Cosmetic Surgery Tips and Tricks
Upper Eyelid Surgery

Leesburg | Loudoun | Ashburn | Virginia

Upper eyelid surgery is one of the most common cosmetic anti-aging surgeries.  Drooping of the forehead and upper eyelids are two of the first signs of aging in the face.  Patients will generally complain that their eyelids feel more heavy and appear to close off the appearance of their eyes.  

There are many contributing factors to the development of heavy upper eyelids.  The first and probably most important contributing factors is the fact that the brow position will fall with age.  As the brow falls, it will put more pressure on the upper eyelids, contributing to the appearance of heavy eyelids.  

The second contributing factor is the development of fat bags behind the eyelid skin.  Although these fat bags are not always visible except in the medial compartment by the nose, the fat fills and pushes out the skin and the weight of the fat will cause the upper eyelids to feel and appear heavy.  

The goals of the upper eyelid surgery are therefore to 

  • conservatively remove extra upper eyelid skin
  • conservatively remove extra upper fat
  • elevate the temples or forehead if needed.

The goals of the upper eyelid surgery are to reduce the appearance of fullness and heaviness caused by the development of extra eyelid skin, fat growth and herniation, and reduce the contribution of forehead droop if necessary.  

The procedure is most commonly performed under local anesthesia without general anesthesia in the office if you are not having any other procedures.  Patients with more complicated procedures or are having multiple concurrent procedures will benefit from general anesthesia at the hospital or surgery center.

  • The procedure begins with the injection of an anesthetic to numb up the area as well as to reduce the degree of bruising.
  • An incision is placed in the normal upper eyelid crease.  You can see your own in the mirror if you lift up any excess skin.  The fact that the incision is located in this “normal” crease makes it relatively inconspicuous
  • The skin excess above the upper eyelid crease is taken up and removed in a crescent shape.
  • Once the superficial skin is removed, it is easy to visualize the excess and protruding fat.  The fat is conservatively removed.  Aggressive removal gives the appearance of hollowing.
  • Once the extra fat is removed, the skin is closed with a combination of absorbable sutures and sutures that need to be removed depending on the situation

The principle goal is to perform the procedure in a way that appears natural.

The goals of the upper eyelid surgery are to reduce the factors that contribute to their appearance of fullness and heaviness.  These include:

  • The removal of any extra eyelid skin
  • The conservative removal of any fat growth and herniation
  • Raise the forehead or temple if a drooping brow contributes to hooding of the lateral upper eyelid

Facelift or Mini-Facelift – for lower facial droop and jowling

Forehead lift- for brow droop 

Lower eyelid surgery- for dark circles, extra skin, or fat bags

Fat transfer or Facial fillers-  for facial volume

Forever Young BBL – For dark skin pigment, sun spots, age spots

Profractional Laser Peel – For fine lines and textural changes of the skin

Micropeel – For fine lines and textural changes of the skin

Botox

The appearance of looking “startled” after upper eyelid surgery are due to poor assessment, judgement, and technique on the part of your surgeon.  The most common reason is over-elevation of the brow if a browlift is performed at the same time as the upper eyelid surgery.  This is particularly true in men ( Think Kenny Rogers ) given that men actually look better and more distinguished with slightly low brows.  

The first step therefore is to find a talented plastic surgeon with a good understanding of facial aesthetics ( not your eye doctor or dermatologist ).  Second, avoid over-elevation of the brows if a forehead lift is needed at the same time.  

More often than not, upper eyelid surgery is performed without general anesthesia if it is performed as the only procedure.  

The procedure is most commonly performed under local awake anesthesia.  A long acting ( 6 hours ) is injected directly into the eyelid.  Most patients are also given a valium-type drug to help them relax.  

  • The best plastic surgeon near you should have the following qualifications
  • In practice for at least 3 years
  • Performs at least 1 upper eyelid surgery per week
  • Is a board certified plastic surgeon ( as opposed to a ENT, optholmolagist, or dermatologist )
  • Look at reviews in google

Complications of upper eyelid surgery are fortunately rare.  The most worrisome complications are the removal of too much upper eyelid skin ( lagopthalmos ) and blindness.  I thankfully have never seen either of these in my own practice.  And short of journal reports, I have never known of any patient to have experienced blindness.

The more common and realistic complications include:

  • residual hooding ( extra skin ) in the lateral eyelid.  This is usually due to the contribution of a heavy forehead and brow.  My patients are always told of this possibility if they have preexisting lateral brow droop and they are not having a brow lift.
  • residual fat protrusion of the medial eyelid near the nose.  The medial fat compartment is deeper and situated near the medial eyelid muscles.  Conservative rather excessive removal of the fat in this compartment is often prudent to avoid complications of muscle involvement.
  • Milia and small cysts along the suture line.  This complication is unfortunately very common.  They resemble pimples and are easily removed in 3 to 6 months and usually without extra charges.  

Upper eyelid scars are hidden in the normal existing upper eyelid crease.  This natural crease provides excellent camouflage for the scar.  The scar is red at first but easily hidden with make-up for first 3-6 months.  After about 3 months, the scar will begin to whiten and lighten.

The goals of the upper eyelid surgery are to reduce the appearance of fullness and heaviness caused by the development of extra eyelid skin, fat growth and herniation, and reduce the contribution of forehead droop if necessary.  

The procedure is most commonly performed under local anesthesia without general anesthesia in the office if you are not having any other procedures.  Patients with more complicated procedures or are having multiple concurrent procedures will benefit from general anesthesia at the hospital or surgery center.

  • The procedure begins with the injection of an anesthetic to numb up the area as well as to reduce the degree of bruising.
  • An incision is placed in the normal upper eyelid crease.  You can see your own in the mirror if you lift up any excess skin.  The fact that the incision is located in this “normal” crease makes it relatively inconspicuous
  • The skin excess above the upper eyelid crease is taken up and removed in a crescent shape.
  • Once the superficial skin is removed, it is easy to visualize the excess and protruding fat.  The fat is conservatively removed.  Aggressive removal gives the appearance of hollowing.
  • Once the extra fat is removed, the skin is closed with a combination of absorbable sutures and sutures that need to be removed depending on the situation

The recovery from upper eyelid surgery is mostly cosmetic as opposed to functional.  That is, most patients are capable of work from a pain and discomfort standpoint in 2-3 days.  But because of the visibility of bruising most patients will not return to work for 7-10 days.  

Patients can work from home nearly immediately.  

Bruising will take up to 2 weeks to resolve.

Bruising of the upper eyelid is almost always present.  The bruising will show as a dark blue in the first week and as a yellow green in the second week after surgery.  Make-up can be used to cover up any bruising once the sutures are removed in 7 to 10 days.  

Candidates for upper eyelid surgery will complain of the following:

  • Upper eyelids feel and appear heavy particularly at the end of a day
  • The eyelids appear to close off the appearance of the eyes

For my patients:

  • First follow up visit is usually 1 to 2 days after surgery.  Out of town patients and some patients who are more comfortable can skip this appointment and replace it with a text image of your eyes from home.
  • Ice the eyes for the first 2-3 days to reduce bruising and swelling
  • Avoid any physical activities for 3-7 days to reduce bruising and swelling
  • Suture removal appointment in 7-10 days

Upper eyelid blepharoplasty is the medical term for upper eyelid surgery

Products after your upper eyelid surgery

Biocorneum

Peroxide

Ice Pack

Common Mommy Makeover Procedures for the Breast

breast augmentation
Breast Augmentation
breast lift Leesburg Loudoun Virginia

Breast Lift

breast lift Leesburg Loudoun Virginia

Breast Lift plus Augmentation

breast lift Leesburg Loudoun Virginia breast augmentationbreast banner

Breast Augment with Fat Transfer

breast augmentation Virginia victory pose

Nipple Reduction

breast augmenation bra dangling copy 2

Areola Reduction

Procedures often performed with an upper eyelid surgery

Mini Facelift

Forehead Lift

Neck Liposuction

Forever Young BBL

Lower Eyelid Surgery

Upper Eyelid Surgery