What Is Blepharoplasty?
Eyelid Surgery also know as a Blepharoplasty has evolved within the last 5 years. There are Chicago surgeons who still remove excessive skin and fat leaving patients with hollow eyes and high eyelid creases, devoid of wrinkles, but lacking a youthful appearance. Many of these surgeons will actually display these photographs on their websites or in journal articles as a “successful result.”
Unfortunately, this traditional approach to eyelid surgery can leave obvious signs of surgery and may actually be counterproductive, making the face more unattractive.
Upper Blepharoplasty
- What Is Blepharoplasty?
- Why Have Blepharoplasty?
- Eyelid Surgery Before and after
- Eyelid Surgery:- Chicago Surgeon Dr. Shah’s Philosophy
- Upper Eyelid Blepharoplasty
- Lower Eyelid Blepharoplasty
- Ethnic Eyelid Surgery
- Blepharoplasty (Eyelid Surgery) Articles
- Eye Problems
- Recovery Time
- Blepharoplasty After Care
- Frequently Asked Questions About Blepharoplasty
Why Have Blepharoplasty?
The benefit of having eyelid surgery is that it reduces the appearance of that “tired look” of heavy bags under the eyes. While time and stress do begin to hollow out the face, eyelid surgery returns that youthful look by filling out that hollowness, slimming out the eyelids, and reducing wrinkles around the eyes. Also, if your vision is impaired by flaccid eyelids, eyelid surgery can help by making the eyelids tight and firm.
Eyelid Surgery Before and after
To See more Before and After Photos of Eyelid Surgery and other anti aging procedure, See more Before and After Photos of BlepharoplastyClick here
Eyelid Surgery:- Chicago Surgeon Dr. Shah’s Philosophy
Eyelid Surgeon Dr. Shah’s approach to brow lifting is to lift the brows in a natural position so that the eyes look more open and less tired. He uses a variety of techniques including some to lift just the lateral portion, lower the hairline or lift the entire brow. Dr. Shah typically elects conservative changes in the brow area so that a natural appearance exists.
Dr. Shah’s approach
Eyelid Surgeon Dr. Shah’s approach is to remove an exacting amount of skin and fat and recreate a youthful eyes. In some patients, he will restore volume in order to help create a youthful appearance. His approach to the eyes looks at patient’s pictures of their youth and attempts to create an eye which fits each patient’s own characteristics. This approach has helped create a natural, individualistic approach to blepharoplasty.
Why Dr. Shah as a Blepharoplasty Surgeon?
Eyelid Surgeon Dr. Shah is a facial plastic surgeon whose practice focuses entirely on the face. He has coauthored one of the landmark articles on lower eyelid anatomy and eyelid position. Since chicago plastic surgeon Dr. Shah also injects facial filler, he can help add volume (either with filler or fat transfer) in an aesthetic manner to help compliment the patient’s surgical procedure. Finally, plastic surgeon Dr. Shah’s use of resurfacing lasers can help smooth the surrounding areas to help improve overall facial appearance.
Upper Eyelid Blepharoplasty
Upper eyelid blepharoplasty is used to remove either excessive skin and/or fat from the upper eyelid area of patients. Doing so helps create a more open eye for the patient to see from, can provide enough lid crease for patients to apply makeup, and can showcase the eyes and make them look less tired.
Chicago plastic surgeon Dr. Shah hides the incision within the upper eyelid crease and uses a particular type of suture technique to help decrease the likelihood of milia ( a common bump seen after blepharoplasty). Some patients can have this procedure performed in the office depending on which type of blepharoplasty the are seeking.
Lower Eyelid Blepharoplasty
Lower eyelid blepharoplasty involves creating a smooth contour from the lower eyelid to the cheek. Again, in Dr. Shah’s opinion, excessive removal of eyelid fat is detrimental to creating a youthful appearance in all patients. An individualized removal and sometimes addition of fat can create a natural eye contour. Preservation of lower eyelid tone and function is an important aspect of lower eyelid rejuvenation. Dr. Shah utilizes a specialized technique to preserve lower eyelid position and maintain lower eyelid function and tonicity. Dr. Shah has co-authored a sentinel article in lower eyelid anatomy and preservation of natural appearance of lower eyelid. It is important to take in consideration the position of the brow and the individual characteristics of the patient.
Ethnic Eyelid Surgery
African American Blepharoplasty
African American blepharoplasty is a procedure in which patients seek to rejuvenate the skin around the eyes. Most patients seek a procedure to make the eyes look younger while looking natural. For the upper eyes, an incision is hidden in the upper lid crease, so that excess skin and in some cases fat is removed. The skin around the eye is the thinnest and most delicate around the body. It is highly unlikely to form keloids and hypertrophic scars. For the lower eyes, an incision is made in the inside of the lower lid so that fat, responsible for puffy and tired looking eyes, can be removed without an external scar. In some cases, Dr. Shah will use an external incision, particularily if there is excess muscle, skin, or laxity to the lower eyelid.
Asian Blepharoplasty
Many Asians seek eyelid plastic surgery to create “double lids”. 50% of Asians have a double lid, while 50% are born with a “single lid”. The Asian eye differs from the Occidental (Caucasian or White) eyelid by some basic anatomic differences. The traditional teaching is that one of the muscles the lifts the eyelid, the levator neurosis, attaches lower or does not attach at all in the Asian eyelid versus the Caucasian eyelid. However, recent anatomic studies have disputed this. Additional differences include the location of eyelid fat (preaponeurotic fat), presence of an epicanthal fold, and lash posit on.
Two types of procedures are available to rejuvenate Asian eyelids: partial incision and incison surgery. The partial incision surgery is used more commonly in Asia, can be performed quickly, is potentially reversible. The downside is that it can lead to suture breakage and the permanence of this procedure is questioned.
The incision eyelid surgery is considered permanent. It is typically necessary in patients with promienet aponeurotic fat. A small amount of fat and muscle is removed to allow for better adhesion of the skin to the pretarsal tissues. A series of sutures are placed through the levator to encourage this creation.
Eyelids can be designed in several ways. Some patients seek a low crease, medium crease or a high crease. This varies by surgeon and patient preference. The shape of the eye can vary from round to oval. In addition, the eyelid crease can be soft or hard depending on patient preference. The epicanthal fold can be difficult to manage. It is along a highly visible portion of the face. Patients seeking surgery here should be cautioned about prolonged healing and visibility of scars.
Overall, the vast majority of patients seeking Asian blepharoplasty are satisfied. Patient dissatisfaction is typically from presence of scars and eyelid asymmetries. Most eyelid scars heal well, however patients seeking epicanthoplasty will have increased risk of scarring. This is a difficult area to correct secondarily. Eyelid asymmetries can be from a result of preexisting eyelid asymmetries being accentuated or creation of an asymmetry.
How does an Asian eyelid differ from a Caucasian’s?
The orbital septum fuses with the levator aponeurosis further inferiorly in Asians than in Caucasians. The orbital septum, which lies just deep to the orbicularis oculi muscle, forms the anterior border of the orbit and confines the orbital fat. It is a fibrous sheath that is formed at the orbital rims as the arcus marginalis, and it is an extension of the orbital periosteum. In Caucasian upper lids, the septum fuses with the levator aponeurosis approximately 3 mm above the superior tarsal border. In Asian upper lids, the septum fuses with the levator aponeurosis further inferiorly, below the superior tarsal border; this allows orbital fat to lie anterior to the tarsal plate, thereby preventing the attachment of the levator to the skin and preventing the formation of an upper eyelid crease.
Hispanic Blepharoplasty
Hispanic patients seek eye rejuvenation often in their 40’s or 50’s as opposed to Caucasian patients. It is important that both the eye and the brow are examined in great detail here. Low brows often play as much of a role as prominent in skin in the upper eye. Dr. Shah utilizes techniques which can minimize or in some cases eliminate scar formation when sculpting around the eyes. He uses the latest techniques and has developed a technique for lower lid rejuvenation which can be helpful.
Caucasian Blepharoplasty
Most websites devote the blepharoplasty to Caucasians. A few will divide blepharoplasty into Western (Caucasian) and Asian sections. Most patients of Caucasian background will have fragile skin. What is particularly important to understand is the fragility of the skin in the area around the eyes, the thinnest skin in the body. This delicate area is often the first area to show signs of aging. The use of sunscreen and sunglasses to help stave off early wrinkle formation is critical. When wrinkles are beginning to set or established a variety of methods described throughout the website are often considered including volume restoration to the eyes, neuromodulators (Botox, Xeomin, Dysport), upper and lower lid blepharoplasty.
Indian Blepharoplasty
Indians seeking eyelid rejuvenation may have a myriad of goals. Many Indians complain of darkness underneath the eye area. This can be a result of hollowing of the eye, due to either a flatter cheekbone or loss of volume with age. In some cases, this can be a results of darker pigmentation to the area. Solutions to this problem can involve the use of filler, fat for volume loss to a stepwise approach to skin lightners to the area.
Repiness, or fine wrinkles around the eye can also be seen with facial aging. The eyelid skin is thin, in all ethnicities, and therefore most susceptible to wrinkles on Indian skin. Light peels and an upper lid blepharoplasty can be options to improve this area.
Middle Eastern Blepharoplasty
Middle Eastern patients seeking eyelid rejuvenation may have a myriad of goals. Many patients of Middle Eastern descent complain of darkness underneath the eye area. This can be a result of hollowing of the eye, due to either a flatter cheekbone or loss of volume with age. In some cases, this can be a results of darker pigmentation to the area. Solutions to this problem can involve the use of filler, fat for volume loss to a stepwise approach to skin lightners to the area.
Crepiness, or fine wrinkles around the eye can also be seen with facial aging. The eyelid skin is thin, in all ethnicities, and therefore most susceptible to wrinkles on Indian skin. Light peels and an upper lid blepharoplasty can be options to improve this area.
Blepharoplasty (Eyelid Surgery) Articles
When Can I Treat my Eye Problem?
Many patients ask, “When is the best time to treat my aging eye area? And where do I start?” Compiled here is a guide to preventing and treating the eye area in your 20s, 30s and beyond.
20’s – Sunscreen should also be used. Both sunglasses and sunscreen will help protect the delicate eye area from the sun’s harmful rays. Since this area is so delicate, the eyes are the first place patients see signs of aging, so preventative measures are crucial.
30’s – Botox can treat crow’s feet and fine wrinkles around the eye and also improve eyebrow position. Filler can be used to treat under eye darkness.
40’s – An upper eyelid Blepharoplasty can treat such problems as creepy skin, heavy eyelid or excess skin, and fat above the eyes. A lower eyelid Blepharoplasty can treat similar problems, such as puffy eyes cause by excess fat, loose skin, and crepy undereyes.
What is Aging my Eye?
The eyes are a complex and varied feature. There is not a ‘one treatment fits all’ solution for the aging eyes. One patient may have pronounced crow’s feet and another, under-eye puffiness. Determine what issues you may be experiencing by viewing this chart.
Dark circles can also be caused by lose of or little volume in the cheek area (think the dark water of the deep sea vs. the light blue, shallow water of the Caribbean). These deeper areas can appear darker, and injecting filler into these areas can help to make the area shallower and lighter.
Eye Problems
Dark Circles:
Identify the cause.
Some dark circles are due to lifestyle (lack of sleep, too much caffeine, dehydration) and can be treated by making lifestyle changes.
Dark circles can also be caused by lose of or little volume in the cheek area (think the dark water of the deep sea vs. the light blue, shallow water of the Caribbean). These deeper areas can appear darker, and injecting filler into these areas can help to make the area shallower and lighter.
Pigmentation can also be the cause, and is often hereditary (Mediterranean and Middle Eastern patients, etc). For these patients, a light chemical peel, laser, or skin lightener can be effective.
Spring has almost sprung! It is time again to shake off the winter blahs and prepare ourselves for some much needed fun in the sun. For many people, spring means renewal, spring cleaning and of course, getting yourself summer ready. Nothing says, “Hello Spring!” like a well-rested appearance. But some of us have trouble looking as fresh, because of the dark circles under our eyes. These shadows can make us look both more tired and older than we really are.
The first step in treating dark circles is to identify the underlying cause. Some factors which can cause dark circles are:
- Allergies
- Aging
- Dehydration
- Congential (genetic condition which runs in family)
- Abnormal blood vessel formation
- Tthryoid
- or excess Caffeine.
For some of us, even with plenty of sleep, genetics can get the best of us and create these unsightly shadows. Luckily, there are ways to correct this-no extra sleep required.
For patients with pigmentation which causes the dark circles:
- To begin with, start with conservative products and work your way up to more assertive products if you are not seeing the results. And be sure to only use on product at a time.
- When using these products, daily sun screen use is essential.
- Discontinue use of eye lightener after 4-6 months, once dark areas are lighter.
- If you experience any irritation, discontinue use of product.
Crow’s Feet:
Botox works to relax and smooth these areas
Heavy Eyelids and Puffy Upper Eye:
Heavy eyelids and puffiness can be treated with an upper blepharoplasty to remove the excess skin, fat or both, which cause this appearance.
Creepy Under Eye:
Mild to moderate creepiness can be treated with a light chemical peel or in some cases botox or facial filler. More severe crepyness can be treated with a lower lid blepharoplasty, to move excess skin and tighten the area.
Puffy Under Eye:
A lower lid blepharoplasty can be preformed to remove the excess fat that causes tis puffyness.
Low Brow:
Botox can help to improve eyebrow position and awaken the eye.
An endoscopic browlift can be used to return a brow that has become heavy over time to a more youthful position.
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- Real patient
Recovery Time
The sutures are typically removed in one week after upper eyelid blepharoplasty. Some patients are able to wear fake glasses and return to limited activity three days after the procedure. For lower lid blepharoplasty patients, some patients are able to be seen in public in three days after, but recovery typically takes around one week.
Blepharoplasty After Care
Ice after Blepharoplasty
It is critical after rhinoplasty to apply ice to the eyes and cheek area for up to 72 hours after surgery. Often times the eyes and cheeks are the source of bruising and swelling. Ice vasoconstricts the area minimizing bruising and swelling.
Instructions for Ice:
- For comfort, a light piece of gauze can be placed over the eyes.
- A glove is filled with long slender pieces of ice. The ice is placed in each finger of the glove.
- Recline the chair back so that the glove will not slide down.
- Place glove on forehead, eyes and cheek almost continuously for the first 72 hours.
Alternative Instructions:
- Some patients prefer the use of frozen peas. Frozen peas are placed in two gloves and tied to each other.
- Allow the ice to remain on eyes and cheek area.
Avoid:
- Blood thinners for two weeks before and after the procedure.
- Alcohol for one week before and on week following the procedure.
- Caffeine for two days before and two days following the procedure.
- Direct sunlight for 6 month, wear sunglasses.
- Do not applying creams or makeup to eyelid area until sutures have been removed.
- Exercise (can be resumed in 10 days).
Frequently Asked Questions About Blepharoplasty
You can wear makeup two days after the sutures have been removed.
It is normal for there to be a small amount of redness in the early postoperative period, most scars fade at the 6 month mark.
There can be some swelling with the eyelid, since the skin is so fragile and delicate. Usually by 3-6 months, the final result can be seen, since most of the swelling has subsided.
There are a few factors to consider after having a Blepharoplasty procedure. There will be bruising and swelling after the procedure as you heal. It would be best to plan to be able to go back to work two weeks after the surgery.
No, this is a separate procedure. An Eyelid Surgery in Chicago is designed to remove excess skin or fat from the eye area. A brow lift is designed to lift the brow.
No, Botox is the best modality to remove crow’s feet.
It usually depends on the patient. The eye are the first to age, so in some patients it can be performed in their early 30s.
Latisse can irritate the skin around the eye, so we recommend waiting at least two weeks before starting Latisse.
For surgeons certified by the American Board of Facial Plastic Surgery, please click here.
For surgeons certified by the American Board of Otolaryngology, certification can be verified by calling 713-850-0399.
Dr. Shah’s office is located in Chicago, IL. at 200 West Superior St., Suite 200.
A blepharoplasty cost can be determined by an evaluation by Dr. Shah. Contact our office for more details.
