Why Upper Eyelid Skin Changes with Age
As we age, we lose elasticity in our skin and actually lose bone volume in our face. This often leads to excess skin, and sometimes fat, in the upper eyelids. People complain of “weight” on their lids and that friends and coworkers tell them they look tired.
How Upper Eyelid Surgery Improves Appearance and Vision
Removing that extra skin and occasionally fat from the upper pocket nearest the nose can greatly improve one’s appearance and actually increase what you can see if the skin is hooded enough to block vision partially. The trick is to remove just enough skin not to look hollow and overdone. In years gone by, not only was the skin removed, but fat and muscle were taken from the upper lid as well. This often led to a “hollow” appearance of the upper orbit, which is not flattering.
A Modern Approach: “Less Is More”
We have learned that “less is more” when dealing with extra tissue in the upper lid. What I mean by this is that if the extra skin alone is removed judiciously and only a very small amount of fat is taken from the nasal compartment, the eye looks rejuvenated.
Addressing Drooping of the Lacrimal Gland
Sometimes the lacrimal gland that helps with tearing is drooping into the lateral (outside) upper orbit. This can be effectively treated by re-suspending the gland back up to its natural position with a few stitches.
What to Expect During Upper Eyelid Surgery
The operation itself does not take a long time and can easily be done with local anesthesia and light sedation. The patient is marked in the upright position to account for gravity, with lines being drawn on the upper eyelid skin, which is then lightly pinched together to see the effect it has on the ability of the eyelid to close naturally. Sometimes the eyebrow is low and can be addressed at the same time (brow lift).
Step-by-Step: The Upper Blepharoplasty Procedure
Once marked, the patient is prepped and the area made numb with a tiny needle and a small amount of local anesthetic. Metal eye shields (contacts) are placed after drops are put in the eye to numb it. The extra skin is then removed, bleeding stopped with electrocautery, and the incision closed. A tiny suture is woven through the cut skin edges and pulled to bring the skin together. This suture will be removed at 5–7 days with little to no pain. It is grasped and gently pulled to unravel it from the skin. This leaves no outer marks at all. Within 7–10 days, any residual swelling comes down, and the eyes look better than ever. Occasionally, a slight bruise may be apparent, but this rapidly resolves with cold compresses.
Recovery and Results
The operation leaves the eyes more open, and the patient looks more alert and rested.
Combine Upper Eyelid Surgery with Other Procedures
This procedure can be done on its own or as part of a more complete facial rejuvenation.
Schedule a Consultation
If you’re interested in restoring a refreshed, youthful look, schedule a consultation with Dr. Jabs to discuss upper eyelid rejuvenation (blepharoplasty) and learn what results you can expect.
Article by Dr. Arthur Jabs, board-certified plastic surgeon in the Washington, D.C. metro area, specializing in deep plane facelift and natural facial rejuvenation.
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