Eyelid Surgery

Eyelid Surgery

Do you have bags under your eyes or excess skin in your upper eyelids? The eyelid region is one of the first facial areas to show aging. Sagging eyelids or pockets of fat under the eye seem to appear overnight and lead to a tired, older appearance. The eyes are the windows to the soul and are truly the first thing that others notice about you.

Unlike full facial rejuvenation, which often requires significant downtime, etc, the eyelids are one of the easiest and quickest areas to rejuvenate. Blepharoplasty, or more commonly known as eyelid surgery is a quick and simple procedure to rejuvenate the eye region and drastically improve overall appearance of the face. Dr. Athré is an expert in eyelid rejuvenation and has even lectured at an international meeting on eye rejuvenation. He is one of the top surgeons in the Houston area for this type of procedure.

Types of Eyelid surgery:
Upper Eyelid surgery – Upper blepharoplasty
Lower Eyelid surgery – Lower Blepharoplasty
Asian Eyelid surgery

Basic anatomy of the eyelid
The eyelid is basically made up of 2 parts: the lower eyelid and the upper eyelid. The upper eyelid moves over the eye during blinking and forms the upper eyelid crease when your eyes are open. The lower eyelid sits just below the eye. Anatomically, both the upper and lower eyelids are virtually identical. Eyelashes are located on the eyelid margin, or edge of either eyelid. The eyelids are surrounded by soft tissue, which is a combination of extremely thin skin, muscle and fat.

Aging and the eyelids
As aging occurs, the thin skin around the eyelids begins to lose its elasticity and its ability to stretch. Therefore, the skin of the upper eyelids can seem to overhang or droop. The appearance of “crow’s feet” or deep-set wrinkles can also appear around the eye. Other signs of aging such as hollowing, bulging fat due to thinning skin, or excess skin around the lower eyelid and cheek can be seen around the lower eyelid.

Nonsurgical approaches
Not smoking and not rubbing the eyes can help prevent the early onset of wrinkles and sagging around the eyes. For patients who wish to drastically reduce the appearance of wrinkles around the eyes known as “crow’s feet”, BOTOX® may be appropriate; and BOTOX® may also provide a slight lift of the eyebrows making the amount of excess skin of the upper eyelid seem less. Furthermore, peels and laser skin resurfacing can firm up loose skin and reduce the appearance of fine wrinkles around the eye.

Upper eyelid surgery
The most common surgical procedure is called an upper blepharoplasty, or eyelid lift. Blepharoplasty surgery removes excess skin and fat to return the eyelids back to a youthful and natural look. Many factors such as the natural shape of the eye, ethnic background, and skin type should all be considered in order to obtain the desiredpost-operative effect and minimize scarring.

Prior to the procedure, the functionality of the eye to open and close properly and ability to crease properly are fully considered. Most blepharoplasties are done under local anesthesia and take approximately 1 hour. Return to full normal activity within a week after the procedure is common.

Lower eyelid surgery
Lower eyelid surgery is called a lower blepharoplasty. This procedure is done in 2 phases: removal of fat and removal of excess skin. Fat is removed slowly from 3 possible fat pads under the lower eyelid. This process is done conservatively to ensure that a youthful fullness still remains.

Excess skin is then either removed from the lower lid or tightened by a peel or laser treatment. Through this process, wrinkles and any remaining sagging or loose tissue can be minimized. There are many approaches to perform a lower eyelid blepharoplasty including the transconjunctival (through the inner surface of the lower lid) andsubciliary (external approach right under the lashes). Dr. Athré is well versed in all of these approaches and will customize the procedure for your particular case.

Asian eyelids
A special case of upper eyelid surgery occurs in Asian patients. Asian patients may have one or more of the following characteristics thatseparates them from patients of other ethnic groups. Some Hispanic and Indian patients may also have these same features.

Characteristics of the Asian Eyelid
Possible lack of a supratarsal crease or double eyelid
Epicanthal fold – the medial portion of the eyelid as it contacts the nose
Fullness and excess fat of middle and lateral portions of the upper eyelid

These characteristics separate Asian patients from other ethnic groups but also add complexity to eyelid surgery in Asian patients. These patients need more detailed analysis to prevent over-Westernizing their eyelids which can cause excessive, and possible irreversible scarring. Dr. Athré is an expert in Asian eyelid surgery.

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