Blepharoplasty (Eyelid Surgery)/Brow Lift
Blepharoplasty is the surgical removal of excess skin and/or fat of the upper and lower eyelids. It is a relatively simple procedure that can have a dramatic impact on both esthetics and function. Upper lid surgery usually involves surgical removal of excess or redundant tissue. The incisions are hidden in the creases of the eye for a maximum cosmetic result. Lower blepharoplasty can be done from two different approaches. If a large amount of redundant tissue exists, an incision is made in a lower lid crease and skin is removed along with the partial removal of three different fat pads. If there is no need to remove skin tissue, only the fat pads are partially removed. This approach is made from inside the lower lid(transconjunctival) so there is no scar.
Lower Blepharoplasty will remove excess fat which has protruded from around the eyes, correcting the apparent bulges, but will not correct the fine wrinkles of the lower lids. Lower Lid Blepharoplasty actually may increase the apparent number of fine wrinkles by deflating the bulging lower lid skin and allowing it to relax. It is often not prudent to remove a large amount of lower lid skin to remove these fine wrinkles because of the risk of actually pulling the eyelid downward (scleral show and ectropion), and in fact these wrinkles can be best remedied by an adjunctive procedure such as CO2 Laser Resurfacing, or light chemical peel.
A brow lift is often recommended alone or in combination with upper blepharoplasty. Often, at least 50% of the apparent problem with the upper eyelids is due to brow sag or brow ptosis. Correcting this component by a Brow Lift will also release some of the muscles causing the 'worry lines' just above the nose, as well as smoothing of the major transverse wrinkles of the forehead, caused by chronically animating the forehead to raise the brows to fully open the eyes. When skillfully performed, this technique does not cause a 'surprised look', but it will nicely refine the appearance of the eyelids and orbital skin, which can then be further enhanced by application of appropriate cosmetics. The incisions are made in two ways. If an individual has redundant forehead tissue that would benefit from removal, a large incision can be made across the hairline and the excess tissue can be removed and thus raising the brow(open brow technique). If there is no need for tissue removal, two to three small incisions can be made in the scalp and the brows can be suspended in that manner.
