Upper Eyelid Surgery

The Way the Eye Ages

The eyes are one of the most complex and delicate structures in the body. It is so delicate, in fact, that even the simple act of blinking weakens and stretches an important muscle in the eyelid, called the levator muscle, which is responsible for lifting the eyelid.

As we age, several changes occur around the eye. First, the extremely thin skin surrounding the eyes becomes more and more prone to damage and wrinkling; second, the delicate fibers that make up the muscles around the eye lose their elasticity and begins to weaken; and third, the fat around the eye that gives it the youthful volume and suppleness is slowly depleted.

One such symptom that occurs is called dermatochalasis. This refers to excess sagging skin that weighs down the upper eyelids, giving it a hooded appearance. In severe cases of dermatochalasis, a person’s vision may become obstructed so skin will need to be surgically removed via blepharoplasty.

Dermatochalasis is excess or stretched eyelid skin that makes the eyes hooded, and can obscure vision. This is the most common reason for age-related blepharoplasty.

Since the eyes are the most prominent feature on our faces, these changes are often immediately spotted and not always for the best reasons. Before you know it, you’re suddenly hearing comments like “are you sick?’’, “did you sleep at all last night?”, and “are you tired?” more often than you’d like.

When is Upper Blepharoplasty Performed?

Coupled with undesirable lifestyle habits such as smoking, drinking and excessive sun exposure, the aging signs around the eyes can become quite pronounced, giving way to saggy and tired-looking eyes that can make you look prematurely old. For most people, the turning point in deciding whether or not to address these aging signs often comes when they begin to be perceived to be older than they actually are, or look older than they feel.

According to Dr. Amiya Prasad, there is no ideal age for blepharoplasty because the need for eye rejuvenation differs greatly for every individual. Some people who have been saddled with genetic eyebags or hollowness around the eyes since birth may feel the need to have surgery much earlier; genetic eye bags can be removed in the teens, and hollowing can be treated non-surgically in the 20s and 30s. Others decide to rejuvenate sagging eyelids well into their 70s and beyond. It ultimately depends on how an individual’s eyelid skin and soft tissue ages, and their personal cosmetic goals.

Upper Eyelid Surgery Before and After

The appearance of the eyes can mask your true age or the youthfulness you feel. Natural-looking eyelid rejuvenation make a profound impact on your overall appearance

Who is a Good Candidate for Upper Eyelid Surgery?

Over the years, an increasing number of people with thriving careers in high-powered and competitive industries more often seek out blepharoplasty procedures in order to look like they’re still “in the game”. In fact, according to the American Society for Aesthetic Plastic Surgery, blepharoplasties have far exceeded facelifts and rhinoplasties in popularity. This is because many of these successful executives understand, based on experience, that looking refreshed and full of energy plays a positive role in the way people perceive and interact with them. Regardless of your age, the truth of the matter is that looking as young and robust as you actually feel gives you a competitive edge in any industry.

This lady’s eyes first appeared tired and aged, but eyelid rejuvenation gave her entire face a more youthful and energetic quality.

That being said, here are some basic points that can help you determine if you’re a candidate for blepharoplasty:

• You are constantly being asked if you are: (1) tired, (2) sick, (3) getting enough sleep.
• People constantly perceive you to be older than you actually are, even though you feel youthful and energetic.
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• You feel that you are working in an industry that places some importance in looking youthful, and you feel like you may lose out on opportunities because you are perceived to be older or “less important”.
• There is significant excess skin over your upper eyelids which obscures the real shape of your eyes and affects your line of sight.
• You feel frustrated when applying makeup on your eyes, particularly eye shadow, because the excess skin causes it to crease.
• You want your eyes to appear brighter and more alert and youthful.
• You have realistic expectations when it comes to achieving a younger and fresher look.
• You are doing it because you have personally made the decision to go ahead with it, not because you are being forced or pressured into it by other people.
• You are generally in good health.

Dr. Prasad’s SmartLift Eyelift

Upper eyelid blepharoplasty is designed to remove excess skin and hooding on the upper lids and is quite a straightforward procedure. Oculoplastic surgeon Dr. Amiya Prasad pioneered a particular technique in blepharoplasty surgery which he calls the SmartLift eyelift. It entails the use of minimal incisions with local anesthesia, and yields very natural-looking results. The SmartLift eyelift differs from traditional eyelid blepharoplasty surgery because it involves minimal risk, minimal anesthesia and maximal results.

After a careful and thorough examination, the area is cleansed, after which a local anesthesia is administered. With the SmartLift eyelift, Dr. Prasad always makes use of local anesthesia with LITE™ IV Sedation during his procedures, as opposed to general anesthesia, as it allows his patients to deal with less downtime and less symptoms of bruising and nausea. Since the patient isn’t healing from the effects of general anesthesia post-surgery, incisions heal better and faster, thus helping patients recover sooner.

Once the area is numb, a minimal incision is made, through which Dr. Prasad is able to sculpt or remove fat and tissue. When this is completed, the skin and muscles are re-positioned (to allow for less bruising) and the incision is stitched closed.

According to Dr. Prasad, the act of creating an incision in the correct place (right at the point where the upper eyelid creases) and the method of suturing it closed afterwards is considered more of a work of art than a technique. Surgeons with less experience in eye surgery will often leave patients with obvious scars that fall outside the crease; however, if done correctly, no scar should be noticed at all.

Overall, the entire procedure should last about 1-2 hours, depending on the extent and complexity of the individual’s case.