Blepharoplasty, also known as eyelift and eyelid surgery, has gone through a significant transformation over the past five years. Traditionally, blepharoplasty surgery involves the removal of significant fat, skin and muscle in order to obtain what is perceived as “youthful” eyes. This approach can result in hollowness of the eye area and a “cat-like” look of the corner of the eyes that looks unnatural and changes the entire appearance of the person. Also, complications were more common with these types of procedures.

Today we know that the aging changes around the eyes does not just involve sagging skin. It has multiple components such as loss of skin elasticity, drooping of the eyebrows and cheek fat pads and weakness of supporting eyelid structures that lead to puffiness under the eyes. In the evaluation of aging eyes the forehead and mid face also need to be thoroughly evaluated.

Upper Eyelid Blepharoplasty / Upper Lid Blepharoplasty The upper eyelid blepharoplasty removes excessive skin, muscle folds and fatty bags that are usually found in the inside corner of the eye. Incisions are made following natural lines and creases. If the eyelid skin is excessive it may obstruct vision leading to a peripheral field defect. This becomes a medical rather than a cosmetic indication for performing an upper blepharoplasty. In such cases, particularly in men with heavy eyebrows pushing the eyelid skin down, a forehead or brow lift is performed in conjunction with an upper blepharoplasty. If necessary, the incisions will extend into the fine squint lines, or crow’s feet, at the outer edges of the eyes. Careful plastic surgical closure uses extremely fine stitches which are removed within three to four days. Once healed, the hairline scars will fade, leaving a very inconspicuous incision line that becomes virtually unnoticeable after a short time.

Lower Eyelid Blepharoplasty / Lower Eye Blepharoplasty Puffiness of the lower eyelids can be caused by an accumulation of fluid within the skin, but it is most often caused by excessive fatty deposits. These fatty deposits can be made worse either from allergies or from fluid retention making them appear worse in the morning. Dark circles under the eyes can be caused by dyscrhromias or pigmentations in the skin, as well as by shadows cast by fatty deposits or the shape of the orbital bone surrounding the eyes.