Blepharoplasty is upper or lower eyelid surgery to improve appearance and at times vision (upper lid blepharoplasty).  Blepharoplasty surgery is performed by many specialists including general plastic surgeons, facial plastic surgeons and oculoplastics surgeons.  As eyelid surgery is a very specialized form of cosmetic surgery it is important to make sure your surgeon has specific expertise in aesthetic eyelid surgery. When surgery does not turn out as planned, or complications occur, a re-operation is often needed.  The reoperation is referred to as a...

Blepharoplasty is the surgical procedure in which skin/muscle and fat (one or any combination) are excised from the eyelid.  Blepharoplasty can be an isolated upper lid surgery, lower lid surgery or both – commonly referred to as four-lid blepharoplasty (as both upper and lower lids are addressed).  Blepharoplasty surgery can be performed under local anesthesia (the patient is awake with the skin numbed), under conscious sedation anesthesia (IV medications given for comfort), or under general anesthesia (patient asleep with some kind of breathing tube in place)....

Male blepharoplasty or blepharoplasty in men is very different than similar surgery in women.  The goal in male blepharoplasty is to avoid over-excision of skin/muscle and fat as to not feminize the patient.  This requires experience and an artistic hand.  Surgeons who perform male blepharoplasty should approach surgery with this very important concept in mind.  Many consider blepharoplasty in men a specialized form of eyelid surgery.  I agree to an extent.  While the surgery (male blepharoplasty) is the same as blepharoplasty in women, it is the approach which...

Often time’s patients come to me for eyelid surgery (blepharoplasty) with desires which cannot be addressed by surgery alone.  One of these desires is the reduction of wrinkles.  The surgical part can remove excess skin muscle and fat.  However, wrinkles will stay.  The only way to consistently remove wrinkles is to do something to the skin (laser, peel, etc.) or weaken the muscle under the skin with Botox.  Fillers like Restylane or Juvederm help in filling hollows more than in reducing wrinkles around the eyes. There is a misconception that blepharoplasty...

Eyelid ptosis is a condition where the eyelid muscle or tendon weakens and the opening of the eyelid becomes smaller.  There are many causes for eyelid ptosis – the most common is simply involution (aging).  Now aging does not always mean older.  Sometimes patients in their 30’s can have this kind of ptosis.  While they are not old - the eyelid muscle and or tendon may have prematurely aged.  It is important to separate eyelid ptosis from excess upper lid skin (dermatochalasis).  Excess skin requires skin excision (blepharoplasty) while ptosis requires repairing...

A common problem after lower blepharoplasty is for the lower lids to pull down or become retracted.  Correcting this problem is a specialized form of blepharoplasty surgery called “Revisional Blepharoplasty.”  Revisional blepharoplasty involves all procedures needed to redo initial blepharoplasty surgery which did not turn out well or led to ocular complications or poor appearance.  This is a highly specialized form of surgery which requires specialized training (Ophthalmic Plastic Surgeon) and years of experience. A retracted lower lid is not only unsightly but...

Last week I wrote about the anatomy of the lateral canthus (the point or angle where the lower lids meet laterally).  Today let me discuss the importance of tightening the lower lid (canthoplasty or canthopexy) during blepharoplasty (ie. why we do it). Traditionally lower blepharoplasty was fraught with the complication of what we call an eyelid malposition such as ectropion (lid turned out) – see figure 1 below, or retraction (lid pulled down) – see figure 2 below Figure 1 Above is an example of a lower lid ectropion (left) after surgery from another...