It has been said that the eyes are the windows of the soul, they convey one’s deepest feelings and emotions. However, the eyes are often one of the first facial features to show signs of aging. Why do the eyelids sag so early? We blink thousands of times per day. The skin of the eyelids is half as thick as the rest of the face, with fewer internal moisture glands. As a result, eyelid skin is more prone to sagging and stretching. This is made worse by sun exposure, squinting and eye rubbing.
As we age, the fat surrounding the eye tends to bulge outward, sometimes at a prematurely early age due to heredity. Eyelid fat also retains water, so these bags often appear puffier in the morning, when one is tired and with those who suffer from allergies.
Bags under the eyes may be reduced by making completely hidden incisions within the eyelids, which is called a transconjunctival blepharoplasty. This is an excellent technique, especially for younger patients with good skin and for men, since there are no visible incisions.
In patients with wrinkles of the lower eyelid, the skin can be smoothed simultaneously by a laser or chemical peel. The combined approach of transconjunctival blepharoplasty and lasers, peels, or transconjunctival skin removal preserves the integrity of the supporting muscle sling of the lower lid, which reduces chances of rounding of the lower eyelid after surgery. For patients with more advanced skin wrinkling of the lower lid, an external incision is made right below the eyelashes, making it barely detectable. The lower eyelid muscle is supported with suspension stitches to reduce rounding of the eyelid.
Upper blepharoplasty should be contemplated when the upper lids hang over the eyes or on top of them . Sometimes the overhang is to the extent that it becomes difficult to put on eye shadow or the hooding of the lids interferes with vision. Visual obstruction is one of the only conditions that may be covered by medical insurance.
The incisions for rejuvenation of the upper eyelids are made along natural creases and are barely visible after healing. Eyelid incisions are closed with very fine sutures. The sutures either dissolve or are taken out by the doctor in three to five days
Post-operatively, patients may often return to work in a week or less after transconjunctival surgery and slightly longer after upper and lower lid surgery.
*Results may vary from person to person