Cosmetic Eyelid Surgery is one of the most frequently performed plastic surgery procedures. By definition, it is an elective procedure, so no one strictly “needs” it; however, if you have one or more of the following Five Indications for Blepharoplasty, you might want it.
#1 – Hooded Upper Eyelids
Upper Blepharoplasty – the above upper eyelid lift before and after pictures show a large amount of upper eyelid skin excess present before blepharoplasty. By removing this visor of skin, her hooding is eliminated; her eyesight is improved, and her tired appearance is erased leaving her looking alert and awake.
By far, the most common reason for eyelid surgery is Heavy Upper Eyelids. The following four features contribute to the formation of heavy upper eyelids:
Thick upper eyelid skin
Thick upper eyelid muscles
Excess upper eyelid fat
Too much skin
The patient shown in the before and after photos (above) had all four factors and wanted relief. The thickening and redundancy created a large visor of skin which hooded her eyes and blocked her vision. After Blepharoplasty, in this case an Upper Blepharoplasty, her eyes are more open. In the after photo you can see more of her eyeball; moreover, she is better able to see upward and to the side without the “blinders” of skin. She appears more alert, awake and attractive with the excess skin removed. Additionally, after Upper Blepharoplasty, she can apply upper eyelid makeup, something that her upper eyelid skin excess prevented.
#2 – A Tired Appearance
Quad blepharoplasty before and after photos – Rejuvenating all four lids (bilateral upper and lower eyelids) is called a quad bleph for short. A quad bleph eliminates both heavy upper eyelid skin and lower eyelid bags.
Another frequent complaint I hear from patients seeking Cosmetic Eyelid Surgery is that they look tired. Even when they are well rested, their droopy eyelids and bags under eyes people might still cause people to ask if they’re tired. Well rested, alert appearing eyes are fully open and do not have bags under them. These are the goals of Blepharoplasty.
For the patient above, Upper and Lower Blepharoplasty was performed to rejuvenate her eyelids. The excess skin and fat was removed from the upper and lower eyelids to open her eyes and smooth her lower lids. The result is a happier, well rested and more youthful appearance.
#3 – Irregular Upper Eyelid Folds
Asian double eyelid surgery is used to create a distinct upper eyelid fold when it does not exist. These Asian eyelid surgery before and after photos show the creation of a single fold on her right eyelid (where several existed) and elevation of her left eyelid fold, creating more open and alert eyes.
Sometimes, the upper eyelids do not have a well defined crease. This can happen to anyone, but is present about half the time for patients of Asian descent. Occasionally, as in the above case, one eyelid has a crease (her left), while the other is indistinct (her right). Creases can also be absent, as evidenced in the first set of photos at the top of this post. After Double Eyelid Surgery, this patient’s upper eyelids are more open and symmetrical.
#4 – Lower Eyelid Skin Laxity
Lower blepharoplasty – these lower eyelid before and after pictures show removal of the lower eyelid bags and tightening of the lower eyelid skin – smoothing out her lower lids.
Indications for Lower Eyelid Lifts are excess skin and/or excess fat. The bright blue eyes above appear tired due to a combination of eyelid skin laxity and excess lower eyelid fat. During a short outpatient lower blepharoplasty procedure, an incision was made just below the lower eyelid lashes to remove the excess skin and fat from the lids, leaving her with smooth lower eyelids and a more youthful and rested appearance.
#5 – Lower Eyelid Bags
Lower eyelid lift – Sometimes the lower eyelids have bags even when the skin is tight. These before and after pictures show how a lower blepharoplasty can remove excess lower eyelid fat and provide a smooth lower eyelid.
Sometimes the main problem with the lower eyelids is the excess fat. By removing the excess fat, or repositioning it into the hollow beneath the eyelid bags, a smooth and youthful lower eyelid can be created. In cases when the skin is tight, the incision to remove the excess fat can be made inside the eyelid.
When considering Eyelid Rejuvenation, be certain to seek an experienced, Board Certified Plastic Surgeon. In the San Francisco Bay Area call (925) 943-6353 and schedule your private, informative consultation appointment.
Today’s post reviews Eyelid Surgery and includes a Blepharoplasty Video from KRON 4’s Body Beautiful.
Indications For Eyelid Surgery
Eyelid Surgery is performed for men and women for both cosmetic and functional reasons. In the Blepharoplasty Video below, you will see Eyelid Lift Before and After Pictures and learn the indications, procedures and recovery for Blepharoplasty.
It is common for people to assume we are tired solely by the look of our eyes. Heavy, droopy upper eyelids and bags under our eyes occur when we need sleep. Unfortunately, these changes also occur with aging.
Bags under the eyes contribute to the perception of being tired. Lower Blepharoplasty (Lower Eyelid Surgery) removes the fullness of the lower eyelids, thereby smoothing and tightening the lower eyelid skin and rejuvenating your appearance.
There are a variety of indications for Blepharoplasty. Aging is the most common reason for upper and lower blepharoplasty. Aging causes skin laxity and hooding of the upper eyelids which not only makes us look tired, but can also block upward and lateral gaze. Aging also causes elongation of the lower eyelids, thinning of the skin and atrophy of the subcutaneous fat, revealing the fat pads beneath the eyes.
There are other reasons why eyelid lifts are performed. Sometimes it is functional, like when the muscles that open the eyes are not functioning properly. This should always be checked before having Blepharoplasty. Sometimes it is cosmetic, like when Asian eyelids have a poor or absent fold. This allows the skin and fat of the upper eyelid to descend and close the eyes. When a fold is present, often it is low and indistinct, giving a sleepy appearance and blocking vision. When desired, Double Eyelid Surgery (Asian Eyelid Surgery) is used to form a clear fold to better support and open the eyelids.
Eyelid Lift Video (Blepharoplasty)
The following Eyelid Lift Video includes several examples of:
Double Eyelid Surgery (Asian Blepharoplasty)
This segment from Body Beautiful first aired on KRON 4, the San Francisco Bay Area’s News Station. In this video, I review Cosmetic Eyelid Lift Before and After Pictures and narrate the indications, procedure and recovery of Blepharoplasty.
Blepharoplasty for Aging Upper Eyelids
Excess upper eyelid skin causes heavy upper eyelids and projects a tired appearance. The upper eyelid before and after pictures above reveal the alert, interested and friendly appearance that upper blepharoplasty can provide.
As we age, the skin on our upper eyelids thins, sags and can take on the appearance of crepe paper. The skin also loses elasticity and its attachment to the muscle beneath it. As a result, the skin drops toward and sometimes in front of the eyes. Upper Blepharoplasty removes the excess upper eyelid skin and rejuvenates our appearance. If the brow also sags, it pushes additional skin down onto the eyelids. An open or endoscopic Brow Lift may be recommended to further improve facial harmony and balance.
Blepharoplasty for Aging Lower Eyelids
Lower eyelid bags can make even young eyelids look old and tired. Lower blepharoplasty (lower eyelid surgery) unstuffs those bags, smooths the lids and provides a more rested, attractive appearance.
When the lower eyelids age, they become longer and fuller. The bags that form in the lower eyelids are caused by fat “pseudoherniation.” The excess fat pushes forward and gives the overstuffed look we associate with aging. A Lower Blepharoplasty removes the excess fat and smooths out the lower lids. The result is a more rested and youthful appearance.
When the eyelid skin is wrinkled and crepey, a lower eyelid chemical peel may also be recommended to address the fine lines. The peel helps tighten the skin on the surface, and can remove excess dark pigmentation. More about alternate ways to remove wrinkles can be found on my Skin Care Page.
Blepharoplasty for Sagging Upper Eyelids
Blepharoptosis (saggy upper eyelids) is corrected with levator advancement during blepharoplasty in the above eyelid surgery before and after photos. In the before pictures on the left, her eyelids are blocking her pupils and obstructing her vision.
Blepharoptosis can occur at any age. If present at birth it is called congenital ptosis; if it appears later in life, it is called senile ptosis. Eyelid sagging can have multiple causes, so a careful evaluation is required prior to choosing the best procedure for correction. In the case above, her eyelid sagging was caused by stretching of the tendon that opens the eyelids. During her blepharoplasty, the levator muscle tendon was shortened, allowing the eyelids to retract properly. This technique, Levator Advancement, is just one of many procedures available to help correct Eyelid Ptosis.
Blepharoplasty for Asian Eyelids
Before surgery, multiple folds are seen in this patient’s right upper eyelid, and a single, low fold is present in her left upper eyelid. Asian Eyelid Surgery (Double Eyelid Surgery) was used to create more distinct, symmetrical and yet natural appearing upper eyelid creases.
Asian Eyelids may have no fold, a single low fold or multiple folds. The fold is dependent on if and how the eyelid skin is attached. Caucasian eyelids normally have a single, strong line of attachment. To form the fold in the Asian eyelid, a line of attachment is created. For the patient above, Double Eyelid Surgery was performed to correct her asymmetry, and provide her with crisp, clean eyelids folds.
Eyelid Surgery is one of the most detail oriented procedures performed by Facial Plastic Surgeons. The key to achieving your best results is to consult with an experienced, well trained and Board Certified Plastic Surgeon. A professional who can balance achieving the ideal aesthetics with maximizing the function of your eyelids is necessary for a great result and satisfying patient experience.
People from all around the San Francisco Bay Area come to my Walnut Creek Plastic Surgery office for just that. Call (925) 943-6353 today to schedule your private consultation.
Saggy upper eyelids and lower eyelid bags make us look tired and add years to our face. This is why the Eyelid Lift remains one of the most popular cosmetic plastic surgery procedures which I, and other Board Certified Plastic Surgeons, perform.
Eyelid lifts can literally open our eyes, making us look more awake and alert. As the upper eyelid skin becomes more redundant, it begins to rub off upper eyelid makeup and can come to rest on the eyelashes. The result is a heavy sensation and a worn down appearance, even when we are well rested.
Blepharoplasty means eyelid changing, and it can rejuvenate our appearance and recharge our persona. San Francisco Bay Are Board Certified Plastic Surgeon, Dr. Joseph A. Mele, discusses eyelid rejuvenation and narrates numerous blepharoplasty before and after pictures on this video segment taken from KRON 4’s Body Beautiful.
Blepharoplasty Video (Eyelid Lift)
The following video segment reviews Eyelid Lifts and illustrates what Blepharoplasty can do with numerous Eyelid Lift Before and After Pictures.
The preview screen on the above Blepharoplasty Video shows how excess upper eyelid skin can weigh down the upper eyelid. In the picture on the left, the upper and lateral visual fields are obstructed and the skin is resting on the eyelashes, making the normal use of eye makeup impossible. In the after picture on the right, the eye and the upper eyelid are now visible.
The Correction of Lateral Hooding
In these Blepharoplasty Before and After Pictures, the before picture on the left shows the lateral brow skin completely covering the outer eyelid. In the after picture on the right the brow skin is elevated, giving a much cleaner, refreshed and younger look.
Lateral Hooding occurs when the eyelid or brow skin descends past the outside of the eye opening also known as the lateral orbital rim. Skin in this position blocks the lateral gaze, like blinders do on a horse. It also impacts a sleepy and older look to our eyes. In the above example, simply removing the excess skin corrected the problem. When the brow itself sags, a Brow Lift may be recommended.
Correcting Upper Eyelid Hooding
The upper (before) photo shows severe hooding of the entire upper eyelid. After her blepharoplasty, her upper eyelids are now visible, and a smooth upper eyelid crease has been created.
Sometimes the upper eyelid skin is so excessive that the entire upper lid is hooded. Wearing upper eyelid makeup properly is short lived at best. By removing the excess skin, the upper eyelid and lashes are revealed, and a natural eyelid crease is created.
If you would like to schedule a personalized consultation appointment, give me a call at (925) 943-6353. There is no substitute for an in-person eyelid consultation with an experienced and qualified, Board Certified Plastic Surgeon. A brief exam and medical history are needed to be sure the procedure is right for you. Safety and predictability are the most important aspects of any surgery, but this is especially true of elective plastic surgery.
Eyelid Surgery, aka Blepharoplasty, remains one of the most popular Cosmetic Plastic Surgery procedures. Last year, according to the American Society for Aesthetic Plastic Surgery (ASPAS), it ranked number four, ahead of Breast Lifts, and behind Liposuction, Breast Augmentation and Tummy Tucks. The statistics do not break down the number of Occidental vs. Asian Eyelid Surgeries performed, but here in the San Francisco Bay Area, the Asian Blepharoplasty accounts for a significant percentage of all the Eyelid Surgery Performed.
You don’t have to be a Board Certified Plastic Surgeon to see that the Asian and Occidental eyelids have different shapes. These differences are directly related to ethnic changes found in the Eyelid Anatomy. While the goals of Blepharoplasty are the same, the techniques to achieve these goals must be modified for differences in the anatomy between Occidental and Asian Eyelids.
Asian Eyelid Surgery Video (Asian Blepharoplasty)
Below is a segment from my latest KRON 4, Body Beautiful show. Several Asian Eyelid Surgery Before and After Pictures are included, and narrated, to help illustrate what Asian Blepharoplasty has to offer.
Asian Eyelid Surgery Goals
The goals for Asian Eyelid Surgery depend on whether the problem is congenital or acquired. Congenital Eyelid Problems we are born with, and these are often caused by deficiencies in the eyelid’s anatomy. The most common problem is poor connections between the upper eyelid skin and the tarsus, causing a poorly formed eyelid crease and the skin to drop into the eye’s visual field. Acquired Eyelid Problems we earn over time and are caused by aging and relaxation of the soft tissues that protect the eye. Protecting the eye is the primary goal for both types of eyelid surgery. Plastic Surgeons aim to restore the normal anatomy and to provide you with eyelids that look good while they are doing their job.
Asian Eyelid Surgery
If you are considering Asian Blepharoplasty, be certain to choose an experienced and Board Certified surgeon who understands, and knows how to repair, your specific eyelid anatomy and achieve your goals. In the San Francisco Bay Area call (925) 943-6353, to schedule a personalized and private consultation appointment.
Attention Plastic Surgery Television viewers. Body Beautiful will be broadcast live on KRON4 this Wednesday, September 7, 2016, At Noon – Live. So tune-in to get the latest Plastic Surgery News, and see if I get it right on the first take.
Plastic Surgery Topics Will Include…
This week’s show will be thirty minutes packed with what’s new in Cosmetic Plastic Surgery. Topics will some of the most popular procedures here in the San Francisco Bay Area including:
Breast Augmentation Revision for…
Breast Implant Deflation
Breast Implant Exposure (Skin Erosion)
Breast Implant Malposition
Breast Implants too small
Gynecomastia Reduction (Male Breast Reduction)
Otoplasty (Ear Pinning for Prominent Ears)
Asian Blepharoplasty (Asian Eyelid Surgery)
There will be plenty of discussion and Before and After Pictures for illustration. Below is a sneak peek.
Breast Augmentation Revision
The patient below had a rare, but serious Breast Augmentation Complication, requiring staged Breast Augmentation Revision Surgery. Her breast implant nearly eroded through the skin on the bottom of her left breast. Oversized Breast Implants in small breasts with poor soft-tissue coverage are at greater risk. This is more commonly seen after Breast Reconstruction when the breast has been radiated to treat breast cancer. It is unlikely to occur in a young, otherwise healthy woman, but it did.
Breast Implant Revision: Sometimes breast implant revision is urgent. The square shape sticking out of the bottom of this patient’s left breast is her breast implant, and it’s about to fall out.
Breast Augmentation Revision Stage I – The Salvage Operation
The top row of photos are the before and after photos from the first stage of her Breast Implant Revision Surgery. The upper left photo shows that the patient’s left Breast Implant is eroding through the skin of the lower breast. It’s about to fall out, and the current breast implant needs to be removed, urgently. If the Breast Implant becomes exposed, infection quickly follows. After careful discussion, it was decided to proceed with Breast Implant Removal on both sides.
Breast Augmentation Revision – Stage I was urgent removal of the left breast implant, which had nearly eroded its way through the lower pole of the breast. It was elected to remove both implants during stage I, because replacing the original saline breast implants with smaller silicone gel filled breast implants was part of the plan to decrease the risk of recurrence.
Having one implant in and one implant out was an option, but would have left her with an almost undisguisable amount of asymmetry. Moreover, the plan was to use smaller replacement implants, to decrease the risk of another breast implant erosion. Leaving both implants out forever would also treat this problem, and completely eliminate any chance of it happening again.
Breast Augmentation Revision Stage II – Asymmetric Breast Augmentation
While the nearly Exposed Breast Implant problem was solved, there were two new problems: 1) obvious breast asymmetry and 2) breasts which are too small for my patient’s preferences. The Breast Asymmetry is two fold. The left breast is smaller than the right, and the left breast is higher and tighter on the chest wall.
Breast Augmentation Revision Surgery – Stage II. The second stage entailed lowering the left implant pocket, expanding the lower, contracted pole of the left breast and asymmetrically augmenting the breasts to decrease the size difference.
Breast Implant Revision Surgery was performed to asymmetrically increase the size of the breasts, and to lower the left breast to match the right. The initial results are shown above, just one week after surgery. An alternative approach would be to raise the right side with a Breast Lift; however, this would require additional, external scars on the right breast.
Breast Augmentation Revision Surgery – Stage II and a patient patient. As time marched on, the results improved. No additional surgery was performed after stage II. While initially the skin stretched well, the muscle was tight. Over several months the muscle relaxed and the symmetry improved, as expected.
The Breast Revision Before and After Photos above show the results after new, smaller Silicone Breast Implants were placed, and the breasts were allowed to heal. The left picture is one week after surgery. In this photo, the left breast mound is firmer, higher and more projecting, as would be expected when more stuffing is placed in a smaller pillow case.
As the breasts heal, the left breast skin and muscle relax, the left breast implant descends and her results improve. The right, after photo shows the results after a few months. A larger breast implant was used on the left, to correct the asymmetry, and while initially it may seem like her Breast Implant Problems are not completely corrected, over time, it settles down. It is a good deal better than the potentially life-threatening complication she presented with originally, as shown below.
Breast Implant Revision Before and After Photos – the left picture is how the patient initially presented. The second picture is a few months after completion of both stages (breast implant removal and breast implant replacement with pocket modifications).
Breast Augmentation Revision Consultations
Breast Augmentation Revision is considerably more complicated than primary Breast Augmentation. If you have problems with your Breast Implants, seek an experienced and Board Certified Plastic Surgeon for your revision surgery. If you are in the San Francisco Bay Area and would like to schedule a personalized consultation appointment call (925) 943-6353, today.
PS – Don’t forget to watch Body Beautiful live at noon, this Wednesday, September 7, 2016, on KRON4, the Bay Area’s New Station.
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.
Blepharoplasty is an Eyelid Lift, and literally means eyelid changing. The nature of the changes can be both cosmetic and reconstructive. Differences in anatomy determine the best methods by which to accomplish our desired goals, and since the anatomy of the upper and lower lids are different, so are the methods used.
The changes usually desired for the upper lids are: 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. Other adjustments are sometimes incorporated, and often multiple corrections are performed simultaneously. While these are accurate generalities, every upper eyelid surgery needs to be evaluated individually for safe and predictable results.
Upper Blepharoplasty Before and After Photos
The goal of upper eyelid surgery is the removal of excess skin, enhancement of upper eyelid alignment and removal of disproportionate fat.
Removal of Upper Eyelid Skin
The Upper Blepharoplasty Before and After Photos above demonstrate the changes possible when the excess skin is removed from the upper eyelids. This patient’s stern and tired appearance is replaced with a more relaxed and rested sparkle in the eyes. Patients with excess upper eyelid skin often complain about being asked, “Are you tired?” even when well rested. Excess skin may also block the upper and outer gaze, obstructing vision. Blepharoplasty can help alleviate these unwanted signs and symptoms.
Removal of Disproportionate Upper Eyelid Fat
The close-up view of the upper eyelid before and after photos below shows both the excess skin and fat present before Upper Blepharoplasty, and the improvements possible with an Eyelid Lift.
Upper Blepharoplasty removes excess skin and fat from the upper eyelids, providing a more rested and alert appearance.
Above, the heaviness and flattening of the upper eyelids is caused in part by excess upper eyelid skin sagging over the lid margin and resting on the eyelashes laterally. Disproportionate fat of the upper eyelid compounds the problem, giving a tired, puffy and disinterested appearance. Once the excess fat and skin are removed, the appearance is more attentive and approachable.
Changing the Upper Eyelid Fold
While seen to some extent in all races, the Asian eyelid is the most likely to have an indistinct eyelid crease. Sometimes there is only the hint of a crease, and sometimes there are folds on multiple levels. It is caused by a softer attachment between the eyelid skin and the deeper structures of the lid. This allows the eyelid fat to push lower on the lid. This is normal anatomy, but can lead to increased upper eyelid fullness and an increased risk of recurrence after eyelid surgery.
Asian eyelid surgery often includes the formation of a more distinct eyelid crease called the palpebral fold.
The above Asian Eyelid Before and After Photos reveals the creation of a distinct palpebral fold (eyelid crease), with elevation of the eyelid skin, reduction of eyelid fat and an elevated upper eyelid position. Several fine sutures are used under the skin to create an attachment that allows the skin to fold smoothly. The eyelid margin was also elevated to open the eyes.
Repositioning the Upper Eyelid Margin
Changing the upper eyelid fold and position is aesthetic in the case above, but is reconstructive in cases where vision is obstructed. In the next case, the eyelids are so saggy that they block the pupils.
Before upper blepharoplasty and levator advancement (muscle tightening), ptosis (sagging) of the upper eyelids is blocking the patient’s vision. He underwent reconstructive plastic surgery to tighten the muscles that elevate the eyelid and raise the upper eyelid’s edge above the pupils.
In the above case, excess skin and fat were removed, and the muscles that raise the eyelids were tightened. The result is obvious when looking at the pupils. Before surgery, the upper eyelid is partially covering the pupils. After Upper Blepharoplasty, a few millimeters of iris are now visible above the pupils. This means light can get into the eye without obstruction, and vision is improved. Lower eyelid surgery was also performed to improve the eyelid position and remove the bags. For about Lower Eyelid Surgery read my next post: Lower Eyelids – Blepharoplasty SF Bay Area.
Upper Eyelid Lifts and Blepharoplasty Consultations
Hopefully, the narrative and photos above help illustrate some of benefits of Upper Eyelid Surgery. To learn what blepharoplasty can do for you call (925) 943-6353 to schedule a private consultation. While the Internet is a great source of general information, there is no substitute for the skill and experience of a Board Certified Plastic Surgeon.
The American Society for Aesthetic Plastic Surgery (ASAPS) has released its 2014 Cosmetic Plastic Surgery statistics. The United State’s premier professional society dedicated to the advancement of Aesthetic (Cosmetic) Plastic Surgery has compiled the procedures performed by its members and others last year, and here are the results:
The ASAPS has released last year’s plastic surgery statistics.
Plastic Surgery Procedures- Who had What?
More than ten million surgical and nonsurgical cosmetic procedures were performed in the United States last year.
Nonsurgical cosmetic procedures are easier, simpler and more frequently performed than surgical procedures.
As expected, nonsurgical procedures accounted for the majority of the total with 8.8 million procedures:
Americans have spent more than 12 billion dollars during each of the last two calendar years on surgical and nonsurgical cosmetic plastic surgery procedures. While nonsurgical procedures outnumbered surgical procedures in frequency, surgical procedures accounted for 60% of the total expenditures.
The Fastest Growing Procedure in 2014
Liposuction, Breast Augmentation and Tummy Tucks have increased dramatically since I started my Walnut Creek Plastic Surgery practice in 1997, while Cosmetic Eyelid and Nasal Surgery have remained steady.
Since starting my San Francisco Bay Area Plastic Surgery practice in 1997, there has been a 274% increase in the total number of cosmetic procedures. Surgical procedures have increased by 82% and nonsurgical procedures increased by 508%. The fastest growing procedure in 2014 was Buttock Augmentation, aka the Brazilian Butt Lift (BBL). While the totals are still less than 10% of the number of breast augmentations, the growth was an impressive 86% last year. The BBL, with over 21,000 procedure performed in 2014, moved up steadily from 20th in 2004, and 18th in 2009 to 15th in 2014.
Breast Augmentation Trends
Breast Augmentation was passed by Liposuction again this year for the most popular procedure. The two are usually neck-and-neck for the top spot each year. With the introduction of breast implants 5.0, form-stable, high-strength, cohesive silicone gel, gummy bear or whatever the latest catch phrase is, 80% of breast implants used in 2014 were silicone and 20% were saline. Breast Implant Revision Surgery increased 30% last year, and may be the result of both the improved alternatives in breast implants currently available and the recognition that breast implants are not life-time devices.
The Ladies Have It
Since 1997, the number of cosmetic procedures for women increased over 429%. Women account for 90% of all cosmetic plastic surgery patients. With breast procedures, excluding breast reconstruction, accounting for over one-third of all cosmetic surgery, this is no surprise. 605,987 female breast procedures (breast augmentation, breast lift, breast reduction, breast revision) were performed in 2014. Comparing this with 24,234 male breast procedures (gynecomastia reduction), women account for over 96% of all cosmetic breast surgery.
Cosmetic Plastic Surgery Consultations
If you are considering Cosmetic Plastic Surgery, be certain to find a Board Certified Plastic Surgeon with experience in the procedure you are considering. If you are in the San Francisco Bay Area, give my office a call at (925) 943-6353. My friendly Plastic Surgery staff in Walnut Creek, CA, is available to take your call, and arrange your private consultation.
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.
Facelifts, Eyelid Lifts, Tummy Tucks and Brazilian Butt Lifts (fat grafting to the buttocks) will all be discussed on this week’s Body Beautiful airing on the Bay Area's News Station, KRON4, this Wednesday at 11:00 AM (12 Dec 2014).
It’s hard to believe that I have been appearing on Body Beautiful for seven years. Doing live television is fun with a little unpredictable mixed in. The nice thing about live TV is that viewers can call in and ask questions. Since there are no retakes, the time commitment is exactly the same as the length of the show, plus San Francisco Bay Area travel time. The downside is there are no retakes, so what you see is what you get.
New Studios Just About Finished
The new KRON studio goes live in the next few days, and I hear it’s as beautiful as it is state-of-the-art, but that will be seen next episode. This week’s Body Beautiful will be one of the last shows broadcasted from the old KRON 4 studios. The current TV studio’s layout is the result of years of use. Every inch is utilized, and every wall has a purpose.
Janelle Marie and Dr. Mele getting ready for another episode of Body Beautiful – Looks like we were talking about Breast Implants that day.
The main KRON 4 studio I will use Wednesday has the Body Beautiful set, the main KRON 4 News set, a large green screen and the weather desk, the traffic desk and seating area used for interviews. In the center are the cameras which rotate around to the desired set. There are lots of cables interconnecting all the equipment on the floor and numerous lights hanging from the ceiling. Somewhere behind the green screen is the speaker that I hear your questions through. Above this is the booth where the producer and director produce and direct. The talent is top notch, and everyone is extremely nice, which helps a lot.
During the show, the phone number for KRON 4 will be broadcast. If you have questions about any of the procedures reviewed, or about Plastic Surgery in general, be sure to call in during the show. It the mean time, you can call my office at (925) 943-6353, or send me a note via the contact form in the margin. Some questions are hard to answer without seeing you, but I will do my best to get you the information you need.