This is part two of a series on Eyelid Surgery or Blepharoplasty. Last week, we reviewed Upper Blepharoplasty. This week, it’s all about the lower eyelids. Lower eyelids have different anatomy, different function and are operated differently than the upper lids.
Lower Blepharoplasty Before and After Pictures
There are four major components that distract from a pretty lower eyelid: bags, wrinkles, lower position and increased height of the lower eyelid. Lower Eyelid Lifts are designed to improve all these.
Lower Eyelid Surgery (Lower Blepharoplasty)
Last post we discussed the changes usually desired for the upper eyelids: removal of excess skin, removal of fat from the inner and central aspect of the upper lids if disproportionate, changing the upper eyelid fold and repositioning the lid margin to open the eye. These goals apply to the lower eyelids too, but the methods and priorities change. For Lower Eyelid Lifts the goals are: removing lower eyelid bags, tightening the lower eyelid skin, creating or maintaining normal lower eyelid position and shortening the length of the lower eyelid.
Removing Lower Eyelid Bags
The primary concern with the Lower Eyelids is the baggage. As we age, the facial fat over the lower eyelid thins and descends, revealing the fat pads located under the eyes. For some, these bags enlarge with age. For others, the large bags are present at birth and become more noticeable as the facial fat descends. Either way, Lower Blepharoplasty is designed to reduce excess fullness under the eyes.
Transconjunctival Lower Blepharoplasty
The heading above is a mouthful, but easily understood. Trans means across, or in this case through, and the conjunctiva is the pink lining of the eyelid. Lower blepharoplasty, from last post, means lower eyelid changing surgery. Transconjunctival Lower Blepharoplasty is a method of reducing the lower eyelid’s fat pads through the lining of the eyelid. The advantage is that the scar is completely hidden inside the eyelid. This method works best for younger patients who do not have excess skin and wrinkles on the lower eyelids as shown below, and is common enough to be shown on the Wikipedia blepharoplasty page.
Transconjunctival Lower Blepharoplasty Before and After Pictures
The Transconjunctival Lower Blepharoplasty before and after pictures above show how the lower eyelid is smoothed by removing the excess fat contained in the lower eyelid via an incision inside the eyelid.
In the Lower Blepharoplasty Before and After Pictures shown above, you can see the bulge in the lower eyelid caused by the excess fat this woman was born with. You can also see her attempt to minimize the appearance with a lighter shade of makeup over the bag. After her Lower Blepharoplasty, the eyelid is smooth and flat. Just enough fat is removed to flatten the bump the excess causes. Removing too much, will cause a hollow. If this patient had wrinkles of loose skin on the lower eyelid, the transconjunctival approach would not be used. Unlike the external approach described below, excess skin cannot be removed with the completely internal transconjunctival method alone.
Tightening the Lower Eyelid Skin
Bigger problems require bigger tools. When the excess lower eyelid fat is combined with loose baggy skin, a Subciliary Lower Blepharoplasty is preformed. Cilium is Latin for eyelash, so the subciliary incision is placed just below the eyelashes on the lower eyelid. This area heals very well, making the incision difficult to see, hidden in the shadow of the eyelashes.
The most frequently used approach for rejuvenating the lower eyelid is the external, subciliary approach. Not only can it remove excess fat like the transconjunctival approach, but it can also tighten the loose skin while lifting and supporting the lower eyelids.
The advantage of the subciliary approach to Lower Eyelid Lifts is the ability to remove excess skin at the same time as reducing the lower eyelid fat. The lower blepharoplasty before and after pictures above show a marked reduction in the lower eyelid bags with tightening of the lower eye skin using the subciliary approach. In this case, only removing the fat is treating only half the problem, and would leave a deflated bag of excess skin under her eyes.
While deep lines caused by skin folds are improved by Lower Eyelid Lifts, the fine lines within the skin need different treatment. The analogy made is between the eyelids and a quilt. Wrinkles in the quilt can be smoothed by gently tugging the quilt flat. This is what lower eyelid surgery does. However, no matter how hard you pull, you cannot smooth the quilting stitched into the fabric. This requires modifying the quilt, not how it lays. For the skin, topical treatments like chemical peels, lasers and dermabrasion are used.
Creating or Maintaining Normal Lower Eyelid Position
The normally positioned lower eyelid covers the lower edge of the colored iris and white sclera under the iris. When the lower eyelid weakens, more of the iris and sclera are revealed. This is termed scleral show, and is associated with a tired, stressed appearance. As the lid descends further, the lower lid may progress to frank ectropion – gapping away from the eye, and interfering with the lower eyelids function of protecting the eye. The pink conjunctival lining may be seen and the tears may not flow properly. This makes the eye feel dry and look red and inflamed. Lower blepharoplasty can be combined with eyelid tightening procedures to prevent or correct this problem.
Before and after photos of lower blepharoplasty with tightening of the lower eyelid support show how the lower eyelid moves up to its ideal position. On the other hand, simply removing the excess fat and skin without the lid tightening would most likely expose more of the white of the eye beneath the iris.
Lower Blepharoplasty for the above patient was more risky. He already had scleral show, and the normal lower blepharoplasty removes the excess fat and tightens the lower eyelid skin potentially removing support and pulling the eyelid down further. However, when the problem is recognized before surgery, the lower blepharoplasty is modified to include a lid tightening procedure. This improves the eyelid position and prevents the scleral show from progressing to hound-dog appearance of frank ectropion. Nothing against hound-dogs.
Shortening the Length of the Lower Eyelid
All the pictures above show a reduction in the overall height of the eyelid. More accurately, this is caused by a decrease in the how far onto the cheek the eyelid descends. As discussed above, supporting the eyelid during Blepharoplasty is important to preserving the function of the lower eyelid and for maintaining a rested, alert appearance. A shorter eyelid is also associated with youth. An infant’s lower eyelids are so short that often it looks like the cheeks are encroaching on the eye opening. As we age, the cheek drops, and the lower eyelid becomes more apparent. Around puberty, the eyelid appears as its own aesthetic unit, and as we age, it occupies more vertical space above the cheek, While blepharoplasty can help decrease this appearance, the underlying cause is the cheek descending. Cheek decent is more directly treated with a Facelift, or in cases where the cheeks are small or retruded, with Cheek Augmentation.
Blepharoplasty Consultation Appointment Available Now
If you are considering tightening up you eyelids, give me a call at (925) 943-6353. Eyelid surgery and other facial cosmetic plastic surgery procedures are provided by my San Francisco Bay Area private practice in the East Bay city of Walnut Creek, CA. Your personalized consultation will include reviewing the areas you want addressed and creating a plan specific to your goals.
Eyelid surgery is a way to open tired looking eyes and reduce lower eyelid bags. It can improve your view of the world and how the world views you. An Eyelid Lift is an outpatient Cosmetic Plastic Surgery procedure that can dramatically improve the appearance of the skin around the eyes.
Eyelid Lift Before and After Pictures
Eyelid Surgery, or Blepharoplasty, shrinks the loose skin than overhangs the upper eyelid and tightens the bags often seen in the lower eyelids.
What Can Blepharoplasty Do For You?
Blepharoplasty literally means “Eyelid Shaping,” and that’s exactly what it does. If you have excess eyelid skin encroaching on your upper eyelashes, or acting like blinders blocking your vision, an Upper Blepharoplasty can help. Removing redundant upper eyelid skin not only makes you look more alert and rested, in cases of visual obstruction, it will increase your field of vision.
Cleaning Up the Upper Eyelids
Excess upper eyelid skin gives a tired look. After upper eyelid surgery, the appearance is alert and rested.
Lower Eyelid Bag Removal
The Lower Blepharoplasty can also diminish the tired look. The fat of the lower eyelid can push forward as we age and looks like the puffiness seen with fatigue. A Lower Eyelid Lift can remove the excess fat and tighten the lower eyelid, restoring a more youthful rested appearance.
Lower Eyelid Lift Before and After Photos
While upper eyelid surgery removes hooding, lower eyelid surgery removes bags. The post-operative appearance is alert, rested and still you.
What Can Eyelid Surgery Do?
The most common reasons that Eyelid Lifts are performed include:
This patient had upper and lower blepharoplasties, also known as a “Quad Bleph.”
The “Quad Bleph”
The rejuvenation of all four eyelids, two upper and two lowers, is also know as a “Quad Bleph.” The above Quad Bleph before and after photos reveal improvements in the appearance of both the upper and lower eyelids. Less upper eyelid skin means smoother, cleaner lines and that eye makeup stays put better. Lower eyelid improvements include smoother appearance and less bagging of both skin and lower eyelid fat.
Schedule an Eyelid Lift Consultation
There are a variety of techniques used for eyelid surgery. If you want more information that is specific to your needs, there is no substitute for an in-person and personal consultation appointment. Call (925) 943-6353 to take the next step toward rejuvenating your eyelids.
Eyes play a central role in defining facial beauty. Unfortunately, the eyelids are one of the first facial features to show the signs of aging.
Eyelid Surgery Before and After Photos
The Eyelid Lift or Blepharoplasty removes the skin that hangs over the eyes and the bags that hang under the eyes.
What Does Blepharoplasty (Eyelid Surgery) Do?
Blepharoplasty is performed to removed excess skin and bagginess from the eyelids. The Blepharoplasty Before and After Pictures above show the difference an Eyelid Lift can make. The excess skin on the upper eyelid presses on her eyelashes causing a heavy sensation, a tired look and it makes wearing eye makeup next to impossible. The lower eyelid is overstuffed and baggy. The after photo shows an alert appearance with a clean upper eyelid fold and smoothed lower eyelid bags.
Blepharoplasty Before and After Pictures
This Blepharoplasty Before and After Photo set shows how eyelid surgery can remove excess upper eyelid skin and lighten baggy lower eyelids.
Keloids and Eyelid Surgery
My patients of African descent, who are considering cosmetic surgery, usually ask about keloid formation. The techniques used in African Eyelid Surgery are essentially the same as those for Caucasian Eyelid Surgery. While keloid formation is common on the chest, shoulders and ears, the eyelids are a privileged area, and keloid formation is extremely rare. Hypertrophic (thick) scars are also very rare on the eyelids, because the eyelid skin is very thin, and usually heals very quickly. As with any surgery, close follow-up is important to assure the best possible results.
Asian Eyelid Surgery
Asian Eyelid Surgery has many of the same goals as caucasian eyelid lifts, but may also include defining the upper eyelid crease. The Asian eyelid has a poorly defined upper eyelid crease. This allows the upper eyelid fat pad to fall forward and hang lower in the lid. The fold itself may be absent, or may consist of multiple folds. Eyelid surgery can be used to form a single clean fold in the lid and elevate the fat within the upper eyelid restoring a more youthful appearance.
Asian Eyelid Surgery can include defining an irregular upper eyelid crease in addition to removing upper eyelid skin redundancy and lower eyelid bags.
If you are considering Eyelid Rejuvenation call (925) 943-6353 today and schedule a personalized consultation appointment. More information about Blepharoplasty is available on the San Francisco Plastic Surgery Blog and on my main website, DrMele.com, but nothing can substitute for an in-person consultation with a Board Certified Plastic Surgeon.
Blepharoplasty is popular with both men and women because not only does it reverse one of the most obvious signs of aging, it also makes us look more alert and interested. As we age, the eyelids tend to loosen and sag. Excess upper eyelid skin can block peripheral vision and cause a heavy sensation as it comes to rest on the eyelashes. Excess lower eyelid skin and fat can give lower eyelid bags, even festooning. This can shadow beneath the eyelids and compound any darkness already present due to pigmentation or vascular coloration. Both excess upper eyelid skin and lower eyelid bags make us look tired, even when we are well rested.
KRON4 Body Beautiful Television Presentation
Last month I had the opportunity to discuss how to improve the appearance and function of the eyelids on KRON4’s Body Beautiful. The show is broadcast live and gives San Francisco Bay Area viewers the opportunity to call in and ask questions. The (415) number used during the video was for the live show. If you have Blepharoplasty Questions call my Walnut Creek Plastic Surgery office directly at (925) 943-6353.
Blepharoplasty and Asian Eyelid Video
Eyelid Surgery Frequently Asked Questions
This Eyelid Surgery Video covers many of the frequently asked questions about blepharoplasty including the narration of multiple Blepharoplasty Before and After pictures:
What does Blepharoplasty mean?
How is Eyelid Surgery performed?
What is done during Upper Eyelid Surgery?
What is done during Lower Blepharoplasty?
Can the excess skin be removed from my Upper Eyelids?
Can the bags be removed from under my eyes?
Can all the fat be removed from around my eyes?
Before and After Pictures showing the removal of excess upper eyelid skin.
Before and After pictures showing the removal of excess lower eyelid fullness.
Before and After pictures showing the removal of excess lower eyelid skin.
Before and After pictures showing Asian Eyelid Surgery.
What is the recovery time after Eyelid Surgery?
What is the difference between Eyelid Surgery and a Chemical Peel of the Eyelid skin?
How can a distinct fold be made on the Asian Eyelid?
What is the difference between an Asian Eyelid and a Caucasian Eyelid?
What is the difference between Female Blepharoplasty and Male Blepharoplasty?
Schedule a Private Blepharoplasty Consultation
If you are considering Cosmetic Eyelid Surgery, whether to improve function or appearance, the best way to get your questions answered is with a private consultation. The specifics of what can be done, and what to expect will be explained, and you can get your questions answered fully. Give us a call at (925) 943-6353 to get started today. You can also contact us via the contact form in the left margin.
Dr. Joseph Mele is a Board Certified Plastic Surgeon who has been in private practice in the San Francisco Bay Area, East Bay city of Walnut Creek since 1997.
Heavy eyelids droop, making us look disinterested or tired. In the extreme, a sagging upper eyelid can block upward and lateral vision. Baggy lower eyelids, on the other hand, won’t block your vision, but they do make us look tired, and can add years to an otherwise youthful face.
Every Blepahroplasty is Different
When it comes to eyelids, Plastic Surgeons are here to help. By removing excess eyelid skin and fat, the Blepharoplasty can reduce the skin folds and open the eye. Every Cosmetic Plastic Surgery, requires specific techniques for individual anatomy. This is particularly important for eyelid surgery.
Male Eyelid Surgery (Blepharoplasty)
Men have differently shaped upper eyelids than women, and require specific attention to the masculine details for the best results. Overcorrecting, or worse over elevating the brow above the, male eyelids leads not only to a surprised look, but also a feminization of the male upper face. Most men do not look better with feminized eyes. Male Blepharoplasty must be performed carefully to get rid of the tired look and maintain the masculine anatomy.
Asian Eyelid Surgery
Asian Eyelids require different techniques than caucasian eyelids. The Asian eyelid attachments and the location of the upper eyelid fat pads are different than the Caucasian equivalent. While eyelid surgery can be used to open the eyelids, it may not be desirable to round the eye opening too much. Julie Chen recently made headlines when she disclosed that she had eyelid surgery to change the shape of her eyelids, after she was told by an agent that she looked bored and disinterested when interviewing a guest due to the heaviness of her upper eyelids.
Blepharoplasty aka Eyelid Lift Surgery Video Presentation
Dr. Joseph Mele appears on KRON4’s Body Beautiful to talk about Eyelid Lifts (Blepharoplasties).
This month, I had the opportunity to discuss popular Facial Plastic Surgery procedures like face lifts and eyelid lifts on KRON4‘s Body Beautiful with Janelle Marie. Before and after pictures were provided, as well as many of the options available for today’s San Francisco Bay Are Eyelid Lift patients. Caucasian and Asian Eyelid lift techniques used to restore more briliant looking eyes are reviewed.
Body Beautiful is a live show, so anyone watching can call in and have their questions answered. The (415) number shown during the broadcast is only for the live show, but if you have Blepharoplasty (Eyelid Lift) Questions, call my San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353.
The quintessential plastic surgery procedure is the Facelift. Others may claim that Breast Augmentation more typifies cosmetic plastic surgery. Breast augmentation is more popular than facelifts (3:1); however, unlike breast augmentation, facelifts are not hidden by clothing. We all see directly the results of every facelift, down to the smallest detail. All the more reason to make certain your Facial Plastic Surgeon is a member of the American Society for Aesthetic Plastic Surgery and Board Certified by the American Board of Plastic Surgery.
Rhytidectomy aka Facelift Video Presentation
Dr. Joseph Mele appears on KRON4’s Body Beautiful to talk about Facelifts (Rhytidectomies).
This month I had the opportunity to discuss face lifts on KRON4’s Body Beautiful with Janelle Marie. Before and after pictures were provided, as well as many of the options available for today’s San Francisco Bay Are Facelift patients. Facelifts, eyelid lifts, cheek implants and other techniques used to reduce facial wrinkles and restore a more youthful face were all reviewed.
Body Beautiful is a live show, so anyone watching can call in and have their questions answered. The (415) number shown during the broadcast is only for the live show, but if you have Rhytidectomy (Facelift) Questions, call my San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353.
Facelifts (Rhytidectomy) as seen on TV
Frequently Asked Facelift Questions
The Face Lift Video embedded above answers many of the most frequently asked questions about Rhytidectomies (Facelifts). Some of the information discussed includes:
When is a Mini Face Lift enough?
When should a full Facelift be performed?
What are the differences between a Mini Facelift and a full Face Lift?
Facelift Before and After pictures
Can a Brow Lift be added to a Facelift?
Can Blepharoplasty (Eyelid Lift) be added to a Rhytidectomy?
Can Chemical Peels or Dermabrasion be added to a Facelift?
Can a Neck Lift be added to a Rhytidectomy?
Can Cheek Implants or Chin Augmentation be added to a Facelift?
What is a Platysmaplasty?
What are Dermal Grafts?
Can Fillers be used during a Facelift?
What is the recovery time for Rhytidectomies?
More Facelift and Facial Plastic Surgery Information
More information about Facelifts and other Facial plastic surgery is available by clicking on the area of interest in the column to the left, or by visiting my main website’s Face Page
Other Segments from This Month’s Body Beautiful
To view other plastic surgery video segments from this month’s show, click on the following links:
We continue the countdown of the Top 5 Cosmetic Plastic Surgery Procedures according the the American Society of Plastic Surgeons. Last week was cosmetic plastic surgery procedure number 5, a tie between the Facelift (Rhytidectomy) and the Tummy Tuck Abdominoplasty. This week, coming in at number 4 is Eyelid Surgery (Blepharoplasty), with 196,000 procedures last year in the United States.
Top 5 Plastic Surgery Videos – Number 4
Today’s Top 5 Plastic Surgery Video is from a recent Body Beautiful appearance on the Bay Area’s News Station KRON4. This video reveals, Blephaorplasty (Eyelid Surgery), as the fourth most popular procedure cosmetic surgery. The top three procedures are yet to come so stay tuned.
Curious About Blepharoplasty? (Eyelid Surgery)
If you have general questions about the Blephaorplasty (Eyelid Surgery) give us a call or use the contact form on the left. Dr. Mele has many happy San Francisco Bay Area Blepharoplasty patients. To schedule your private consultation just give us a call. The (415) number shown in this video was only for viewers to call in with questions during the live show, so please call (925) 943-6353 to make an appointment.
Live on KRON channel 4 next Monday, March 12, 2012, at 11:00 AM, I will be discussing the top 5 (or 6) cosmetic plastic surgery procedures. The show is live, so you can call in with any questions you might have.
The American Society of Plastic Surgeons 2011 Cosmetic Plastic Procedure Statistics are Released.
Every year the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) publish their Cosmetic Plastic Surgery Statistics. The 2011 statistics show a gradual increase in the number of cosmetic plastic surgery procedures.
Cosmetic Procedures on the Rise
Overall Americans had 13.8 million cosmetic procedures in 2011. The majority of these were minimally invasive procedures with the neuromodulators (Botox, Dysport) and dermal fillers (Restylane, Juvederm, Perlane and Radiesse) accounting for the majority of treatments.
The Top 5 Minimally Invasive Procedure
Top 5 Minimaly Invasive Cosmetic Procedures
12.2 million minimally invasive procedures were performed in 2011. Here is how the top 5 minimally invasive procedures rank:
1.6 million cosmetic surgery procedures were performed in 2011. Breast Augmentation remains the number one choice, while the Facelift and Tummy Tuck are essentially tied for fifth place. Here are the numbers:
To schedule a consultation appointment, please call my office at (925) 943-6353. You can click on names of any of cosmetic plastic surgery procedures listed above to visit the main website, or use may use the contact form in the side bar to send your questions to me. Thanks for visiting the San Francisco Plastic Surgery Blog.
Considering Eyelid Surgery? It is one of the most popular Cosmetic Plastic Surgery procedures. In some cases, an Eyelid Lift also improves peripheral vision, by removing the excess skin, which blocks sight. This Blepharoplasty Video discusses the Eyelid Lift, also know as Blepharoplasty.
Blepharoplasty Before and After Pictures Explained
I have included Blepharoplasty Before and After Pictures, and a discussion of what can be helped; how the procedure is performed; and what sort of recovery period is involved.
Eyelid Lift Video Presentation
This blog entry is part 2 of a recent appearance on KRON4‘s Body Beautiful with Vicki Liviakis discussing Eyelid Lift Surgery or Blepharoplasty. For part 1 click here: Eyelid Lift (Blepharoplasty) San Francisco – Part 1 of 2, The 800 number on the video was for the live show, to contact my office for additional information, call (925) 943-6353.
What’s In This Blepharoplasty Video?
This Eyelid Lift presentation covers:
The difference between surgical Eyelid Rejuvenation and other complementary procedures both surgical (Brow Lift) and non-surgical (Laser, Chemical Peel, Dermabrasion, and Topicals)
How do dry eyes effect Blepharoplasty?
Can Upper Eyelid Lifts and Lower Eyelid Lifts be combined?
When should Upper Eyelid Lifts and Lower Eyelid Lifts be staged?
What is the Tear Film?
Can Eyelid Surgery be performed under Local Anesthesia?
What can I expect during Eyelid Surgery recovery?
Does an Eyelid Lift (Blepharoplasty) hurt?
How long does Blepharoplasty last?
Eyelid Surgery Consultations
More questions? Please let me know. I might add them to my next TV show. You can send your questions to me via the Contact Form on the left, or see if they are answered here: Blepharoplasty page on DrMele.com. To schedule a private consultation appointment, call (925) 943-6353. Thanks for staying tuned.
Blepharoplasty remains one of the most popular cosmetic plastic surgery procedures. It reduces excess skin and bags around the eyes, and allows for a more rested and alert appearance. Although there are subtle differences, it works well for both men and women, and that helps keep the procedure in the top 5 year after year.
What Is A Blepharoplasty?
The Eyelid Lift is a quick, outpatient procedure that can be performed under local or general anesthesia. It has a short recovery period and a minimum of discomfort. I discuss Eyelid Lift Surgery in this video of a recent appearance on KRON4‘s Body Beautiful with Vicki Liviakis. The 800 number on the video was for the live show, to contact my office for additional information or to schedule a private consultation appointment, call (925) 943-6353.
Blepharoplasty Video Presentation
This Eyelid Lift Video Presentation Includes
This Eyelid Lift Video Presentation includes answers to the following frequently asked questions:
What is done during an Eyelid Lift (Blepharoplasty)?
What can be improved with Eyelid Surgery?
What are the differences between Upper Eyelid Surgery and Lower Eyelid Surgery?
How do I to treat dry eyes around the time of Blepharoplasty?
Where are the incisions in Eyelid Rejuvenation?
Why get Eyelid Surgery?
Will insurance cover an Eyelid Lift?
Can my dog have Blepharoplasty?
Do You Have Eyelid Lift Questions?
Many other questions are also answered in this segment, and there is more to come. If you have additional questions, feel free use the Contact Form to the left, or check out the Blepharoplasty page on DrMele.com.
While the information here, and on my main website, DrMele.com, is provided to give you some general background information, no course of treatment can be recommended without a careful medical history, and targeted physical examination. If you are interested in rejuvenating your face, and would like to take the next step, scheduling a consultation appointment is as easy as calling (925) 943-6353. I am located in the San Francisco Bay Area, in the East Bay community of Walnut Creek.