Earlier this year I wrote an article about various surgical and non-surgical options to improve the appearance of your face and eyes. These include face lift, brow lift and eyelid surgery. Non-surgical options to treat wrinkles and creases include dermal fillers, neurotoxin injections, and medical-grade skin care products from ZO Skin Health and SkinCeuticals that are available at our practice.
As a result of that piece, we received lots of calls from prospective patients interested in learning more about my approach to eyelid surgery. This month’s article will cover that procedure (blepharoplasty) in more depth. Eyelids are both more complicated and more simple than traditionally taught.
Your eyes are a key part of the overall appearance of your face. Over time, the eyelids and brows can begin to sag and wrinkle which can give your eyes an aged look. In addition, facial volume loss over time results in deflation of the cheek and hollowing of the lower lid area. Thankfully, eyelid surgery offers a way to lift and smooth upper and lower eyelids and rejuvenate the appearance of your eyes. But there is a catch…
Upper eyelid surgery is most often done simultaneously with a brow lift. In most people, the brow provides at least as much improvement as the lid. When I talk about brows, I mean the improving the lateral hooding over the eye, not lifting the entire brow (more commonly done). Lifting the lateral brow looks natural, lifting all of it does not. Once the lateral brow is out of the way, the excess upper eyelid skin and fat is removed resulting in a lighter, youthful appearance. For most people, doing the eyelids without the brow leads to descent of the brow and minimal result.
When I was in training many of the lower lid articles in the journals were about limiting lower lid complications. The reason for the high complication risk (and/or lack of results) was a fundamental misconception of how facial aging takes place. The traditional thinking involves removing the laxity, removing fat and tightening things up. This is unfortunate as most surgeons still think this way today. Lower lid procedures tried to lift the upper cheek leading to complications and poor results. The actual process of facial aging involves loss of facial fat, descent of the cheek, and hollowing of the lower lid area (or upper cheek). When this undereye area or upper cheek is treated with volume replacement (fat) and sometimes elevation of the cheek, the lid becomes a simple procedure with low risk and better results.
If you are bothered by the aged and wrinkled appearance of your eyelids and are interested in exploring the various options available to you, please give us a call at 925-736-5757 and/or come in for a free consultation. We look forward to hearing from you!
By Dr. Stephen J Ronan, MD FACS