Blepharoplasty North New Jersey
Blepharoplasty (Eyelift, Double Eyelid Surgery)
Cosmetic and functional eyelid surgery goes under many names, but when most people think of the procedure that can reverse the effects of aging and eliminate bags under the eyes, they’re thinking of a surgery called blepharoplasty, which is the removal of skin, muscle, and sometimes fat from the eyelids to enhance the appearance and tighten the area. Blepharoplasty, essentially an “eyelift”, can also result in a more wide awake look as well as eyes that appear larger and brighter.
The delicate, thin skin of the eyelid can sag because of a number of factors: age, heredity, allergies, and other systemic diseases. But a drooping eyelid can cause more than cosmetic problems. In some cases, this skin can hang over the eyelashes and actually block peripheral vision. At this stage surgery is more than cosmetic, and corrects a serious functional problem known as mechanical ptosis.
Some patients who require eyelid surgery not only have excessive skin on the eyelid but also cannot fully open the eyes because the muscle that opens the eyelid (levator muscle) has detached, weakened or become too loose. Although this can be compensated for by raising the eyebrows, the eyelid might eventually droop even more and block the front as well as side vision. Eventually raising the eyebrows doesn’t work and surgery is the only solution. Surgery to correct ptosis involves opening the eyelid in the same manner as a cosmetic blepharoplasty, with the additional step of strengthening the levator muscle. In a simple cosmetic blepharoplasty, only skin and muscle are removed. Here’s how it works: The first incision is made where the normal lid crease should be (this varies according to gender and ethnicity), and the appropriate amount of excess skin is removed.
With ptosis surgery a more extensive surgery is performed. A deeper cut is made, and the fat is exposed and possibly removed. The muscle that opens the eyelid is then exposed and tucked or pleated with several sutures across the eyelid. The incision site is closed with sutures, giving a precise plastic surgery hairline scar, positioned so that it will be hidden in the eyelid crease.
In lower lid blepharoplasty, the incision can be made just below the eyelashes or, in some cases, through the inside of the eyelids so the scar is completely and in most cases successfully hidden. Some patients also require a tuck in the corner of the lower eyelid to tighten any lax tissues so that the eyelid remains in a normal position at the end of surgery. The lower eyelid skin can be resurfaced with the carbon dioxide laser, which shrinks the excess skin and has the added advantage of diminishing crow’s feet, those fine wrinkles at the corner of the eyes.
How do you know if your surgery was successful? Compare your results with normal eyelids: The upper eyelid should be one to three millimeters below the limbus, the area where the colored part of the iris meets the white part of the sclera. The lower eyelid position should be at or just above where the edge of the lid margin meets the limbus. Remember, some skin must remain in the upper eyelid to allow it to close. If too much skin is removed, many complications can result, such as inability to close the eyes (lagophthalmos) and/or lid retraction in which the eyes open too widely and too much white is visible. This can lead to exposure problems, dry eyes, and the inability to blink properly. These are just general guidelines and may not be appropriate for every patient.
Although this general overview gives you an idea of what eyelid surgery entails, there are many parts to the procedure that must be tailored individually to each patient. A surgeon who fails to individualize each surgery increases the risk of complications.
Browpexy is the concept of lifting the central and outer portion of the eyebrow, just enough to “open up” the eyelid so it looks more rested and youthful. Typically a youthful eyebrow rests above the orbital rim with a gradual lateral arch. A browpexy will return your brow to an anatomical, aesthetically- appealing location on the upper face. It provides an excellent outcome without a traditional coronal, scalp or forehead incision.
Our oculoplastic surgeons specialize in an innovative technique that anchors the underlying brow soft tissue to the bone for stabilization. It is done through the upper lid, which means it can be done simultaneously with an upper eyelid surgery using the same incision site. This subtle technique does not create scarring or numbness of the scalp and there is very little bruising and swelling.
Some patients may need a brow lifting procedure to improve their peripheral vision and reduce the heavy feeling over their eyes. If a patient needs a browpexy procedure to improve their vision, in most cases it is covered by insurance. This is often determined at the time of your consultation.