Blepharoplasty & Eyebrow Lift

Blepharoplasty or eyelid surgery is a cosmetic beauty treatment used to reduce the signs of aging that are most visible around the eyelids. The treatment lifts droopy, sagging eyelids, and removes under-eye bags, thus restoring the skin around the eyes to its natural, youthful appearance.

The procedures involved include correcting the lower and upper eyelids, by removing fat deposits, excess tissue and skin, repositioning the lower eyelid, removing muscle from the eyelids, smoothing the lower eyelid skin texture with a chemical peel, and lifting the eyebrows.

Each of these procedures is optional. However, the proper combination of these procedures can bring amazing changes to your facial appearance, without revealing any signs of a surgery having been performed. When correcting the upper eyelid problems, the scars remain hidden in the eyelid crease. Excess fat pouches without loose skin that are found in the lower eyelids can be removed successfully through a transconjunctival approach. In such cases, the incision is placed inside the lower eyelid. At the same time, in order to remove the loose lower eyelid skin along with the fat pouches, an incision is placed under the eyelash line. 

Stress or over activity of muscles can cause heaviness of the inner eyebrows and vertical furrows between the eyebrows. Botox injection is considered the best solution for treating this problem. BOTOX is Botulism Toxin Type A, a purified form of protein, which is injected directly to the lines or wrinkle causing muscles so as to smoothen this area by temporarily paralyzing these muscles. 

While effective, Botox injections are expensive and sometimes painful. Repeat injections are necessary to yield improved results. So for a more permanent solution, the best treatment is to surgically remove these muscles through an incision made on the upper eyelid at the time of eyelid skin removal.

Blepharoplasty can be done as a standalone procedure or in conjunction with browlift to achieve excellent results. A combination of upper eyelid surgery and a browlift is the best treatment strategy for correcting the hooded upper eyelid that is caused by sagging eyebrows.

Depending on the particular needs of the patient, several types of brow lifts are possible by making several small incisions. The location of the brow lift incisions will depend on the technique used. In the endoscopic technique, a one inch incision is placed on the scalp above the hairline on each side. The surgery basically involves loosening the forehead skin and then lifting it. Through the incisions, dissolvable plastic anchors are attached to the bone so as to hold the lifted forehead skin in place.

Another treatment option is the “open” browlift, recommended for people over 60 years of age having more extensive sagging of the forehead. It is also a suitable treatment for people with deep horizontal forehead lines. For this, a long incision is made on the scalp extending over the top of the head. This generally involves removing a strip of scalp skin for lifting the forehead. Dissolvable anchors are placed in this case also. Open brow lift method is not an ideal treatment option for those with thinning hair or a high forehead.

Finally, there is a wide range of ancillary procedures, used for some associated conditions of the eyelids. Botox injections can correct the deep smile lines (crow’s feet) more effectively than a chemical peel. At the same time, fine wrinkles on the lower eyelid skin can be effectively removed using dilute trichloroacetic acid (TCA).  Following the TCA peel treatment, light crusting can be expected for about a week. A slight redness/pink color may occur, which can be concealed through makeup. It is rather difficult to treat dark circles successfully, however, some such cases do respond well to a chemical peel.

If the support to the lower eyelid is weak, then it may cause the dry eye symptom. Dry eye symptoms can be removed and minimized by removing excess skin and fat from the eyelids along with a tightening process. Some individuals may experience chronic eye irritation resulting from decreased tear production. All patients with symptoms such as tearing or itching are tested before the surgery.  Surgery can be performed for people with minimum effects of the symptoms. It is not recommended in patients who carry relatively high risks of symptoms.  In such cases, it would be better to carry out the upper and lower eyelid surgery in two stages.           

At our facility, blepharoplasty & eyebrow lift is performed as an outpatient procedure, by Dr. Christopher T. Chia, an experienced and board-certified plastic surgeon. The procedure itself takes about one hour, which might vary depending upon the complexity of the case. The required time for eyelid surgery, if done in conjunction with brow lift is approximately 3 hours. General anesthesia will be required if the procedure is done in conjunction with another cosmetic procedure. Details regarding this aspect can be discussed with our anesthesiologists prior to the surgery.

Side effects following the surgery vary from person to person. In most cases, slight discomfort or a mildly blurred vision may occur for the first few days. Following the surgery, eye bandages are not used. Instead, ice compresses are applied to the area for a day.  Those who undergo brow lift surgery may experience more discomfort.  Numbness and swelling are normal after all types of brow lifts, which may resolve with time. 
After the surgery, browlift clips are removed after a week and the suture on the eye is removed in 5 days. After a week, a light cover-up is applied to the lower eyelids, and a chemical peel is applied by two weeks. Makeup can be used a week after the surgery. Swelling and discoloration persist for two weeks. Patients can return to normal activities within a week or two. Jogging, bicycling, aerobics, and other non-contact and non-ball sports can be started three weeks after surgery. Ball sports should be avoided for six weeks.
Blepharoplasty & eyebrow lift has much to offer in terms of restoring the lost youthful contour to your face, and giving you the look and feel you desire.