The eyes are the window to the soul – so how can we stop the blinds from coming down? Healthy, youthful-appearing eyes are generally associated with minimal skin laxity over the upper eyelids and a short, smooth lower eyelid that gently transitions to the cheeks causing little to no shadowing around the eyes. Unfortunately, the skin around the eyes is the first place to show the signs of aging and sun damage. The skin in this area is thin, delicate, very mobile, and regularly exposed to the sun—combined, this is a perfect storm for prematurely aging skin.
As we get older, excess fat around the eyes starts becoming more noticeable and causes undesired puffiness. Plus, volume shifts in the tear trough area, and anterior cheek can cause deep hollowing that increases shadowing, which further ages the eyes. How much someone squints can increase wrinkles, as can furrowing the brow. Genetics also plays a role when it comes to the severity of wrinkles and crow’s feet, droopiness, dark circles, and bags under the eyes.
Heavy eyelids and under-eye bags are two of the earliest hallmarks of the aging face. An upper or lower eyelid surgery, also known as blepharoplasty, can immediately restore your eyes to their bright, youthful appearance with virtually no scarring. Today’s eyelifts are minimally invasive, and incisions are hidden either inside the eyelids or in the creases.
Eyelid surgery can quickly address all of your eye area concerns, and Dr. Roy provides a highly skilled, expert approach for these life-changing surgeries. How do you know which type of eyelid surgery is right for you? Discuss your needs and goals with Dr. Roy at your consultation, and learn more about how dramatic yet natural-looking this procedure can be.
Aging of the upper eyelids often presents as excess skin over the eyelids (dermatochalasis) and generalized volume loss in the areas beneath the brows and upper eyelids, which uncovers bulging fat pads around the eye. Upper eyelid surgery (upper blepharoplasty) involves a conservative removal of excess skin over the upper eyelids, which creates more youthful eyelid show. Targeted fat removal can also be accomplished through the same incision.
Upper eyelid surgery scars are minimal and hidden in the natural eyelid crease. This results in a refreshed appearance of the eyes, without altering the shape or function of the eyelids. In some cases, a lateral browlift may first be necessary to address lateral upper eyelid hooding from a low set brow.
Upper Eyelid Before/After Photos, Real Patient Results*
Aging of the lower eyelids is typically associated with the development of crepey, lax skin, volume loss around the bony orbital rim and upper cheek as well as bulging of fat pads around the eyes. There are a few ways to perform lower eyelid surgery, depending on your skin and goals. Dr. Roy often uses the transconjunctival method, which puts the incisions on the inside of the eyelid. These scars are completely hidden, and patients are pleasantly surprised to learn that they heal very well and quickly.
Lower eyelid surgery may also require the removal or excess orbital fat. In some cases, a fat transfer, skin pinch excision or skin resurfacing may be recommended in order to smooth out the wrinkles in this area.
Dermal fillers can also help with many lower eyelid surgery patients. It is often not enough to tighten the skin in this area, because the dark circles and hollowness will remain. However, dermal fillers can be a complementary procedure to fill out the area, which will naturally minimize dark circles and smooth the skin.
Lower Eyelid Before/After Photos, Real Patient Results*
Both upper eyelid surgery and lower eyelid surgery are an outpatient procedure. Upper eyelid surgery can be performed safely in the office under local anesthetic, with patients being awake and mildly sedated for the entire procedure. Sutures are removed after one week and low-impact activities can be resumed at two weeks. Most patients are completely back to their normal lives after one week, once any swelling or bruising has subsided.
Lower eyelid surgery usually requires IV sedation, but no general anesthesia. With this procedure, there are no sutures because the inner eyelids are especially good at healing.
There is no ideal age for eyelid surgery since everyone ages at a different rate. However, the majority of patients start to consider eyelid surgery in their 40s or later. Other patients choose eyelid surgery at a younger age, perhaps due to a family history of early eyelid hooding or as a preventive measure.
The results from an eyelid surgery are dramatic and yet natural-looking. It’s amazing how many secrets our eyes give away. It’s the first place people look and a big source of our personality and self-confidence. The results of eyelid surgery last several years, but can also be extended with complementary non-surgical procedures such as laser skin treatments and chemical peels.
Candidates for upper eyelid surgery can range from younger patients in their 20s-40s who exhibit familial (i.e. running in the family) eyelid skin excess or older patients experiencing typical aging changes around the eyes. In some cases, upper eyelid surgery is covered by your insurance. This may be possible if sagging skin and excess fat is interfering with your vision.
Candidates for lower eyelid surgery can range from young adults to retirees. This is almost always a cosmetic procedure, and as long as you are healthy and will benefit from a lower eyelid lift, you are likely a good candidate.
Supplementing your upper or lower eyelid surgery with additional procedures (both cosmetic and dermatological) may help make your results even better. However, the exact complementary procedures will depend on your unique eye area and your goals. For example, fillers or a fat transfer are often recommended for lower eyelid surgery in order to further fill out hollowed areas, while a lateral brow lift might be recommended for some upper eyelid candidates.
Additional complementary procedures may include a thread facelift or a wide range of skin tightening procedures to optimize and help sustain results. From Botox to microneedling, RefinedMD offers a wide range of services to make the most of any procedure, including upper or lower eyelid surgery. Discuss your goals with Dr. Roy during your consultation, and start creating a customized plan to get the youthful aesthetic you deserve.
Upper blepharoplasty, in isolation, is typically performed under local anesthetic and minimal oral sedation in the office. ProNox Nitrous Oxide (“laughing gas”) is also available upon request. Lower blepharoplasty requires IV sedation and is generally performed at an outpatient surgical center. General anesthesia is not necessary or required.
For upper blepharoplasty, Dr. Roy typically removes redundant skin through an incision that is hidden within the upper eyelid crease. A small amount of eyelid fat is also removed through the same incision to improve the eyelid’s appearance. For lower blepharoplasty, Dr. Roy almost exclusively uses the transconjunctival technique (no external incisions, just one on the inside of the eyelid) for removal of lower eyelid excess fat. Rarely, a small amount of redundant skin on the exterior surface of the lower eyelid will be removed in the same setting. Sometimes, instead of excising redundant skin, a gentle lower eyelid chemical peel can also be performed to help tighten skin.
The incision for upper blepharoplasty is hidden within the natural upper eyelid crease and is barely perceptible once healed. The incision for lower eyelid blepharoplasty is on the inside of the eyelid, so not visible. Dr. Roy is invested in optimal scar healing and provides patients with the most cutting-edge skin care products to improve scars’ appearance.
The use of local and oral anesthetics/analgesics in preparation for the surgery allows the actual surgery itself to be performed without pain for the patient. For procedures under IV sedation, there is no intra-operative pain. Most patients are surprised at how tolerable post-operative discomfort is, and many patients transition to extra-strength Tylenol only after 1-2 days. A sense of tightness of the upper eyelid can be experienced. Post-operative pain medication is prescribed but seldom used by patients after the first couple of days.
After upper blepharoplasty, sutures generally remain in place for 6-7 days. There are no sutures involved with lower blepharoplasty. Bruising and swelling typically last for 7-10 days, by which time patients generally resume social activity. Improvement in incision appearance and swelling will continue beyond this time frame. Low impact activities can typically be resumed after 2 weeks, while more high impact activities (running, jumping etc) is permitted after 3 weeks.
This is generally dependent on the patient. Some patients with limited swelling and bruising are able to work at least a partial day (assuming a non-physical job) after 4-5 days. If discretion is sought, then probably a period of 7-10 days is more appropriate. Eyes can be used without limitation for reading or screen viewing. Contact lenses must be avoided for at least 2 weeks.
Light walking can be resumed after about 1 week after blepharoplasty. Low impact activities (such as elliptical, weight lifting, exercise bike etc.) can begin after 2 weeks, while high impact activities need to be restricted for 3 weeks.
The goal of RefinedMD is to offer patients all of the best treatments and procedures for lifelong gorgeous, glowing, healthy skin. This means both surgical and non-surgical aesthetic treatments are available, and we will always work with you to customize a plan to suit your goals. Dr. Roy is a board-certified, fellowship-trained facial plastic surgeon who is 100% dedicated to surgical treatments of the face and neck. His immaculate credentials and glowing reviews tout his surgical skills. The natural results he achieves and exceptional bedside manner are proof of the five-star experiences he provides his patients. Find out more about eyelid surgery today, and find out if upper eyelid or lower eyelid surgery is your avenue to the “refined” you.