Posts Tagged ‘blepharoplasty’
Tuesday, June 15th, 2010
Although eyelid surgery (blepharoplasty) treats only a small area of the face, it has a dramatic impact on facial appearance. Dollar for dollar, blepharoplasty surgery has the best value of any plastic surgery procedure of the face because it is seen by all in everyday conversations. The eyes show age more than any other body part due to smiling, squinting, frowning, sun damage , and heredity. A lot of what you perceive in other people has to do with how their eyes appear. Most of us know this because when we go into work, more often than not, what does someone seem to frequently say…you look tired!
Upper eyelid surgery gets rids of hooding and excess skin that may be hanging down on your eyelashes. Upper blepharoplasty helps restore a natural, youthful appearance by removing skin through an incision in the eyelid crease. In some cases, fat may also be removed or redistributed. Since the incision is carefully placed, it is undetectable once healed. The only way that fine little scar can be seen in the upper eyelid is if they look while you are sleeping!
The lower eyelids are one of the first areas of the face to show age-related changes. Most of us know this because the appearance of bags and wrinkled skin. Loose skin and muscle create a droopy appearance and a protrusion of fat, which normally is under the eyeball, creates that classic but dreaded appearance of lower eye bags. These bags are really prone to absorbing fluids which is why they are more swollen in the morning or if you have eaten really salty foods the day before. The lower eyelids can be improved by an incision which is hidden either inside the eyelid (if fat only needs to be removed) or just below the lashline. (when all tissues need to be treated) The muscle, support tendon, and skin are reshaped and tightened back up against the eye. That protrusion of fat is either removed, tucked back in, or repositioned over the edge of the eye socket bone, dependent upon what will look best. In some patients, chemical peels or laser resurfacing can be done at the same time (only when the incision is on the inside of the eyelid) to improve wrinkles and loose skin on the lower eyelid and crow’s feet area.
One of the most interesting things about these procedures is that most patients say… the most surprising thing about eyelid surgery is the lack of pain during recovery. While eyelid surgery may look bad, it actually produces very little pain. Your recovery is largely social and about how you look.
The other comment that patients often say is…why did I wait so long? I spent a lot of money on creams and other potions and none of them worked…and they promised they would! (hope still remain the #1 selling point) Eye creams are beneficial but they are largely about prevention and not about reversing the age changes that are already there. They simply can not tighten or lift skin to any visible degree.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: blepharoplasty, dr barry eppley, eyelid surgery, indianapolis, plastic surgery
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Monday, May 24th, 2010
Q: I’m interested in learing more about dermabrasion or micropeeling. Can this be done on the eyelids? (above and below) Will this help reduce the beginnings of a fold in the top eye crease? I live two hours away. If you can answer these two questions about this procedure would help me determine if I should come in for a consultation.
A: By the way your question is phrased, it appears that you seek a non-surgical solution to the appearance of wrinkles on the eyelids. There are a variety of skin resurfacing methods that are commonly used on all other areas of the face so it is reasonable to ask about their use on the eyelids.
The eyelids represent skin that is very unique from that of the rest of the face. It is different primarily because it is so thin. Being thin makes it very sensitive with higher risks of scarring if the skin resurfacing method is not carefully selected and performed.
Microdermabrasion (superficial) and dermabrasion (deep) are not effective (microdermabrasion) or safe (dermabrasion) skin resiurfacing methods for use on the eyelids. Traditional laser resurfacing is not either for the same reason that dermabrasion should not be used, it penetrates too deep.
The use of laser micropeeling and chemical peels, however, are both effective and safe methods for the eyelids. Laser micropeeling at the depth of 20 microns or less, TCA (trichloroacetic acid) chemical peels of 15%, 25% and 35% as well as the newer Vi chemical peel are all potential choices. Which one of these is best for your eyelids will require an actual consultation to determine.
Another very effective option is the combination of ‘mini-blepharoplasties’ with chemical peeling. The actual removal of a small amount of excess skin and then tightening the rest can be a very effective eyelid wrinkle-reducer.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: blepharoplasty, chemical peels, dr barry eppley, eyelid wrinkles, indianapolis, laser resurfacing, plastic surgery
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Monday, May 3rd, 2010
Q: I am in the very early stages of looking into treatment for the area under my eyes. I believe the problem could be easily fixed by the right Dr. and this is my first attempt to find out what is involved and how much it would cost. The skin directly under each eye is all wrinkled and takes completely away from my appearance and has caused me to be completely self conscious for many years now and if I can do something about it, I would like to.
A: Aging around the eyes is often one of the first signs that many people notice as they get older. Changes in the lower eyelid are usually more obvious than that of the upper eyelids since they are not hidden or distracted by the eyebrow and are larger by surface area. Since so much of human conversation involves direct eye contact, how our eyes look is seen by all. It is no wonder then that many people seek plastic surgery for an improved and more youthful eye appearance.
While there are many topical creams out there, and they do have some anti-aging merits, they are no replacement for more invasive eyelid skin treatment methods. Depending upon the amount of loose skin that exists on the lower eyelid, some version of a lower blepharoplasty or eyelid tuck can be very helpful. Through a fine line incision along the lower eyelash line which extends slightly out from the corner of the eye, loose skin is removed and the lower eyelid is tightened.
Lower blepharoplasty will definitely help remove some but not all of the eyelid wrinkles. You never want to risk removing too much skin from the lower eyelid in an effort to work out every sinle wrinkle and then end up with a pulling down of the eyelid after. (ectropion) Lower blepharoplasty is an excellent wrinkle reducer but should not be thought of as a complete wrinkle remover.
Dr. Barry Eppley
Tags: blepharoplasty, dr barry eppley, eyelid tuck, eyelid wrinkles, indianapolis, plastic surgery
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Saturday, April 17th, 2010
Q : I am writing because I am bothered by bags under my eyes. Since I was a teenager these bags have been there but are now much more prominent as I have gotten older. I don’t expect my eyes to be perfect but I shouldn’t look this way at only 38. I have tried every cream out there and nothing seems to make them better. Is there a plastic surgery for this problem?
A: Lower eye bags are the result of herniated eye fat. Most of the time they appear as a result of aging. But some people have it appear much sooner in life, even during their teenage years. One occurs as a result of weakening of a lower eyelid membrane with age, teenage eyebags are the result of a congenital weakness in the same membrane.
To understand lower eye bags, one must know that our eyeball sits in a bed of surrounding fat for padding and protection. The lower eyelid is like a gate in which fat underneath the eye is held back by a membrane between the lower eyelid margin down to the lower edge of the eye socket bone. When this membrane is weak, eye fat can protrude through like a hernia through an abdominal wall defect. This is easy to demonstrate by closing your eye and pressing on the eyeball. You will see that the tissues underneath the eye bulge out as you press in. This is eye fat being pushing out.
Lower eyebags can only be removed by lower blepharoplasty surgery. No topical treatments or other external treatments will cause the fat to go away. If there is no significant extra skin which is common in younger patients, the fat can be removed through an incision from inside the lower eyelid. (trasnconjunctival blepharoplasty). If there is extra skin from aging, the fat and skin are removed through an incision right underneath the lashline. (external lower blepharoplasty)
Dr. Barry Eppley
Tags: blepharoplasty, dr barry eppley, eye bags, eyelid fat, indianapolis, lower blepharoplasty, plastic surgery
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Sunday, April 4th, 2010
The eyes may be the window to the soul, but they also create a strong impression of how we look. So many people comment to and about others based on how their eyes look. We all have had the experience of someone asking us if we are tired or have been up late. You can be certain their question is not probably based on how we were dressed or what we were eating.
But it is not the eyes per se that give these impressions, it is what is around them. The drapes of the eyes, the lids or window shades, are largely responsible for their appearance. Too much skin, deepening wrinkles, and bulging fat creates a tired and aging appearance. When combined with falling eyebrows, the amount of eye we see gets smaller and one really does look older. All this excess lid tissue is also prone to collect and retain fluid, hence those swollen eyes in the morning.
Because of the impact of how our eye area looks, eyelid surgery (blepharoplasty) is the best value in all of facial rejuvenation surgery. This is certainly true based on the size of the treated surface area. But more importantly, changing the look of the eyes does exactly what one is after…to look more refreshed. Few want to look different, but all want to look like themselves, only better.
While there are some non-surgical treatments that can make some areas around the eyes look better, none of them can improve the way the eyelids look. Botox can decrease wrinkling between the eyebrows and around the sides of the eyes, and that can be a great benefit for sure, but that affects expression only. If you look in the mirror without your face smiling or moving and your eyes still look tired, eyelid surgery is the only option.
By the way, forget about some magical cream making your eyelids look better. Amongst the many hundreds that exist, a few can make some minor reduction in fine wrinkles and puffiness. But really visible differences require removal of what makes them look that way, too much skin and fat.
While blepharoplasty surgery works on the lid skin, there are differences between what is done on the upper versus the lowers. The upper eyelids are largely about skin removal and re-creating an upper eyelid crease. Having a well defined eyelid crease is more important than trying to remove all excess skin. In the lower eyelid, more focus is on fat removal and skin tightening and making it as smooth as possible. There is no lower eyelid crease that needs to be made.
Many potential patients fear that blepharoplasty surgery will make them look unnatural. While this is possible if too much skin is removed from the eyelids, most overdone results come from browlifting not blepharoplasty. While browlifting can be a valuable addition to eyelid tucks, it is a procedure that is easily overdone. High eyebrows can easily change the appearance of the eye area and not favorably. Consider browlifting very carefully. It is not a cavalier addition to eyelid surgery.
If you are tired of looking tired, blepharoplasty may be a good choice to get a more youthful look back.
Dr. Barry Eppley
Tags: blepharoplasty, browlift, dr barry eppley, eyelid surgery, eyelid tucks, indianapolis, plastic surgery
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Tuesday, February 9th, 2010
One of the first signs of aging is what happens around one’s eyes. We are so expressive with our eyes and forehead that they bear the brunt of much of the early and visible signs of the aging process. How many times has someone said to you…are you tired?…have you been working late?…when in fact you just had eight hours of sleep. The development of extra eyelid skin, lower eye bags, and wrinkles around the eyes can be telling.
This makes the blepharoplasty (eyelid tucks) a vital plastic surgery procedure in making one look more refreshed. Many patients fear, however, that such an eyelid procedure will change their appearance rather than just making it more youthful or rejuvenated. This fear is promoted by just looking at today’s over-operated celebrities who have had too much surgery, or overly aggressive surgery, and look very unnatural. Such changes do make one look different, but not better.
Modern blepharoplasty surgery avoid these problems using a more conservative approach based on a better understanding of how the eyelid and face changes with age. Greater emphasis is placed on not disturbing the eyelid’s complex system of support and removing just the right amount of extra skin. This leads to a more natural looking result that does not alter one’s appearance.Baggy upper and puffy lower lids can now be treated with less tissue disruption and scarring for a safer and more natural long-term result. The goal is to look like yourself…just better!
When considering an upper eyelid procedure, the position of the eyebrow must be considered. A low hanging eyebrow can make it look like there is more skin in the upper eyelid than really exists. A browlift procedure is occasionally done with a blepharoplasty when it is determined that a higher brow is aesthetically beneficial. How do you know if your eyebrow is too low? That would depend on where one’s brow was when they were young. I would submit that most people do not remember where it was in their younger days. You simply have to play with it in the mirror to decide if higher is better.
Browlifts are primarily a procedure for women, they are rarely done in men. When browlifts are done, emphasis should be on more lateral brow elevation and less inner brow elevation. A woman’s eyebrow usually has an upward and outward sweep to it towards one’s temple area. Bringing up the inner part of the eye brow is what creates an unnatural overelevated look.
Today’s in-office ‘needle’ treatments can also provide some around the eye area improvement. Botox (and Dysport), not injectable fillers, is what is used. It is a great treatment for reducing the frowning look between the eyebrows, horizontal forehead lines, and crow’s feet wrinkles at the side of the eyes which can be particularly evident when one smiles. As an early treatment before significant eye aging changes occur or as a complement after blepharoplasty surgery, Botox is a simple and cost-effective non-surgical treatment.
One no longer has to be told that they look tired or are seeing their eyeball slowly disappear in a sea of loose and hanging eyelid skin. Between the three Bs (blepharoplasty, browlift and Botox), a more rested and refreshed you awaits!
Dr. Barry Eppley
Tags: blepharoplasty, botox, browlift, dr barry eppley, eyelid tuck, indianapolis, plastic surgery
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