Eyelid Surgery, or Blepharoplasty: An Introduction

Rejuvenating your eyes can be that little step that goes a long way. When we talk about looking young, looking fresh and new and energized, it’s all about the eyes. When you’ve been up all night after a late shift, when you’re tired, it’s the eyes that give it away.

Sometimes you see people who are in their forties or fifties with the eyes of a thirty year old. Usually, when we see these people, we think they simply have good genes and got lucky, and that’s why their eyes don’t look so old. In reality, if you could get most of these people to reveal their secret, they might confess that they took matters into their own hands and had a little help. Perhaps they had an eyelid lift or blepharoplasty surgery.

Blepharoplasty

The first question you have may be “What is blepharoplasty?” This is a surgical procedure to tighten the skin and readjust the contours of the fat bags. It is usually performed at a hospital or surgicenter with IV sedation (twilight). This can take 1-2 hours depending on if it is upper eyelids and/or lower eyelids. Recovery involves placing ice packs, keeping the head elevated, putting on ointment on the incisions or eyedrops in the eyes for about one week. Bruising and swelling can last 10-14 days. A supplement may be recommended to help speed up the bruising and swelling. Non surgical blepharoplasty may be recommended using a filler like Restylane® to fill the hollows under the eyes and get rid of the tired look. Filling the hollows can camouflage the fat bags by smoothing the contour of the eye area.

Surgical Blepharoplasty 

Upper blepharoplasty can be performed by excising the excess skin and volumizing the brow fat pad for youthful contours using various techniques. If the eyelids are drooping, ptosis can be addressed at the same time using various lifting techniques. If there are fat bulges these can be addressed as well.

Lower blepharoplasty can be performed with multiple techniques:

Fat Transposition Blepharoplasty: The most exciting new advance is fat transposition blepharoplasty. This technique takes the bulging fat and repositions it in the hollow area below it through and incision in the back of the eyelid. This smooths the contours and does not change the eyelid shape or position. This has been a revolutionary advance in eyelid surgery and is great for both women and men. Skin changes can be addressed with a laser, a skin peel or a skin pinch. These techniques will be discussed with you at the consultation.

Transconjunctival blepharoplasty: The eyelid fat is sculpted and minimized through a hidden incision. This is a great technique for a young person with genetic eyelid bags, tight skin without hollowing underneath. The skin can be addressed with lasers, peels or a skin pinch procedure.

Smoothing the Lid cheek junction: The eyelid is adjusted layer by layer. The fat is addressed through the back of the eyelid and the skin and muscle are each individually addressed. The junction between the eyelid and cheek are smoothed out rejuvenating the eyelid area.

Anterior approach. An incision is created under the eyelashes to sleek and tighten the skin and muscles. This is a great procedure for mature patients with a lot of excess soft tissue.

Canthoplasty: The lower eyelid is supported with a variety of techniques to allow for optimal positioning of the eyelid. This can smooth the contour of the eyelid and can correct or prevent eyelid malpositions.

There many non invasive methods of rejuvenating the skin around the eyes such as Botox/Dysport, Restylane, Pelleve, Micropen microneedling, lasers and peels. These methods go a long way towards eyelid rejuvenation, but for many, blepharoplasty may be the best answer. Especially if there is an excess of fat or baggy skin, blepharoplasty may be the right choice for you.

As long as you undergo the procedure in a hospital or surgicenter with an experienced and board certified surgeon, blepharoplasty can be very low risk. Small incisions are carefully hidden in anatomic lines in the eyelid or in the underside of the eyelid which are not visible. After the healing process is complete, people may ask if you had your haircut or went on vacation. They may not be able to identify what is different about you, but they know you look great.

If you wish to undergo blepharoplasty, schedule a consultation with an Oculoplastic Surgeon or a surgeon with extensive experience around the eyes. She will be able to examine you and discuss with you the best options for eyelid rejuvenation both surgical and non-surgical. .

eyelid repair

Hooding of the upper eyelid: What You Can Do About It

Eyes are often the first area that begin to show age. Even in relatively young people, eyelid sagging or bulging can lead to a tired, aged appearance. For many seeking to improve these most obvious signs of age, a blepharoplasty may be the answer.

Benefits of Upper Blepharoplasty

Surgical eyelid rejuvenation, also known as a blepharoplasty, corrects many common cosmetic eyelid complaints. This includes loose or sagging skin on the upper eyelid, excess fat deposits, and drooping of the upper eyelids. Lower eyelid puffiness will be discussed separately.

  • Loose or sagging skin – Excess skin around the eyes not only looks unsightly, it can also impair vision. Eyes appear heavy and tired, and deeper wrinkles begin to form as it gets worse. Sometimes excess skin becomes so saggy it can hood over the eyes and make it difficult to see. Perhaps you are having difficulty wearing eye makeup or eye shadow. A blepharoplasty can remove this excess skin and leave eyes looking youthful again.
  • Excess fat deposits – Eyes, just like many other parts of the body, can experience excess fat. When fat builds up under the skin it can cause puffiness. adding years to the appearance.
  • Drooping– Drooping eyelids or lowering of the height of the eyelids often times can be caused by excess skin pushing down on the eyelids.   Sometimes there can be loosening of the eyelid lifting muscles: the levator aponeurosis and Muller’s muscle causing lowering of the eyelids. This is called eyelid ptosis (“toe-sis”). The eyelid height will be evaluated during the consultation. This can be addressed with appropriate targeted procedures which are customized and selected based on the exam findings.

Candidate Qualifications

While blepharoplasty is a relatively safe surgery, there are some personal factors that help plastic surgeons determine if someone is a good candidate for surgery. Firstly, candidates should be in good health with no current illnesses that can impact healing. Individuals who have medical conditions that affect the immune system or blood clotting may not be considered for surgery. Candidates with dry eye need to proceed with caution and there is a chance that the dry eye could worsen. If someone is not a good candidate, other options may be discussed such as a non surgical blepharoplasty and other minimally invasive procedures.

Finally, candidates should be non-smokers. Smoking can affect the way a person’s immune system operates, particularly when healing from surgery. Smokers are more likely to develop infections, have delayed healing or encounter other adverse complications. Likewise, those recovering from surgery should stay away from secondhand smoke.

Safety and Recovery

Most risks or concerns with blepharoplasty are temporary which include swelling, bruising, eye dryness, light sensitivity, difficulty closing eyes, and some discomfort. Most people will be given medication and directions during recovery to help ease the recovery process. More rare side effects will be discussed as well.

Swelling and bruising is normal and can be most pronounced in the first 48-72 hours after surgery.. Most people are able to resume their normal daily activities within 1-2 weeks after surgery.

As with any type of surgery, there can be more serious risks such as adverse anesthesia reactions, infection, or need for additional surgery. These are very uncommon occurrences, and most do not experience serious complications. It is important for potential candidates to discuss any concerns they may have prior to deciding on surgery.

non-surgical eyelid lift

Understanding Non Surgical Rejuvenation of the Eyes with Restylane and How It Can Help Make You Look Younger

Over time, bags and wrinkles can form around the eyes making a person look years older than how they feel. Soft tissue changes and atrophy allow prolapsed fat to become more visible causing bags to form both under and above the eye. This can give the eyes a puffy look which often can be the first sign of aging.  There are several corrective options for people suffering from wrinkles, excess skin folds, bags and bulges around the eye area. Blepharoplasty, more commonly known as an eyelid lift, can make a world of difference in both the appearance and functionality of the eyes.

For those who do not desire surgery, non-surgical blepharoplasty with Restylane is a great option. It can subtract years from one’s appearance, and this procedure is overall considered to be safe and effective. Non-surgical blepharoplasty can rejuvenate either the upper or lower eyelids creating an overall refreshed look with little downtime.

Restylane is a dermal filler injection designed to reduce the appearance of wrinkles and provide extra volume around the eye area. This material is FDA approved in the lips and smile lines (although the eye area is considered “off-label”) and is a non-animal stabilized hyaluronic acid, sometimes referred to as NASHA. Hyaluronic acid is a naturally occurring substance found in every living organism in the skin, joints and eyes which is why it has been so widely accepted by patients seeking rejuvenation. Restylane is a clear gel that restores extra volume and corrects wrinkles and bags while improving the overall contour of the eye area. Improved appearance around the eye area can be seen immediately after having a Restylane injection, and the results generally last up to six months although some may see longer lasting results. The gel injection slowly dissolves in the body over time naturally. Another great fact about hyaluronic acid fillers is that if there is undesired product, it can be reversed with a special medicine called hyaluronidase.

Some swelling can be seen the first day and ice after treatment is recommended.

Restylane is produced using a special type of bacteria in a laboratory environment by a natural fermentation process. Unlike some other dermal fillers, Restylane contains no animal derived products. The lack of animal products in Restylane means that the product does not require skin tests or allergy tests before being administered for the first time. It is safe for use in people who have allergies or sensitivities to eggs or other animal foods. The safety of Restylane has been thoroughly tested, and the product is sold in over 65 countries. It has been successfully and safely applied in over 10 million procedures. The results from Restylane injections create a youthful look without the recovery of other blepharoplasty options.

The use of Restylane injections to correct wrinkles, puffiness and bags on and around the eyelids is a popular treatment because of the excellent, long lasting results that quickly leave the face refreshed and looking years younger. Schedule an appointment with a board certified Oculoplastic surgeon or other physician with expertise in treating this area to see if you are a good candidate for this procedure.

Eyelid Rejuvenation NYC

Thinking About An Eyelid Lift? Here’s What You Need To Know About Blepharoplasty

If the eyes are the windows to the soul, then the eyelids have a very important job to do. Excess fat around the eyes or loose and sagging skin can cause a person to look older, more tired, or generally unhappy. One effective solution is blepharoplasty, or an eyelid lift. This procedure can improve the appearance of your eyelids and leave you looking younger and more refreshed.

What are the benefits of eyelid surgery?

This procedure is used to treat a number of eyelid issues that can alter the appearance of both men and women. It can also help improve the function of the eyelids.

Blepharoplasty rejuvenates the area surrounding your eyes by treating:

  • Bags under the eyes that cause a person to appear tired
  • Loose or sagging skin above the eyelids that can sometimes hinder vision
  • Puffiness caused by extra fat around the eyelids
  • Extra skin or wrinkles on the lower eyelid that often give a person an aged appearance

This procedure can benefit you by improving the look of upper, lower or both eyelids, resulting in a more healthy and youthful appearance.

Who is a good candidate for an eyelid lift?

The best candidates for an eyelid lift are healthy individuals who want to refresh the appearance of their eyelids. Ideal candidates are non-smokers who do not have any serious eye conditions or other illnesses that might hinder the healing process.

Ultimately, a surgeon who specializes in eyelid rejuvenation will be able to best assess if you are a good candidate for this surgery. The only way to find this out is to schedule a consultation.

What happens during the procedure?

During blepharoplasty, an incision is made on the natural crease of the eyelid (upper eyelid), the inside of the lower eyelid or just below the lower lash line (lower eyelid). This incision is designed to be concealed within the natural contours of the eyelid.

Bulging fat in the eyelids is either sculpted or repositioned depending on the anatomy around the eyes.  Excess skin can be addressed with lasers, peels, radiofrequency skin tightening or conservative excision.  After the procedure is completed, the healing process can begin.

What is the recovery process for eyelid surgery?

The initial healing process may include bruising, swelling, irritation, or dry eyes for 1-2 weeks. You may also experience some slight discomfort at the incision site.

Your doctor will give you specific aftercare instructions and answer any questions you have about the recovery process, such as what medication you should take after surgery and when you should return for a follow-up appointment.  Discontinuation of blood thinners, herbal medication and aspirin products will be discussed prior to surgery (and should be discussed with your primary care physician).

Is blepharoplasty safe?

If performed by an experienced surgeon who specializes in eyelid rejuvenation, the risks for this procedure are minimal. As with any surgical procedure, there are some potential complications, but these are rare.

Want to look as young as you feel? An eyelid lift might be an effective option for you. Consult with an eyelid rejuvenation specialist to find out if you are a good candidate for this procedure.

Eyelid Rejuvenation Treatments: Surgical and Non-Surgical

You may notice that your eyelids are making you look tired and aged. Often times wrinkles and bags around the eyes are the first sign of “maturing”. There are various ways to rejuvenate the eye area such as surgical or non-surgical treatment. Patients have noticed significant improvements in appearance, and they have felt more confident afterward.

Eyelid Rejuvenation — Surgical and Non-surgical Treatment

Sagging skin on the upper lids can be treated with an eyelift, also called blepharoplasty. This procedure involves making hidden incisions that excise extra skin from above the eye. Patients remark that the eyelids feel lighter and they are able to wear eyeshadow again.

For bags under the eyes and wrinkling of the skin, a lower blepharoplasty is recommended. Various techniques are utilized. A transconjunctival blepharoplasty (TCB) is performed via the inside of the eyelid which hides the incision, a fat transposition blepharoplasty where the fat is maintained and placed into an area of hollowing below the fat and transcutaneous techniques that hide the incision below the lashes which tighten the skin, and smooth the area between the eyelid and cheek.

Non-Surgical Eye Treatment

Sometimes a less invasive option can be considered. Under eye treatments with Restylane, a hyaluronic acid filler, has become popular since 2005. The aesthetic trend is going towards minimally invasive treatments with a faster recovery. This hyaluronic acid substance is used to fill areas that have become hollow over time because of skin thinning, fat atrophy and other factors. The skin around the eyes may appear tighter and less creased. Additionally, Restylane can camouflage some under eyelid bags in certain patients. Filler mimics the hyaluronic acid that exists naturally in our joints, eyes and other areas in the body. Traditionally, hyaluronic acid fillers have been used in the nasolabial folds (smile lines) and lips. Restylane is FDA approved in these areas, but has not been officially studied in the eye area (considered off-label). Additionally, a benefit of using an hyaluronic acid filler is that it can be dissolved if needed.

The longevity of treatment depends on how much muscle movement is in the facial area and the individual’s metabolism. One filling session can provide improved appearance for about six to twelve months.

Preparing for Treatment

Whether you seek surgical or non-surgical treatment for signs of aging in your eye area, you can meet with a specialist who can speak with you to find out your areas of concern. She can examine you and assess your aesthetic needs and if you are a good candidate for various procedures. During this consultation, you will discuss the possible benefits of the different types of cosmetic eyelid and facial treatments available, as well as any risks and alternatives to treatment. Together you can find a plan that can help you achieve realistic aesthetic goals.

Non Surgical Face Rejuvenation NYC

Non Surgical Rejuvenation Using Botox and Pelleve

If you’re tired of looking at fine lines, wrinkles, sagging skin, and other signs of aging, then you might be wondering what options are out there to help give you that youthful appearance once again. At the same time, you may be wanting to avoid surgery which can be more serious with a longer recovery..

Fortunately, there are plenty of non-surgical rejuvenation options available these days, including Botox, Pellevé®, and Restylane.

Botox®

Botox® is a drug that’s injected directly into the skin as a means of temporarily paralyzing muscles, which has the effect of reducing the appearance of wrinkles. Most commonly, Botox® injections are used to achieve a more youthful appearance in the face.

Getting Botox® injections takes just a few minutes in most cases, and effects can be seen as early as 48 hours but evolve over 5-7 days, depending on the patient. The effects typically last 3-4 months, so patients will need to be retreated.

Overall, Botox® can be a great option for those who want an effective, quick method of reducing the appearance of fine facial lines and dynamic wrinkles (wrinkles associated with movement) without having to go under the knife. Still, as with any injection, there are some possible side effects, so it’s best to meet with your physician first to discuss the risks, benefits and alternatives to treatment.

Pellevé®

The Pellevé® treatment is another method of non-surgical skin rejuvenation that’s recently gained popularity among those looking to take years off their appearances. This particular treatment option is great for those who have a fear of injections because it doesn’t involve any kind of injection or surgery.

Specifically, a Pellevé® treatment involves the application of a gel to the treatment area (usually the face and/or neck). A highly trained and experienced clinician will spread the gel around the area, during which time the patient will feel a warming sensation in the skin. As such, this treatment is completely painless, and some patients even claim that it feels like getting a warm facial massage.

Plus, a Pellevé® treatment typically takes just 30-60 minutes to complete, making it a painless and quick way to smooth out wrinkles in skin.

Restylane® and other facial fillers

Restylane® is a treatment that’s proven to help reduce the appearance of facial wrinkles. It is injected beneath the skin and can also be used to add fullness to certain areas of the face, such as the lips and the smile lines (nasolabial folds)  More recently, it has been used to fill the hollows underneath the eyes (tear trough) and even camouflage bags of the lower eyelids.

Typically a Restylane® injection can last for about 6-12 months depending on the movement of the area and each individual’s metabolism. After that time, treatments may be repeated as needed.  Results will vary from patient to patient.

As you can see, there are plenty of non-surgical options out there for giving your skin that young, smooth and vibrant appearance once again. Before you make a decision, however, just be sure to consult with a board-certified specialist who has extensive experience in facial aesthetics. This way, you can determine which options will be best for you based on your needs and find the safest most effective treatments for you.

Pelleve

Still not sure Pellevé® is right for you?

What if you could turn back the clock without pain, without surgery, without a long recovery needing social downtime, without looking done? What if you could tighten the loose crepey skin around the eyes, elevate your eyebrows, smooth out fine lines and wrinkles, tighten your jawline, firm your neck. Your wishes have come true…

Pellevé® is a revolutionary radio frequency energy based device for minimally invasive facial rejuvenation which is not a laser. Anesthesia creams and injections are not needed. Many patients say that the treatment not only is painless, but it is relaxing and feels like a hot stone massage. Your skin may be slightly pink at the end of treatment, but it quickly fades and you can still return to work that day or go out to dinner the same night.

Pellevé® works in several ways. It targets heat into the deep layers of the skin without damaging the top layer of the skin. The heat tightens and contracts these deeper layers, causing the skin to produce new collagen, improving its firmness. The result is a naturally fresher looking you.

There is no recovery, no wound care, no ointments or vinegar soaks like what is needed with lasers. Your friends will say you look more rested, refreshed and younger, but will not know why. Pellevé® offers a more pleasant and natural experience than many other treatments with results you can feel confident about.

Results can be seen immediately after one treatment, however for optimal results a series of three treatments are recommended one month apart. A touch up may be needed at about eight months or when you are ready for an update. A full facial treatment takes less than an hour and an eye treatment takes less than 30 minutes. You can bounce back to your normal life with minimal to no downtime.

Pellevé® is a treatment for both women and men patients that are new to facial aesthetics that don’t want to look “done”, too tight or “windblown”. It is ideal for those who don’t like the idea of injections. Ideal candidates are between 35-60 with wrinkles around the eyes, early sagging brows, eyelid, forehead, and mouth wrinkles, mild to moderate skin laxity (looseness) and jowls. Pellevé® is especially effective around the thin skin of the eyes. To get maximum effect best results, hydrate the skin by drinking lots of water ahead of time. Please remove all metal jewelry and makeup before your Pellevé® session .

Make an appointment today with Dr. Kroll to see if you are a good candidate for this procedure. Pellevé® can be used in conjunction with other aesthetic treatments such as a superficial chemical peel with minimal downtime utilizing NeoCutis® products, Restylane®, Juvéderm®, Botox® or Dysport®. Your secret is safe.

This blog does not represent medical advice and does not provide any guarantees of results. A consultation in person with Dr. Kroll, or your aesthetic physician, is recommended to review your medical history and the risks, benefits and alternatives to treatment. She will determine if you are a good candidate for this procedure.

NY Eyelid Specialist - Dr. Debra Kroll

NY Eyelid Specialist – Dr. Debra Kroll