Eyelid surgery has changed significantly in recent years. The traditional method involved excision of skin and fat from both the upper and lower eyelids. The problem is that excess skin and fat are not the only consequences of aging and, in many patients, they aren't the problem at all.
It is impossible to discuss eyelid surgery without considering the brow position so I encourage you to read the brow section in addition to this section on blepharoplasty (eyelid surgery). After all, when we see a person whose eyes appear attractive, it is probably the whole region around the eyes that looks attractive, not just the eyelids. Consequently, when an eyelid lift is performed, the nearby structures such as the eyebrows, crow’s feet, hollowing in the temples and indentations at the lid/cheek junctions are all evaluated and potentially treated.
New concepts in blepharoplasty
It has become clear that one of the consequences of aging in the upper eyelid region is more than stretched skin; it is deflation. Fat is lost over time and the brow and upper eyelids, which were full in youth, become emptier. The brow that used to have more shape and projection, becomes flatter against the head. The result is apparent excess upper eyelid skin. The modern day eyelid lift considers the associated changes, not just the excess skin. In other words, eyelid surgery is more than just lifting or removing.
Dr. Thorne's upper (blepharoplasty) eyelid surgery technique
The eyelid lift procedure in the upper lid involves the traditional removal of skin and fat but eyelid surgery is more conservative than in the past. In addition fat is frequently ADDED to the brow region when performing eyelid surgery to give it some shape and too take up some of the apparent excess skin. As mentioned above, the outer part of the brow is often elevated as well.
Dr. Thorne's lower (blepharoplasty) eyelid surgery technique
There is tremendous variability in the lower eyelid lift procedure. Some blepharoplasty (eyelid surgery) patients require removal of fat only. Other eyelid surgery patients require removal of fat and skin. Some patients also require either the addition of fat or the redistribution of fat into the trough below the eyelid bags, at the junction of the lid and cheek. Finally, some eyelid lift patients require a resurfacing procedure to the eyelid skin to improve the texture and eliminate some of the fine wrinkles.
To see before and after images, please click Blepharoplasty (Eyelid Surgery).
Dr. Thorne is the Editor-in-Chief and the author of several chapters in Grabb and Smith's PLASTIC SURGERY, 7th Edition.
