Blepharoplasty or Eyelid Surgery – One of the first areas of the face to begin showing the effects of aging are the upper and lower eyelids, a region referred to by plastic surgeons as the “periorbital tissues.” The entire periorbital anatomy needs to be viewed in its totality in order to determine the best possible approach for aesthetic restoration of the area. Typical changes that occur in the orbital area as patients age include drooping of the brow (eyebrow ptosis), excessive fullness or sagging of the upper eyelid skin, the formation of “bags” of the lower eyelids, soft tissue wrinkles or creases of the lower eyelids and often accentuation of the tear trough deformity (the crease between the lower eyelid and the cheek). To properly rejuvenate the periorbital area, it is important that the plastic surgeon carefully evaluate each and every one of the components that may be contributing to the aging look.
Dr. Neal Handel performs Blepharoplasty / eyelid surgery in Beverly Hills, CA and will examine you and tell you about the options available for rejuvenating this area. Typically, it consists of a combination of upper lid blepharoplasty (an upper eyelid tuck) to remove the redundant hanging skin of the upper eyelid and often to remove some of the bulging fat. Lower eyelid surgery usually consists of repositioning of lower eyelid fat, to give a smoother contour and to fill in the “tear trough.” Some excessive lower eyelid fat (especially from the lateral area) may be removed. Sometimes, nothing needs to be done to the skin; at other times, the fine wrinkles of the lower eyelid skin are treated by conservative skin removal or by chemical peels or laser.
Often, patients who are older (those in their 50s, 60s and beyond) have laxity of the lower eyelid. In these situations, an additional procedure should be performed at the same time to tighten the lower eyelid and to prevent the lower lid from being pulled down. The “pulled-down” look is very unnatural and most patients find it unappealing from the cosmetic standpoint. To prevent this from happening, Dr. Handel will perform a lateral canthopexy or canthoplasty when indicated. This operation is performed easily at the same time as a blepharoplasty through the same scars and consists of repositioning and tightening of the lateral canthal tendon to prevent lid retraction and scleral show.
Eyelid surgery typically is performed on an outpatient basis, most patients like to have it done under general anesthesia, although in certain cases, the surgery can be performed under local anesthesia with sedation. Oftentimes, blepharoplasty or eyelid surgery is performed as an independent procedure. At other times, it is performed as part of an overall facial rejuvenation, which may consist of a brow lift and/or cervicofacial rhytidectomy (face and neck lift), etc.