Her World

The eyes are the “window to the soul” and our most important facial feature. Unfortunately the eyelids are the first of our facial features to show the signs of facial aging often as early as the late 20’s or early 30’s. Many people complain that they are told that they look tired when they do not, a condition called tired eyes

Consequently many people seek plastic surgery to reverse the eyelid aging changes with a procedure called a blepharoplasty also known as an eyelid lift or eye tuck. This is one of the most frequently performed plastic surgery procedures performed in the United States and usually the first facial rejuvenation procedure that people seek.

The operation involves removing hooding or excess skin from the upper eyelid (upper blepharoplasty) and removing puffiness or bags from the lower eyelid (lower blepharoplasty).

Unfortunately most people do not really understand what these operations can and cannot correct and many people undergo the surgery only to be disappointed with the results achieved during the typical blepharoplasty as done in the United states today. The purpose of this article is to educate the consumer by exposing commonly held myths about the plastic surgery operation known as the blepharoplasty so that people considering eyelid rejuvenation will seek the appropriate treatment to correct the particular eyelid aging changes which are occurring on their own unique face.

Blepharoplasty Myth 1- Blepharoplasty will remove crow’s feet. Crow’s feet occur because of the repeated movement and contraction of the eyelid muscles that surround the eye and upper cheek. When we smile, blink etc, the muscle contracts and causes a wrinkle in the skin. After many years these lines become permanent. The blepharoplasty removes fat that causes bags, and can tighten the eyelid skin, but the muscle continues to contact and cause crow’s feet. Blepharoplasty does not correct crow’s feet. Fortunately Botox® can remove the crow’s feet from the cheek very effectively although Botox® needs to be repeated.

Blepharoplasty Myth 2- Blepharoplasty will remove wrinkled aged skin often called “crepiness” and restore the lower eyelid skin to fresh, young looking smooth skin. The Blepharoplasty can tighten the lower eyelid skin, but blepharoplasty alone leaves the eyelid skin looking old and damaged. The LaserLyte Peel™ when done at the time of a blepharoplasty can resurface the lower eyelid skin and leave it fresh looking-but blepharoplasty alone cannot achieve this

Blepharoplasty Myth 3- Blepharoplasty lifts the cheek and corrects puffiness below the eyelid. Many people have excess skin that creates a bulge or swelling on the cheekbone just below the eyelid. When you take your finger and pull the lower eyelid up this bulge, which is called a “festoon” smoothes out. Blepharoplasty alone will not improve the festoon. In fact if during a lower eyelid blepharoplasty fat, which is causing puffiness of the lower eyelid, is removed the festoon actually looks worse. This is a very common problem and can be a very unhappy result of a blepharoplasty. Festoons are hard to treat but can be improved by doing a cheek lift in some people. The important thing is to avoid worsening them by not doing fat removal during blepharoplasty in people who have festoons unless the cheek lift or other procedure is done at the same time. Other procedures such as canthoplasty or orbiculopexy done during the blepharoplasty can help.

Blepharoplasty Myth 4- Blepharoplasty will remove dark circles under the eyes. Many people have dark circles under the eyes-a dark shadow overlying the bone just below the eyelid. In many people a blepharoplasty will make the dark circle worse if too much fat is removed. To remove the dark circle under the eyes a special procedure called the arcus marginalis release and fat grafting must be done to correct the dark circle.

Blepharoplasty Myth 5- Blepharoplasty will remove hooding of the upper eyelid and improve eyebrow position. Many people have hooding of the upper eyelids that is caused not only by loose upper eyelid skin but also by the fact that the eyebrow has sagged as well. In these people an eyebrow lift must also be done to restore the upper eyelid to a youthful look.

Blepharoplasty Myth 6- A lower eyelid blepharoplasty must leave a visible scar on the lower eyelid. While traditional scalpel blepharoplasty does use an incision on the lower eyelid, more modern contemporary blepharoplasty is done with a laser through a small opening on the inside of the lower eyelid and leaves no visible scar. This technique, called the transconjunctival laser lower blepharoplasty not only avoids a scar but also preserves the beautiful natural shape of the eyelid. The traditional scalpel blepharoplasty done through an external incision often damages the supporting muscles of the lower eyelid and as a result the outside corner of the lower eyelid turns down into a “sad eyed” or ”hound dog” look.

Beautiful eyelid rejuvenation is possible today using advanced new laser techniques, and additional new variations such as the arcus release, canthoplasty, and orbiculopexy. However these techniques are new and not widely practiced yet. It is very important that you understand what the eyelid rejuvenation techniques called blepharoplasty or eyelid lift or eyelid tuck can and cannot achieve and also that you have knowledge of the newest, safest, and most effective techniques. Only by being well informed can you hope to be happy with your result and not be disappointed or worse, have a different problem than you had before surgery. For a more thorough discussion of these issues study blepharoplasty in the archives of “ask dr seckel” and “whats new” at saveyourface.com.

About the Author:
Dr Brooke R. Seckel, Asst. Professor of Surgery at Harvard Medical School was recently named a Top Doctor in Boston by Boston Magazine. He is also listed as one of the Best Doctors in America. Dr Seckel is an internationally recognized expert in Plastic Surgery. Dr Seckel’s office is in Boston at 617-262-2208 or at http://saveyourface.com/