Eyelid Surgery

The eyes are the windows to the soul and are truly the first thing that others notice about you. Unlike full facial rejuvenation, which often requires significant downtime, the eyelids are one of the easiest and quickest areas to rejuvenate. Blepharoplasty, more commonly known as eyelid surgery, is a quick and simple procedure to rejuvenate the eye region and drastically improve the overall appearance of the face. Dr. Athré is an expert in eyelid rejuvenation and has even lectured at an international meeting on eye rejuvenation. He is one of the top surgeons in the Houston area for this type of procedure.

Types of Eyelid Surgery:

• Upper Eyelid Surgery – Upper Blepharoplasty
• Lower Eyelid Surgery – Lower Blepharoplasty
• Asian Eyelid Surgery

Basic anatomy of the eyelid

The eyelid is basically made up of 2 parts–the lower eyelid and the upper eyelid. The upper eyelid moves over the eye during blinking and forms the upper eyelid crease when your eyes are open. The lower eyelid sits just below the eye. Anatomically, both the upper and lower eyelids are virtually identical. Eyelashes are located on the eyelid margin, or edge of either eyelid. The eyelids are surrounded by soft tissue, which is a combination of extremely thin skin, muscle, and fat.

Aging and the eyelids

As aging occurs, the thin skin around the eyelids begins to lose its elasticity and its ability to stretch. As a result, the skin of the upper eyelids begins to overhang or droop. The appearance of “crow’s feet” or deep-set wrinkles can also appear around the eye. Other signs of aging, such as hollowing, bulging fat due to thinning skin, or excess skin around the lower eyelid and cheek, can be seen around the lower eyelid.

Nonsurgical approaches

Not smoking and not rubbing the eyes can help prevent the early onset of wrinkles and sagging around the eyes. For patients who wish to drastically reduce the appearance of wrinkles around the eyes, known as crow’s feet. BOTOX® may be appropriate. BOTOX may also provide a slight lift of the eyebrows, causing the amount of excess skin of the upper eyelid to seem less significant. Furthermore, peels and laser skin resurfacing can firm up loose skin and reduce the appearance of fine wrinkles around the eye.

Upper eyelid surgery

The most common surgical procedure is called an upper blepharoplasty, or eyelid lift. Blepharoplasty surgery removes excess skin and fat to return the eyelids back to a youthful and natural look. Many factors, such as the natural shape of the eye, ethnic background, and skin type, should be taken into consideration in order to obtain the desired post-operative effect and to minimize scarring.

Prior to the procedure, the functionality of the eye to open and close properly as well as its ability to crease properly are carefully examined. Most blepharoplasties are done under local anesthesia and take approximately one hour. Return to full normal activity within a week after the procedure is common.

Lower eyelid surgery

Lower eyelid surgery is called a lower blepharoplasty. This procedure is done in two phases:

First, fat is removed slowly from three possible fat pads under the lower eyelid. This process is done conservatively to ensure that a youthful fullness still remains.

In the second phase, excess skin is then either removed from the lower lid or tightened by a peel or laser treatment. Through this process, wrinkles and any remaining sagging or loose tissue can be minimized. There are many approaches to performing a lower eyelid blepharoplasty including the transconjunctival (through the inner surface of the lower lid) and subciliary (external approach right under the lashes). Dr. Athr is well-versed in all of these approaches and will customize the procedure for your particular case.

Asian eyelids

A special case of upper eyelid surgery occurs in Asian patients. Asian patients may have one or more of the following characteristics that separate them from patients of other ethnic groups. Some Hispanic and Indian patients may also have some of these same features.

Characteristics of the Asian Eyelid

• Possible lack of a supratarsal crease or double eyelid
• Epicanthal fold and the medial portion of the eyelid as it contacts the nose
• Fullness and excess fat of middle and lateral portions of the upper eyelid

These characteristics can add complexity to eyelid surgery in Asian patients. These patients need more detailed analysis to prevent over-Westernizing their eyelids which can cause excessive and possible irreversible scarring. Dr. Athré is an expert in Asian eyelid surgery.

*Individual results may vary