Eyelid Surgery

Eyelid Surgery (Blepharoplasty) | Eye Lifts

Upper Eyelid Surgery

Upper eyelid blepharoplasty (eyelid surgery) is our second most common eyelid procedure overall and our most common cosmetic procedure in men. Upper eyelid blepharoplasty can be done in our privately owned surgical center with minimal anesthesia and with next to zero downtime. Patients commonly return to work within 48 hours.

As we age, the upper eyelid skin tends to elongate and droop.  It is also common to develop bulging eyepads on the inner eyelid whereas, we tend to get extra skin on the outer eyelid.  When bulging eyepads and/or excess skin occurs in the upper eyelids, we look  tired, fatigued, or even sad.

One of our most common requests that we hear from our cosmetic patients is a desire to look less tired. Our patients often report feeling good, but wish that their outer physical appearance better reflected their inner spirit. At Ocean Drive Plastic Surgery, we believe in offering a variety of services for rejuvenating eyes that can include surgical as well as nonsurgical approaches such as BOTOX cosmetic. Upper eyelid rejuvenation involves evaluation of the patient’s eye and facial skin, eyelash length and fullness, and presence or absence of excess fat around the eyes and face.

Ideal Upper Eyelid

The ideal upper eyelid should provide a bright, youthful, and energetic look. The eyelid and eye itself should have either an oval or almond shape. In women, there should be a robust row of eyelashes on the upper and lower eyelid, but the upper eyelid is more noticeable. There should be minimal excess skin in the upper eyelid, and surrounding the orbital area in general. Crow’s feet should be minimized. Lastly and most importantly, there should be a well defined cleft between the superior end of the upper eyelid and the inferior beginning of the lower brow. This upper eyelid cleft is crucial to your overall appearance, as it provides definition between the upper eyelid and the brow.

4 Important Eyelid Features

During your consultation, there are 4 critical structures in the upper eyelid that must be evaluated to improve your overall aesthetics.

  1. Upper eyelid skin.
  2. Upper eyelid fat pads
  3. The Obicularis muscle & upper orbital septum
  4. Presence or absence of ptosis (aka eyelid droop)

Upper Eyelid Skin

As we age, our brow position tends to fall over time. We fight this brow descent by activating our Frontalis muscle, which lifts and elevates the brow position. By doing this, we create a tension on your upper eyelid.

These movements, which happen thousands of times a day will effectively stretch and elongate upper eyelid skin over the course of daces causing dermatochalasis, which is the term for having excess upper eyelid skin. The only truly effective treatment is upper eyelid blepharoplasty.

Upper Eyelid Fat Pads

There are 3 fat or glandular components in the upper eyelid. The three components are the medial fat pad, the middle fat pad, and laterally the lacrimal gland (aka the tear gland). During upper eyelid surgery, we routinely reduce or remove the medial fat pad to emphasize the natural almond shape of the upper eyelid. However, we do not routinely reduce the middle fat pad as reduction or removal of this pad commonly creates a hollowed out appearance to your eye. Instead of reducing or removing the middle fat pad, we tighten this fat pad using a specific type of laser to create a revitalized appearance to the upper eyelids. Lastly, the lacrimal gland is left untouched to prevent disruption of tear flow and to maintain appropriate eye function.

Upper Eyelid Cleft

We strongly advocate for defining the upper eyelid cleft during upper eyelid surgery. There is a natural elegance to a clearly defined upper eyelid and brow. If this cleft is obscured or absent, many patients will require a surgical brow lift or a chemical browlift to create the cleft. Conversely, in patients who have good overall brow position and merely have descent of upper eyelid, those patients can achieve outstanding results though reduction of the orbicularis muscle and removal of the excess upper eyelid skin and septum. By removing the septum and reducing the muscle, Dr. Durkin is able to recreate the natural upper eyelid cleft that you were born with. This specific maneuver that Dr. Durkin utilizes separates our upper eyelid results from our competitors. By addressing the foundation tissue planes of the upper eyelid, we are able to create natural, youthful appearing eyes with lasting results.   Reduction of the orbicularis muscle and septum has no effect on eyelid function. It is an accessory function muscle and manipulation of the orbicularis does not alter your ability move your eyes.

Eyelid Droop or Ptosis

As we age, facial structures and landmarks tend to drift downwards. When this happens in the upper eyelid, we call this ptosis. Ptosis refers to the overall position of the upper eyelid in relation to the eye itself. It does not indicate whether or not the eyelid has exta skin. Rather, this refers to eyelid position overall. This assessment is taken during your initial evaluation. Repair of ptosis is traditionally done through manipulation of the Levator muscle, or another important muscle known as Muller’s muscle. Ptosis repair can provide a dramatic improvement in facial appearance. Dr. Durkin has extensive experience in regarding ptosis repair of the upper eyelid, and brow. There are many causes of eyelid ptosis, and the repair of each type differs. Ptosis evaluation is one of our cornerstones in eyelid surgery, as repair of upper eyelid droop is absolutely crucial towards overall outcome in upper eyelid surgery.

Not all patients are candidates for isolated upper eyelid surgery. Many require brow lifting as well because their brow has fallen. This is very common in women. Upper eyelid evaluation is not complete unless your brow position is evaluated as well. We eval both for you at your consultation and define your options for you.

We also commonly employ upper eyelid blepharoplasty with Botox® and or latisse to get the maximum result possible. As well, all patients are evaluated in terms of brow position. Many patients who request an up eyelid surgery, commonly need a brow lift as well. We discuss this at length during your consultation and ensure all of your questions are answered before surgery.

Pros & Cons Upper Eyelid Surgery

Pros to Upper Eyelid Surgery

  • Comprehensive eye rejuvenation that lasts 15+ years
  • Direct controlled & precise rejuvenation
  • Minimal anesthesia
  • Treats all layers of eyelid: muscle, fat, skin, & septum
  • Minimal downtime, back to work in 48 h

Cons of Upper Eyelid Surgery

  • Requires surgery
  • Cosmetic complications could occur

Lower Eyelid Surgery

One of the most prominent stigmantas of aging is bagginess or puffiness in the lower eyelid, making eyelid surgery a widely popular cosmetic surgery procedure. As we grow older, we develop excess fat projection, excess skin, and skin discoloration in our lower eyelids. Dark circles under the lids are especially bothersome to women. Lower lid blepharoplasty is a permanent solution to dark circles/pigmentation ounder the eyelids.

We take the lower eyelid rejuvenation is one of the most complicated procedures in cosmetic surgery. The definition of the perfect lid varies between gender and race. Many believe that Scarlet Johansen has the perfect lower eyelids for a caucasion woman whereas, this does not fit for an Asian or African female. Naomi Cambpell is a great example of a woman with ideal lower eyelids for an African American.

What should the lower eyelid look like? There should be a smooth transition from the lower eyelid to the cheek. There should not be excess skin or lumpiness. Lastly, in woman, cheek mass commonly equates to modern beauty.

As with upper eyelids, if you are going to operate on the upper lid, you must evaluate the brows. With the lower eyelid, if you are going to operate the lower lid, you eval the cheek. Many patients presenting with lower eyelid surgery will require a cheek lift. The line that forms underneath the eyelid forms because the cheek fat has fallen. The line is called arcus marginalis. To remove this line the cheek must be reposition in conjuction with the structure of the lower eyelid. The primarly goal is to create a harmonious lower eyelid/cheek junction without a tear trough deformity.

Our services include lower eyelid rejuvenation, repair of tramatic injuries, repair of drooping eyelids and revisional surgery following previous cosmetic eyelid surgery. People come with ectropins, which are drooping lower lids. Scarring after lower lid bleph or trama can cause ectropionss. Scarring can be technique driven.

Pros to Lower Eyelid Surgery

 

  • Rejuvenates appearance of face
  • Foundation for facial rejuvenation
  • Minimal anesthesia
  • Treats all layers of eyelid: muscle, fat, skin, & septum
  • Minimal downtime, back to work in 48 h

Cons to Lower Eyelid Surgery

  • Requires surgery
  • Cosmetic complications could occur