Q: Hello! Do you perform the laser eyelid rejuvenation procedure? I am 48 and have eye hooding and really don’t want to have the surgery at this time. I have read that there is laser treatment that is quite successful. Thank you for your help!
A: I am not aware of any laser eyelid procedure that does not involve making incisions to do a blepharoplasty or eyelid tuck. The term ‘laser eyelid rejuvenation’ may suggest that there is some type of a laser which magically tightens eyelid skin without surgery, but that is not the case. When eyelid hooding exists, the only known effective treatment is actual skin removal. When upper blepharoplasties are done alone, they can be performed under local anesthesia and, in some cases, may even be done in an office setting. Mini-blepharoplasties exist using a pinch technique which is also an office procedure done under local anesthesia. Given the effectiveness of even these more limited skin removal procedures, any non-surgical approaches have never yet been developed that remotely compares.
Dr. Barry Eppley
Has anyone ever said to you that you look tired…have puffy eyes…or commented on the bags under your eyes or your dark circles? If you are over 35 or 40 years of age, you have undoubtably been told that at least once. Many have been told that more than just a few times. While I could espouse on the merits of pointing out the good in people rather than the bad, that would be a pertinent subject for a different column that has little to do with plastic surgery.
Without being told, most people that develop tired-looking eyes know it from looking in their own mirror. Women are particularly sensitive to how their eyes look as they engage in the daily ritual of make-up application. The vast majority of men, however, are unaware until their tired eye problem almost interferes with their vision. While there are some useful simple home ‘remedies’ that can help, such as astringents and endless numbers of creams, they do not remotely produce an improvement that is comparable to what blepharoplasty surgery can do.
Blepharoplasty, or ‘cosmetic eyelid’ surgery, is one of the most successful of all facial plastic surgery procedures. By removing loose and extra skin and fat from the eyelids, one can look refreshed again helping restore an eye appearance that one used to have. But many people are unduly hesitant about undergoing it because of misconceptions about recovery and pain after the surgery.
The thinness of the eyelid tissues and their superb blood supply make swelling and bruising an inevitable, but temporary, sequelae of the surgery. Despite how it looks, it is not painful and most patients only comment that their eyelids initially feel a little tight. There may be some slight stinging discomfort around the eyes the first night after surgery, but that passes quickly by the next day. Bruising and swelling are what persists and that will take up to two weeks after surgery until one is fully in the ‘benefits’ period. For some, this is a time for social reclusion. For others, they embrace it and do not let it be a hindrance for returning to work or getting out and about.
One of the great things about blepharoplasty surgery is that it is not a ‘one size fits all‘ procedure. There are different types of eyelid tucks based on how slight or severe the tired eye problem appears. If one has a lot of droopy or hanging skin then the traditional blepharoplasty would apply. But for those that have just a little extra skin or lower eyelid wrinkling, then the new ‘pinch and peel’ blepharoplasty can be done where just a pinch of skin is removed and the wrinkles reduced by a chemical or laser peel at the same time. If one is just bothered by their undereye bags, that protruding fact can be removed from inside the eyelid, having no external incision at all.
While the eyes may be the window to the soul, the eyelids are the window shades. They create, fairly or unfairly, an impression of our alertness and liveliness. A crisper and refreshed eye appearance is readily possible through blepharoplasty surgery and is easier to go through than most people think. Whether one’s tired eyes are just beginning or are quite advanced, blepharoplasty surgery can be customized to just the right amount needed to put that twinkle back and still fit into one’s lifestyle.
Dr. Barry Eppley
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