The Surgeon Minute

Is It Time for Eyelid Surgery?

Is It Time for Eyelid Surgery?

The eyes may not be the “window to the soul,” but they are definitely the gateway into plastic surgery for both men and women. According to the latest statistics from the American Society for Aesthetic Plastic Surgery (ASAPS), blepharoplasty (eyelid surgery) is the fifth most popular surgical procedure for women and the second most popular surgical procedure for men. The reason is simple: rejuvenating the eyes is a relatively easy procedure, but one that delivers a big pay off in how a person looks and feels.

Dr. Adam Hamawy of Princeton, New Jersey discusses the differences between an upper and lower blepharoplasty, as well as some of the signs that it may be time to take that surgical plunge.

Do You Need an Upper Blepharoplasty?

A blepharoplasty is a surgical procedure to rejuvenate the eyes via the eyelids. It may involve surgery on the upper eyelid, the lower eyelid, or both. How is a patient to know if he or she is really needs surgical intervention?

The most common complaint that Dr. Hamawy hears from his upper eyelid surgery patients is that they look in the mirror and “see lots of skin.” Some may have trouble placing makeup on their upper lids, and most potential blepharoplasty patients say that they are “tired of looking tired.” A few even look as if their eyebrows are coming down.

In an upper blepharoplasty, Dr. Hamawy makes an incision in the natural crease of the eye through which he removes excess skin and sometimes small pockets of fat. “The goal is to give you a refreshed appearance,” he shares. “Basically, we give you that crease back and remove the folds above your eyes.”

Eyelid surgery patient - Hamawy.

By placing the incision in the crease, any subsequent scar is easily hidden. This means that you won’t see it when you look at yourself in the mirror, and neither will others.

Lower Blepharoplasty – More Complicated

“A lower blepharoplasty is a little more detailed than the upper eyelids because there is more involved,” explains Dr. Hamawy. In addition to the possibility of excess, droopy skin, there is also muscle that may have become lax over time and needs to be tightened. More fat in that area can also create bags under the eyes that need dealt with.

Lower eyelid surgery needs to address all three of these things:

  • remove extra skin
  • tighten up the muscle
  • reposition or remove the fat pad

Fillers Are Not Always the Answer for Lower Eyelids

The other issue that can make a lower blepharoplasty more complicated is the transition between the cheek and the lower eyelid. Having a cheek/eyelid juncture that is smooth and plump is a hallmark of youth. With a lower blepharoplasty, the surgeon has the ability to really blend the fat to make this transition very subtle and natural-looking.

Eyelid Surgery Results - Hamawy.

Many patients who’ve reached this point think that it can be fixed by simply adding fillers, a non-surgical option. It’s possible, but usually not the case. According to Dr. Hamawy, fillers under the eyes may work initially, but overtime, it becomes less efficacious because “you can only fill so much.” Lower eyelid surgery allows the surgeon to subtly blend the transition to create a more youthful looking eye. It’s truly the ideal procedure for rejuvenating the lower eyelids.

Blepharoplasty is Always Individualized

“Eyes are one of the most unique features in a person,” says Dr. Hamawy. They are one of the central points on the face that give you your specific character. Therefore, there is never a set way to do eyelid surgery.

What worked for your friend may not be right for you. The procedure must be customized to each patient’s individual anatomy and needs. “There’s a lot of moving parts and, depending on your specific anatomy, we are going to tailor the procedure so we can make it look natural on you,” shares Hamawy.

Eyelid Surgery Before and After - Hamawy.

Eyelid surgery is also one of the first plastic surgery procedures that some people will consider because it’s great (needed) for both men and women. It has a fairly easy recovery, and is often performed in the office under local anesthesia with some mild sedation. You can expect a little bruising and swelling afterwards, but both can be easily covered with makeup and/or sunglasses.

Patients Are Very Happy with Eyelid Surgery

“Eyelid surgery has one of the highest satisfaction rates,” says Hamawy. Not only can patients see the results right away, but it is usually something that has bothered them for a while.

It is important to find a plastic surgeon with a lot of experience taking care of the eyes and who is board certified. “The whole goal of plastic surgery is not to have people notice that you’ve had it,” explains Hamawy.

This is why experience matters. You want others to notice that you look different, but not to know exactly why. “I love eyelid surgery,” concludes Hamawy. “It’s something that I do in the office all the time. People come back in a month and they’re ecstatic.”

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