Sagging hoods of skin and bulging fat pads can cover the brilliance of your eyes, masking your interest, energy and personality, leaving people to assume you have not had enough rest or that you are indifferent to situations and opportunities around you.
The delicate surgery to reduce the sagging folds of skin and to remove or transpose the fat “bags” is called a cosmetic blepharoplasty or eyelid lift. In days gone by, the standard approach was using a knife and scissors, or “cold steel”. Even with the most experienced surgeons, bruising and swelling lasting 2 – 2½ weeks was not an unexpected result. This is of obvious concern because of the prolonged recovery time for the patient before they can resume their normal activities.
With modern laser assisted blepharoplasty, the laser light beam is used instead of the knife and scissors to gently define the surgical planes and as the laser beam seals blood vessels and lymphatics as it cuts, the patient experiences reduced bleeding and bruising and thus a much shorter recovery time. Many of our patients are ready to return to work in 5-7 days.
As with all surgical techniques, the surgeon’s first concern is for the patient’s safety and so the eyes are protected during the surgery with laser proof stainless steel contact lenses. As with “standard” eyelid lift surgery, sutures are placed to gently hold the skin edges together to give the least noticeable incision line afterwards. When the eyes are open, the upper eyelid incision is invisible.
In the lower eyelid, the dark “tear trough” deformity can be assisted with the simple transposition of the patient’s own eyelid fat pads to the area under the dark”circle,” thus smoothing this aging lower lid step junction to a more continuous and youthful lower eyelid contour. In the lower eyelid, the surgical approach can be made from the skin surface(“Infralash approach”) or from the internal surface of the lower eyelid(“Transconjunctival approach”). If a patient has a transconjunctival approach to restore the appearance of the bulging fat pads, a tiny skin pinch just under the eyelashes or laser eyelid resurfacing can be used to smooth and redrape the lower eyelid skin.