Overview of Eyelid Lift Surgery
An eyelid lift or blepharoplasty is a procedure performed on the upper and/or lower eyelids that involves some type of modification to the skin, muscle, and fat of the eyelids to produce a more youthful appearance. There are many techniques available to the surgeon who must tailor the operation to the individual characteristics of each patient. Some typical signs of aging of the upper eyelids include the development of excess skin that can hang down and interfere with peripheral vision, and excess fat usually seen at the inner portion of the upper eyelid. The muscles and hence the wrinkles of the glabella (the area between the eyebrows commonly treated by botox) can also be reached through an upper blepharoplasty incision and modified as in a browlift. Common findings with aging of the lower eyelid include sagging of the skin, lower lid bags, drooping of the eyelid margin, and the development of a distinct junction between the eyelid and cheek.
For the upper eyelid, the procedure involves an incision that lies inside the entire length of the fold of the lid which allows for the removal of skin and fat. Through this incision, some surgeons like to modify the position of the brows and also modify the muscles that cause frowning to produce a more permanent affect as compared to botox. For the lower eyelid, an incision can be made either on the inside of the eyelid (transconjunctival) or on the outside (transcutaneous). The advantage of the inside incision is that the scar is better concealed but if there is excess skin, this cannot be treated. The outside incision allows access to any of the structures of the eyelid but does result in an external scar. Through either incision, the fat pads of the eyelids can be removed or repositioned to treat bags and provide a more youthful, smooth transition from the lower eyelid to the cheek. A cheek lift can also be performed through this incision, however a facelift is much more effective at lifting the cheek.
Although both upper blepharoplasty and transcutaneous lower blepharoplasty result in scars, these usually heal very well and after several months are barely visible and rarely problematic. When the incision is placed on the inside of the lower eyelid, the scar is invisible.