Do people ask you if you’re tired even when you feel awake and alert? Or perhaps, as you’ve aged, you’ve noticed less and less skin visible on your eyelids when applying makeup. Hooded or droopy-looking eyelids are one of the most common complaints among patients seeking cosmetic surgery, and a simple surgical procedure can help you look as bright-eyed and alert as you feel.
Eye lifts, known clinically as blepharoplasty, involve removing excess skin from the upper eyelids, says Dr. Gregory Branham, chief of the Division of Facial Plastic and Reconstructive Surgery for Washington University Physicians. “Sometimes, we include lower eyelids or brow lifts. It’s all part of rejuvenation of the eye area, and it’s popular because it spans a larger age group than facelifts or things more typically associated with an aging face,” he says. “People in their 30s and 40s are more likely to have an eyelid procedure than a facelift. It’s done on a broader range of patients, all the way up to older patients who have a facelift done at the same time.”
Although the surgical procedures themselves have changed little in recent years, “our attitude toward these procedures has changed,” notes Dr. Brock Ridenour of Ridenour Plastic Surgery. “Brow lifts are much more subtle these days. Everyone wants to avoid the overarched, surprised or ‘clown’ look that surgeons often achieved with over-aggressive lifting of the forehead or brow,” he says. “Eyelid operations have also evolved slowly. In the past, eyelid surgery has emphasized a deep-set (hollow) upper eye that often appears aged or cadaveric. Again, most surgeons now emphasize a more subtle approach, preserving some of the necessary fat to achieve a more natural result.”
The specific technique chosen depends on a variety of factors, such as the skin’s natural elasticity and smoothness. In younger patients for whom skin laxity and texture is not a problem, a puffy appearance may call for “going in behind the eyelid, so there’s only an invisible incision, and taking excess fat out from the inside,” Branham says. “For older patients who have other kinds of problems (like the lid has fallen a bit or there’s more of a valley or shadow), sometimes you have to re-suspend some of those tissues with an outside incision, plus deal with the fat. And if there’s redundant (excess) skin on the upper eyelid, it’s just a simple procedure to remove that. People are typically pleased with the results and happy they had it done.”
The procedure does cause bruising, and visible sutures are removed after about a week. Most patients are able to return to public activities within two weeks, Ridenour says. “That said, there are procedures of a nonsurgical nature that can be performed on patients who are poor surgical candidates, or have the earliest signs of aging,” he adds. “A majority of these procedures involve the use of radio-frequency energy or heat to rev up the production of collagen and tighten lax skin. Filling agents can also be used to improve the position of the brow and create a more youthful look around the eye.”