The eyes have been called the “window to the soul,” but they can also be a telling indicator of a person’s age. As we get older, the region around the eyes is disproportionately affected by age-related collagen and elastin loss; it’s more likely to develop loose, drooping skin and deep lines than other regions of the face. This occurs due to a combination of factors: One, the skin of the eyelids is inherently thin and delicate, so the loss of tensile strength that accompanies decreasing collagen levels makes it extremely fragile. Two, the area around the eyes is subjected to frequent stress in the form of repeated blinking and creasing when we squint, smile, laugh, etc.
Sometimes, collagen loss in the eyelids results in an unattractive and medically problematic drooping of the eyelid tissues. This can affect both eyes, but in some individuals, it affects one eye much more prominently than the other. While most people are not symmetrical, this can lead to a distinctly lopsided appearance.
Wrinkled, sagging upper and lower eyelids, drooping brows, and a wrinkled forehead are often interrelated problems, resulting in a tired, angry, or sad appearance, which does not reflect how someone feels. Dr. Singer will advise whether correction can best be achieved by a blepharoplasty (eyelid surgery), a coronal approach (forehead redraping), a limited-incision endoscopic forehead correction, limited lateral brow positioning, or by a supraorbital brow elevation.
How Drooping Eyelids Can Negatively Impact Your Life
Eyelid aging has several negative effects. For many people, drooping eyelids are the cause of disturbing self-consciousness. They can make you look many years older than you actually are, and because eyes are such a focal point of the face, drooping eyelids are usually highly noticeable. Unlike age spots and fine lines, the appearance of drooping eyelids cannot be minimized with makeup. In fact, having saggy skin around the eyes makes it much harder to apply makeup properly.
Drooping eyelids can affect how others see you in a professional context, too. Drooping eyelids are often accompanied by the development of prominent under-eye bags, which can make someone appear very tired and sullen. This can lead others to view them as being less engaged when conversing and less alert. They may be perceived as being “slow” and unable to compete with their younger, more energetic colleagues.
The Eyelid Lift: A Simple Surgical Solution for Drooping Eyelids
The eyelid lift, professionally known as blepharoplasty surgery, can address both the cosmetic and functional problems caused by drooping eyelids. During this procedure, loose skin is carefully removed from the eyelids, then the skin is repositioned so that it looks attractive and allows for a full field of vision. An eyelid procedure can correct all of the following issues:
-Sagging of the upper eyelid
-Puffiness and/or bags beneath the eyes
-Poor eyelid contour
-Limited peripheral vision
-Excess fatty deposits around the eyes
Will I still look like “me” after eyelid lift surgery?
The general comments from friends and associates after returning to normal activities “are:” Gee you look great. Did you change your hairstyle?” “New makeup? Or “Have you been on vacation?” Retaining your uniqueness is the sign of a successful procedure. Although the change may be significant to you, it’s not uncommon that friends and family don’t really notice the specific changes unless patients request dramatic changes. Eyelid or forehead surgery performed meticulously, in the hands of a skilled, experienced, board certified plastic surgeon should not result in an unnatural over-operated appearance. Most patients want to look natural and like themselves yet refreshed. This is achieved by the artistic combination of repositioning and removing the lax excess tissue and adding micro fat grafts or fillers where the tissue is deficient.
How is an Eyelid Lift Performed?
Anesthesia will be administered by a board-certified anesthesiologist and patients are asleep, comfortable, and unaware of any pain during the procedure. Most patients prefer to “go under” anesthesia, either general or deep intravenous sedation when having this procedure (let’s face it—having your eyelids operated on can feel like an intimidating prospect!) However, in some cases, local anesthesia is also an option. If you have health concerns that make general anesthesia a poor choice, ask Dr. Singer whether or not you can have your eyelid lift performed using just local anesthesia.
Dr. Singer will talk with you before you are sedated and use a surgical marking pen to draw several lines on your face. These will guide him during the operation. For the upper eyelid surgery, an elliptical incision is made in the natural crease of the lid. Extra skin and fat are removed, sagging muscles are tightened, and the incision is sutured. For the lower lid, an incision is made just beneath the lashes. This incision extends slightly beyond the outside corner of the eye. If the patient has excess fat beneath the eyes, this fat will be conservatively removed. Patients with depresses areas called tear troughs can get further improvement with micro-fat grafts which are usually performed at the time of the blepharoplasty. Finally, the incisions are closed with tiny sutures. The sutures are removed after 5-7 days. Because these incisions are small and placed within the folds of the eyelids, they do not usually produce visible scars. If the incision is on the inside if the lid, fat, but no skin is removed.
What to Expect During Eyelid Lift Recovery
Most patients who have eyelid surgery say how surprised they are at how mild is the discomfort that they experience. Patients more typically complain of tightness from swelling or a pulling sensation. Understandably, after any surgical procedure, some discomfort can be expected, and pain tolerance varies from patient to patient. All patients are provided with prescriptions for pain medication. Many patients use the prescription medication 2-5days after surgery and then switch to Extra Strength Tylenol. In addition to using analgesic painkillers, you can gently apply a cool compress to reduce these symptoms. It is uncommon for patients to report extreme pain after surgery.
While the eyelids are healing, you will probably have dry eyes. You will be given a prescription for medicated eye drops that are safe to use so that you can keep your eyes comfortably moist.
Additionally, it’s common for patients to experience mild blurry vision after having this procedure. If this happens to you, don’t worry—it’s temporary. Blurry vision usually resolves on its own after about one to two weeks. You may also find that you are very sensitive to light for a couple of weeks after having an eyelid lift; as such, you should plan to stay indoors as much as possible and wear sunglasses when you are outside. You should also plan to strictly limit your “screen time” as the blue light emitted by backlit screens is very hard on the eyes.
How long will bruising and swelling last after eyelid surgery?
Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of bruising or swelling may take 2-3 weeks. Bruising is variable, and many patients can camouflage bruises fairly easily at seven to ten days with a concealer. Our aestheticians at the Singer Skin Care Center are available to help patients with this during their recovery period.
When can I go back to work after eyelid surgery?
It depends on the type of work you perform. Restrictions from work are generally 7 days to two weeks after eyelid surgery. Because some bruising and swelling may still be present, an occasional patient will take three weeks off to be safe.
When can I “work out?” When can I return to the gym or “work out?”
Aerobic activities should be avoided for three weeks following surgery. Any activity that potentially increases blood pressure will increase the amount of time it takes for postoperative swelling to resolve.
Exploring the Benefits of Eyelid Lift Surgery
The benefits that having an eyelid lift can confer are more far-reaching than is immediately evident when reviewing the list of symptoms this procedure can address. Many people who have eyelid lift surgery report experiencing one or more of the following advantages:
1. Quicker, Easier Makeup Application.
Having smooth, defined eyelids makes it much easier to apply eyeliner and eye shadow. Additionally, it reduces the likelihood that your makeup will clump together within the creases of your lids, creating unattractive dark lines. In fact, even some younger people have eyelid lift surgery to reap these rewards. Some people have a type of eyelid structure known as an “epicanthic fold,” where one large fold of skin forms a kind of single upper eyelid that lacks a distinct crease fold. While this eyelid type is commonly linked to being of Asian descent, many Europeans and Africans are also born with an epicanthic fold. While epicanthic folds can certainly be an attractive and unique feature in their own right, and some people have no desire to alter their fold, others find that it makes applying makeup too difficult. As such, they choose to have a specialized type of eyelid lift that is designed to create a crease in the upper eyelid.
2. A Reduction in Migraine Headaches.
Migraine headaches are one of the leading causes of temporary and chronic disability in the world. In fact, migraines are the 3rd most prevalent disease in the world and can lead to sufferers missing between 2 and 15 days of work per month. According to the Migraine Research Foundation, “Every 10 seconds, someone in the U.S. goes to the emergency room complaining of head pain, and approximately 1.2 million visits are for acute migraine attacks.” Migraine sufferers are also at greater risk of experiencing comorbid conditions like insomnia, depression, and anxiety.
Fortunately, research shows that having an eyelid lift can reduce the incidence of migraine headaches. It accomplishes this in a few different ways: One, it improves the patient’s visual field, reducing eye strain. Two, surgeons often place incisions strategically so that they disable the “trigger” nerves that cause migraine attacks. Finally, many practitioners use Botox or Dysport therapy in addition to surgery to treat the area around the eyes. Botox is a proven treatment for migraines and also works by inhibiting problematic nerve activity. For some patients, these steps are sufficient to completely cure their migraines.
3. A Boost in Confidence.
This is, of course, one of the primary reasons why patients seek out eyelid lifts: They want to feel better about how they look. Even if you choose to have just an eyelid lift (rather than incorporating your eyelid lift into a full facelift), this procedure can take five to ten years off your appearance. What’s more, for a minor operation, it can do a lot to change how others perceive you. After having an eyelid lift, even if you have other visible signs of aging, people will view you as youthful. To them, you will look more energetic, dynamic, positive, and alert—all qualities that we associate with being “forever young.” Not only does it feel good to be seen in this light, it can help to protect you from experiencing the pitfalls of ageism in the workplace.
4. Eyelid Lift Surgery Can Help You Stay Active.
By improving your eyesight and peripheral vision, eyelid lift surgery can help you engage in a number of activities that require visual acuity. If you want to drive safely, play sports, or operate certain types of machinery, then you need an unobstructed field of vision.
Being able to participate in the kind of activities mentioned above can help you socialize more easily and stay fit. This in turn will safeguard you against age-related isolation, depression, and cognitive decline. Socializing and exercising regularly are among the best ways to prevent Alzheimer’s and dementia.
How long will the results of eyelid surgery last?
The results of eyelid surgery may be considered permanent in that you will continue to look younger years later than you would have without undergoing the eyelid improvement. However, eyelid or forehead surgery cannot stop the aging process and you will continue to age. You will, however, always look younger and better than a twin, if you undergo the correction and the twin does not.
The results will vary from person-to-person. Most patients can expect their results to last between eight and twelve years. The length of time that patients enjoy a satisfactory improvement after an eyelid surgery depends on many factors including the quality of their skin, which is influenced by the degree of sun damage or loss of elasticity. Smokers typically have poorer quality skin. Older patients will see an earlier return of laxity, while younger patients will see a more long-lasting improvement.
Heredity is important. If your parents aged slowly, you probably will, too. Your diet, general health, time spent in the sun, smoking, weight gains and losses, emotional traumas, and type of skin will all play a role in determining how long the improvement will last.
Complementary Procedures to Consider When Having an Eyelid Lift
As a final note, it’s important to be aware that several nonsurgical procedures can be used to enhance the results of eyelid lift surgery. As mentioned above, Botox or Dysport is often used in conjunction with this surgery, both to treat migraines and to further reduce the appearance of crow’s feet.
Can I combine eyelid surgery with other facial surgery?
Yes, it’s generally preferred to combine procedures. It is financially beneficial because you only undergo 1 anesthesia and minimize the cost of the operating room and surgical supplies. In addition, you minimize downtime by having to go through the recovery process following surgery only once. Commonly combined procedures with face lift surgery include the following:
- Brow lift
- Micro fat transfer
- Laser or dermabrasion
- BOTOX® Cosmetic or Dysport
- Face or neck lifts
- Chin implant
- Rhinoplasty (nasal surgery)
Sometimes skin rejuvenation procedures (like IPL or light chemical peels are also used) to reduce discoloration in the skin around the eyes. When you come in for a consultation, ask us which additional procedures might be appropriate for you.