Unfortunately, the tissue around the eyes is often the first part of the face to demonstrate an aged appearance. Often, a distinct pattern of aging here can be hereditary, usually characterized by “puffy” or “baggy” lower eyelids, with loose redundant skin.
As with the upper eyelids, as the lower eyelids age, the associated skin can begin to loosen, the muscle can form fold-like redundancy, and the underlying fat collections can bulge. The lower eyelids can appear, “droopy,” or “tired.” Individuals can begin to notice this phenomenon in their 40’s, and with certain genetic predisposition, perhaps earlier. There are two primary ways to address problems with lower eyelid aging. The first is by way of deep laser skin resurfacing. The second is a surgical solution, called lower blepharoplasty (or lower eyelid surgery).
Deep laser skin resurfacing is a very effective way to non-surgically tighten loose skin of the lower eyelids. Some indirect tightening of the underlying bulging fat pads occurs, and any loose “crepe-paper” pattern of wrinkling is nicely addressed. Laser skin resurfacing is also a very healthy procedure for lower eyelid skin, and facial skin in general. Whether any given patient is a good candidate for laser skin resurfacing is determined during private consultation with Dr. Sparano.
Lower eyelid blepharoplasty is a powerful solution to lower eyelid aging. Dr. Sparano believes there are several great ways to surgically contour the lower eyelids. Certain patients are candidates for an incisional approach made only through the inner pink part of the eyelid called the conjunctiva. Other patients are best served with an incision immediately under the lower eyelid lashes, in a natural subciliary line. Patients require varying degrees of underlying muscle and fat pad work. Repositioning the lower eyelid fat pads in certain individuals can often lead to a more youthful appearance than definite fat pad removal. Similarly, adding fat to the regions around the eyelids by way of fat transfer techniques can often recreate a youthful appearance around the eyes. Thus, lower eyelid surgery is quite a surgical art, which should be performed by facial plastic surgeons experienced with the intricacies of lower eyelid anatomy, and lower eyelid patterns of aging.
Lower eyelid surgery can be performed as an isolated procedure using oral sedation and local anesthesia, or in an operating room setting combined with other procedures. Lower eyelid surgery is commonly performed in conjunction with upper eyelid surgery, facelift procedures, or TotalFX™ laser skin resurfacing.
Youthful and inviting eyes are essential for a restful, rejuvenated appearance. Part of the art of aesthetic facial plastic surgery involves diverting attention away from more aged parts of the face, to bring focus instead upon more youthful-appearing eyes. Youthful eyes appear engaging and attractive. When performed on the appropriate candidate, eyelid reshaping is a very gratifying procedure with powerful, long-lasting results completely natural in appearance.
FREQUENTLY ASKED QUESTIONS
Does lower eyelid surgery require anesthesia?
Many types of lower eyelid procedures are performed using local anesthesia and oral sedation. Surgical approaches through the inner pink part of the eyelid (i.e., a conjunctival approach) are performed in an operating room setting. When lower eyelid surgery is combined with other surgical procedures, it is usually performed in an operating room setting with deeper anesthesia.
Is the surgery painful?
Lower eyelid surgery is not a painful procedure once the eyelids are anesthetized. Patients usually sleep during the procedure, or handle it quite comfortably.
Where are the scars for lower eyelid surgery when performed through the skin?
Lower blepharoplasty incisions are well hidden in the natural crease of the lower eyelid, immediately beneath the lower eyelid lashes. As the incision is carried out laterally toward the side of the eyelid, it is oriented in a natural “crow’s feet” line. Dr. Sparano uses a careful tension-free technique for his lower eyelid closures, which he feels maximizes potential for invisible scars. Generally, incisions from lower eyelid surgery are hidden and heal exceptionally well.
Can my lower eyelid surgery be covered by my insurance company?
Cosmetic lower blepharoplasty is an elective procedure not covered by insurance companies.
What is the recovery period like after lower eyelid surgery?
The eyes will be bruised and swollen for about 10-17 days after surgery. Stitches are removed usually on day 6-7 after surgery. Eye make-up can be worn in certain instances to help disguise the healing eyelids.
How much time off from my daily activities should I schedule?
Most patients return to their normal daily activities after 10-14 days.
When can I return to exercise or strenuous work?
Exercise and strenuous work or activities are restricted for 2 weeks following the procedure.
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