The eyes are probably the first area of the face to show the signs of aging. Your eyes are the windows of the soul and you want to protect your individuality. If your eyes are making you look tired, weary, depressed, or angry regardless of how you feel, you may consider aesthetic facial surgery to the eyes so that you will obtain a whole new look and a much more rested and less tired look. Blepharoplasty, or eyelid surgery, may be the appropriate procedure to restore the youthful appearance of the eyes.
There are a number of factors that result in the aging appearance of the eyes. Ones genetic heritage is a major factor and there is a distinct similarity amongst family members in the eye appearance and changes. Skin care and prior sun exposure additionally may affect the progression of aging changes of this area. The eye appearance is related to changes involving the upper eyelid area and the lower eyelid area that may be quite different.
There are generally two areas of concern, the apparent excess of skin tissue and possible pockets of fatty fullness under the lids. The excess skin tissue needs to be carefully evaluated and the reasons for the redundancy assessed. In many cases it is in fact not excess skin at all but rather a generalized laxity of the brow area that in turn results in a “heaping up” of the skin tissue. If this is the case the solution is not to surgically remove this tissue but rather to correct the cause of the problem generally by performing a brow lift procedure. If one tries to simply remove this apparent “extra” skin and ignore the problem of the brow position then there is often an unsatisfactory result and worse, the possibility of the inability to correct the problem as one has removed too much tissue thus “burning the bridge”. We routinely see individuals who have undergone upper eyelid surgery only to find that the results did not accomplish the desired goal. When in fact there is a roll of excess skin tissue this is easily treated by simple excision of the extra tissue leaving a very fine line looking like a natural crease. The fatty pockets, if they exist, are treated by simply removing the extra fatty tissue either in conjunction with removing extra skin or via a very small incision over the area.
The most common problem that we see is the formation of areas of fullness (bags) under the eye. There is a strong genetic association with the formation of this “baggy” appearance often being noted fairly early in life. This appearance is due to fatty tissue that is normally present around the eye but is not being held in position allowing it to bulge out. The supporting structure is called the orbital septa and this is what in fact weakens resulting in the bulging effect. When the fat tissue herniates out it then creates the bags resulting in an overhang of tissue. There is then a shadow cast under this area causing the typical dark circles under the eyes. The ideal treatment option for this condition is known as a transconjunctival blepheroplasty. This involves making a small incision just inside the eyelid and we are able to directly see the excess fat and then remove it. There is no visible incision and no suture is used. In almost all circumstances any seeming excess skin tissue generally disappears. It is rare that we need to actually trim away any skin.
Eyelid surgery is easily and quickly performed with sedation administered by our anesthesiologist and added local anesthesia- it is essentially painless. Recovery is very rapid with a socially presentable appearance often as early as three days later with some cover-up. There is typically a small bruise at the lower lid region that rapidly resolves.
Well-planned eyelid surgery results in a dramatic restoration of the youthful appearance of the eyes eliminating the heaviness and fatigued look.
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