Upper Eyelid Surgery
Removes the folds created by the extra sagging skin. The incision is strategically placed in the upper eyelid crease and thus it is very well hidden. The other main goal of upper eyelid surgery is to create a beautiful eyelid fold or crease. Upper eyelid surgery for Asian populations entails the creation of a supratarsal upper eyelid fold as well. The healing time is only a few days. The recovery is painless. Most of the swelling takes 2 weeks to settle.
Lower Eyelid Surgery
Lower eyelid surgery is more complex than upper eyelid surgery. The goal of lower eyelid surgery is fourfold:
1) To remove the excess saggy eyelid skin and tighten it.
2) To remove the excess saggy muscle of the lower eyelid called the orbicularis and tighten it. Tightening of the lower eyelid muscle supports the lid, which becomes lax with age and offers youthful eyelid shape. In some people the lower eyelid muscle can hypertrophic and thickened. This condition is called festoon. Festoons can also be corrected with lower eyelid surgery.
3) To remove excess eyelid fat and/or reposition it.
4) Remove the dark circles.
The combination of upper and lower eyelid surgery together may yield better results. In many cases I do the upper and lower eyelids together with the endoscopic brow lift. The combination of these surgeries creates an amazing rejuvenation of the eyes.
It can be done under local anesthesia or, local with sedation or general anesthesia depending on patient choice.
The sutures are removed after 7 days. Patients are encouraged to wear sunglasses, as they tend to get more sunlight after eyelid surgery!
In those patients who have a history of dry eyes I educate them that their eyes may feel dry after this kind f surgery for a few days to weeks afterwards in some cases.
Dark circles-eyelid dark circles
Dark circles deserve special mention in eyelid surgery. There are many theories about what causes the dark circles and their treatment.
In my experience dark circles are caused by the many tiny blood vessels that exist right under the eyelid skin. Most of these blood vessels carry venous blood, which is darker in color than arterial blood. Arterial blood is bright red. Venous blood is dark red. The eyelid skin is very thin. It is 7 cell layers thin. Because this is the thinnest skin in the body the blood vessels right under can be seen since they are so close to the surface. Therefore when patients have an abundance of blood vessels mostly carrying dark looking blood this is seen through the skin as a dark circle.
Treatment for dark circles
It is surgical. With eyelid surgery I detach most of the blood vessels from the eyelid skin. The skin may become lighter and lose its dark red/violet hue.
Same etiology as above. Puffy eyes come form the abundance of many very fine blood vessels under the eyelid skin. If you eat foods that have high sodium content you will notice the next day that the eyes will be puffy. Why? Because the blood vessels under the eyelid skin become engorged or dilated. Eyelid surgery helps with that because it disconnects many of those blood vessels from the eyelid skin.