COSMETIC EYELID SURGERY

Upper Eyelid Blepharoplasty

When we speak to each other, we look each other in the eyes. Not surprisingly, aging changes around the eyes are one of the first things you may notice in yourself and others. Similarly, restoring a more youthful look around the eyes can have a powerful effect in one’s entire facial appearance.

With age, the upper eyelid skin becomes thinned and crepy. It stretches out, resulting in redundancies and folds that overhang the eyelid “platform” that is normally visible (where women would normally place eyeshadow). This creates a tired, aged and sometimes sad or angry look. Fat that previously was held by youthful, taught tissue is now able to prolapse forward, often creating puffy mounds in the corner of the upper eyelid by the nose.

Upper eyelid blepharoplasty removes this redundant skin and fat that accumulate with age. While many plastic surgeons perform this procedure, Dr. Callahan is a plastic surgeon who has spent years specializing in the area around the eyes and eyelid. She is trained to preserve not only the natural appearance of the eyelids, but also their functioning in protecting the health of the underlying eyes. Dr. Callahan carefully hides the incisions in the natural creases of the upper eyelid and can extend this outward into the “smile lines,” to address the folds that accumulate at the outer corner of the eye.

The result is a younger, happier and more rested appearance in a natural way that others often cannot pinpoint. Because upper eyelid changes rarely occur in isolation, upper eyelid blepharoplasty is often performed in conjunction with lower eyelid blepharoplasty.

Lower Eyelid Blepharoplasty

Aging changes in lower eyelid are common and contribute to a tired, aged and “puffy” appearance. They usually result from a combination of protruding fat previously held out of view by more toned tissue, skin redundancy from lost elasticity over time, and a hanging or drooping of the eyelid as it looses its natural tone and loosens from its anchoring support at the lateral orbital rim. These changes sometimes take decades to accumulate, but can occur earlier in life particularly when associated with a known family trait.

Lower eyelid blepharoplasty can address each or all of these aging changes and the surgical approach should be tailored to each individual. Prolapsed fat can be approached internally via an incision on the inner surface of the eyelid (transconjunctival) or externally via an incision well-hidden underneath the lash line (transcutaneous). The external incision is additionally utilized when significant skin tightening is indicated. Whenever fat or skin is being removed from the lower eyelid, it is important to assess for looseness of the lower eyelid as the healing process can further pull down an already “lax” lower eyelid. When laxity is noted prior to surgery, an additional step to tighten the lower eyelid is recommended. Dr. Callahan’s specialized training in eyelids allows her to perform these tightening maneuvers in a way that maintains a natural appearance. This enables optimal removal of fat and skin while preserving the position and contour of the lower eyelid.

When lower eyelid puffiness is only mild, less invasive treatments with filler and/or botox are often recommended. Surgery is reserved for cases in which less invasive options would not yield optimal results. Those in whom surgery is recommended often would also benefit from upper eyelid blepharoplasty.

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ALISON CALLAHAN, MD

Oculofacial Plastic Surgeon