The Surgeon Minute

Improving the “Windows to Your Soul”

Improving the “Windows to Your Soul”

With a respectful nod to Shakespeare and his romantic description of our eyes, what surrounds them – our upper and lower lids – are important “drapes” that can either enhance or take away from the beauty of the eyes themselves.

They are the first thing people see when we introduce ourselves to new people in our lives. It doesn’t make any difference about your gender or your age; the eyes are key. Lee Thornton, MD, a board certified plastic surgeon in Meridian, Mississippi, firmly believes in the importance of that first impression we make with our eyes.

“The first place we see aging in many people, especially in females and later on in older males, is the upper eyelids,” Dr. Thornton tells The Plastic Surgery Channel. “Usually that’s a surgical procedure. We have a lot of non-surgical options for the peri-orbital area, but more geared for the lower lids. Upper lids I would tell you the mainstay is still an upper lid blepharoplasty. It’s a quick procedure to go through. It’s easy, it has a quick recovery period. It’s not painful and in the right hands it’s a very reliable very good procedure that also has great lasting value.”

What Causes Puffy and Aged Eyes?

Puffy eyes – under eye bags are often misinterpreted as being caused by fatigue or allergies. The bags that are seen under the eyes unrelated to sleep or allergies are due to lower eyelid fat prolapse. The fat that prolapses is referred to as orbital fat. This is based on the fact that the eye sits in a space called the orbit and this space has fat in compartments. To improve the appearance of the bags under the eyes, the fat may be removed, repositioned and sculpted.

Loose Skin – Many people are concerned that after the bags are removed from under the eyes, there will be loose skin. Depending on the support of the lower eyelid, loose skin can be addressed at the same time. Often, the skin that accommodated the eye bags/fat pockets is tightened after surgery by the orbicularis oculi muscle. The orbicularis oculi muscle contracts like a belt and tightens loose skin.

Eyelid Support – There are several unrecognized problems with lower eyelid support. Properly restoring lower eyelid support requires several different specialized techniques. In addition, the support structures of the eyelid can be shaped in a way that can create a brighter appearance to the eyes.

Surgical Eyelid Surgery – Blepharoplasty

Blepharoplasty is the technical name for eyelid surgery, often called an ‘eye job’ or ‘having your eyes done’ for short. As we age, our eyelids stretch, and the muscles supporting them weaken. As a result, excess fat may gather above and below your eyelids, causing sagging eyebrows, droopy upper lids and bags under your eyes.

Correcting the eyes with Blepharoplasty.

Besides making you look older, severely sagging skin around your eyes can reduce your side vision (peripheral vision), especially the upper and outer parts of your field of vision. Blepharoplasty can reduce or eliminate these vision problems and make your eyes appear younger and more alert.

Blepharoplasty may be exactly what you need/want if you have:

  • Baggy or droopy upper eyelids
  • Excess skin of the upper eyelids that interferes with your peripheral vision
  • Excess skin on the lower eyelids
  • Bags under your eyes

“Depending on how they’re aging, [patients] in their late 40s-early 50s, even early 60s, the procedure can last 20, 25 years or more,” Dr. Thornton says. “It is a good rejuvenation procedure that, if done well, really creates a natural look and turns back the signs of aging.”

Lower Lids Can Sometimes be Fixed Without a Scalpel

“When you look at lower lids, it’s a multi-component evaluation,” Dr. Thornton adds. “Some people just have issues primarily with excess skin or wrinkling around the eyes, some have more fat deposition or swelling in the fat around the eyes and the last signs of aging is when the cheek begins to descend and you get a real break between the eyelid and the cheek.”

“So the procedures have to be matched to that. Early on, some people may develop what’s called a tear trough deformity but they don’t have a lot of excess skin or sagging of the cheek. It’s more of a sagging, genetic process and that can be treated with fillers very, very acceptably. Also, with just crepey skin or excess skin around the eyes, there are good laser procedures, there are chemical peels, that again, in the right hands, can really help with the skin around the eyes. Beyond that, we’re getting into surgery. Now surgery also has to be tailored to match what defect we’re talking about around the eye.”

Lower eyelid fixes for the eyes.

Regardless of getting your lower or your upper or both sides of your eyes cosmetically improved by a board certified plastic surgeon, you will be able to rest assured your ‘windows to the soul’ will portray a vision that your friends and family haven’t seen in many, many years.

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