appearances in a middle aged person is the appearance of hollows or circles under the eye. These are not necessarily the ‘eyelid bags’ that people mention. This situation occurs because the weight of the tissue underneath the skin of the lower eyelids falls and this exposes the boney part of the lower eye rim.
The selection of a surgical procedure to improve this area is critical. Fat removal would be inappropriate in many cases. The primary treatment is to reposition the tissue which has fallen towards the side of the nose and which had created the ‘bags’ and the ‘grooves’ in the area. This procedure can be called a SOOF lift or a mid face lift. These are procedures that are done from hidden incisions behind the lower eyelid or. below the lower eyelashes and/or inside the mouth. Outstanding results can occur with this attention to detail. The key is to establish a smooth contour from the cheek to the lower eyelid and maintain natural fullness in the area. One must avoid creating a ‘hollow’ look of the eye since it an unnatural appearance in the youthful patient.
Another approach to minimize the hollows or grooves under the eyes is the use of Tissue Fillerssuch as Juvederm or Restylane. These are materials placed in the proper tissue level underneath the ‘lines and grooves’ and to smooth out the contours. The materials are replacing the lost volume of aging. Unfortunately, the tissue fillers will only last up 12-16 months; after which time, another procedure has to be done again. Cost could become a consideration over the years, but tissue fillers are a simple way to improve the appearance of the ‘under eyelid’ area. Dr. Wittenberg can help you decide if you are a good candidate for tissue fillers or blepharoplasty/SOOF lifts. All procedures have varying risks and benefits and you will have a complete description of these factors.
The blepharoplasty procedure can be quite simple and yet extremely beneficial in restoring the natural contours of the eye region. Patients are very pleased with the ability to restore this important region so successfully and genuinely.
Please visit our Before and After Gallery for Eyelid Surgery/ Blepharoplasty.