The thin skin of the eyelids can be susceptible to early signs of aging, accelerated by factors like sun exposure and daily movement. Sometimes genetics can impact the function and appearance of the eyelids, causing natural under-eye bags or drooping lids long before aging affects other facial features.
At Ridenour Plastic Surgery, we offer several types of eyelid surgery to address these issues through adjustments to skin, muscle and fat. Some patients come in with functional concerns, while others want to improve heaviness or puffiness that has developed with age. Each approach provides a more open, alert appearance for the right patient.
Age-Related Changes in Upper and Lower Eyelids
Aging reduces collagen and elastin in the eyelid tissues, and the loss of these structural proteins weakens the skin and makes it more prone to folding or stretching. The orbital septum that holds the fat around the eye can thin, which allows fat pads to shift forward and create puffiness in the lower lids. Some concerns are caused by changes in the muscles that support the lid’s position, and this can lead to drooping or heaviness in the upper lids.
Upper Blepharoplasty
What Can Upper Eyelid Surgery Treat?
As the upper eyelids age, excess skin can begin to drape over the natural crease, sometimes reaching the lash line or obstructing the visual field. Upper eyelid surgery is often primarily focused on removing excess skin and making adjustments to the muscles.
Incision Options for Upper Eyelid Surgery
Incisions for upper eyelid surgery are placed within the natural fold of the upper lid. This hidden placement gives your plastic surgeon access to remove or reposition skin, fat or muscle. The incision follows the patient’s natural eyelid contour so it can blend and heal with a subtle, discreet appearance.
Upper Blepharoplasty Techniques
Techniques used in upper eyelid surgery depend on the structure of the eyelid and the source of the concern, such as skin laxity or muscle drooping. In some cases, the approach may involve only skin removal, while others require adjusting underlying structures to provide better support for the tissues. When necessary, ptosis repair can be incorporated to improve lid height and restore symmetry.
Lower Blepharoplasty
What Can Lower Eyelid Surgery Treat?
Concerns in the lower lids often appear when fat pads begin to shift forward and cause puffiness or prominent under-eye contours. Skin in this area may also stretch or wrinkle, leading to creasing that makes the lower lids look uneven or shadowed. Lower eyelid surgery can address these structural changes by improving how the skin, muscle, and fat support the lower lid.
Lower Eyelid Incision Types
- Eyelash Line Incision (Transcutaneous): A transcutaneous approach is taken when excess lower eyelid skin needs correction. The incision is placed just beneath the lower lashes. This method allows the surgeon to address loose skin and remove or reposition fat. This technique provides better access in certain cases.
- Internal Eyelid Incision (Transconjunctival): A transconjunctival incision is created inside the lower lid when adjustments are desired beneath the surface but skin removal is not necessary. The surgeon works through the inner lining of the eyelid to reposition or reduce fat pockets while leaving the outside of the lid untouched. This approach avoids an external scar and provides deep structural refinement.
Can I Combine Upper and Lower Blepharoplasty?
Yes, upper and lower eyelid procedures are often performed together to address aging across the entire eye area in a single session. This combination allows for the correction of drooping upper lids and puffiness or laxity under the eyes simultaneously. Combining surgeries allows you to have a single recovery period rather than multiple ones.
How to Choose the Right Type of Blephroplasty
We will recommend the ideal surgical technique based on the structures involved, the amount of skin present and whether internal or external access is most appropriate. During your consultation, we will thoroughly examine your eyelids and provide you with information about the results you can expect from each option.
Questions to Ask Your Surgeon About Eyelid Surgery
How Long Do Blepharoplasty Results Typically Last?
Eyelid lift results tend to be long-lasting, especially when excess skin and fat are permanently removed or repositioned. The eyelid tissues will continue to age naturally, but the improvements often remain noticeable for several years. Some patients choose to maintain their results with nonsurgical treatments that address skin texture or laxity as needed.
What’s the Difference Between Fat Removal and Fat Repositioning?
Fat removal eliminates puffiness by taking out excess fat, while fat repositioning shifts the fatty tissue to areas where volume has been lost. Repositioning is typically used when there is hollowing under the eye or along the lid-cheek junction. Both methods can be part of eye lift surgery, but the decision depends on your unique anatomy and the desired outcome.
Is Transconjunctival Eyelid Surgery Always Better Because It Avoids a Visible Scar?
A transconjunctival approach avoids an external incision, but it is only appropriate when no skin removal is needed. If loose or wrinkled skin is present, a transcutaneous incision near the lash line may be necessary to achieve optimal results. Choosing between the two depends on which tissues need to be addressed, not just scar visibility. We always take care to blend the incision with natural creases.
What Is Recovery Like After Blepharoplasty?
Most eyelid surgery patients experience swelling and bruising for the first week or two, particularly around the eyes, which gradually fade as the area heals. Stitches are typically removed within several days. Although you may still experience some puffiness, you can usually return to regular activities within about seven to 10 days. The incision lines take a bit longer to fully settle, but they continue to fade and soften in the months that follow. We will walk you through how to care for your eyes during recovery, including how to use cold compresses and when to ease back into your usual routine.
Learn More About Blepharoplasty Options in St. Louis, MO
Blepharoplasty can address structural concerns in the upper and/or lower lids through surgical techniques that improve function and appearance. At Ridenour Plastic Surgery, our results come from an in-depth understanding of facial anatomy, aesthetics and the aging process. Located in St. Louis, MO, we offer a range of facial procedures led by Dr. Brock Ridenour, our board-certified facial plastic surgeon with more than 25 years of experience.
To schedule a consultation or ask questions about eyelid surgery, please contact us online or call (314) 878-8600.
