Description of Blepharoplasty (Eyelid Surgery)

No. There are many differences between the upper and lower eyelids and treatment requires different approaches for each.

The problems of the upper lids are generally one of stretched, loose or excess skin and muscle, which can hang down onto the eyelashes and below causing a tired and aged look as well as blocking a portion of the visual fields.

The problem of the lower eyelids is most commonly one of too much fat behind the eyelid, which pushes outward. This creates a mound or pillow under the eye and since most light comes from above us, this causes a shadow beneath that fat pad. This gives the appearance of dark circles under the eyelid, which is perceived as making one look tired. Fatty accumulation can also affect the upper lids as well.

How are the upper eyelids treated?

Treatment of the lower eyelids is most commonly directed at the fat pad, which causes the shadowing and appearance of dark circles, which give one that persistent tired appearance. Dr. Lent, the Beverly Hills Plastic surgeon says, "there are several ways to perform this procedure, but the safest way is to approach the problem from behind the eyelid with, what is called a "Transconjunctival" approach". This technique helps prevent scarring from getting into the actual eyelid mechanism, thus preventing that terrible pulled down appearance that so often affects the lower eyelid when the 'old fashion' method is used which requires an incision on the outside of the lid.

By removing the excess fat, you remove the cause of the bulging and eliminate the shadowing and its' associated tired appearance. Patients often worry about whether the skin will tighten or sag afterwards. This is usually not a problem as the skin has a natural elastic quality, which allows it to shrink into place and therefore sagging is not an issue.