Blepheroplasty (eye lid lift)
The eyes are the first to show the aging process. Patients often complain of the "tired look", "angry look". The eye brows descend down, excess skin over hoods the upper lids. This is usually associated with puffiness of the lids, also called bags, or herniated fat bags.
The lower lids show their aging with wrinkles and excess skin. Bags of fat in the lower lids. 
The surgery is designed to improve on the appearance of skin around the eyes.
Blepheroplasty can be performed on the upper and lower lids or separately upper or lower eye lids.
Understanding the standards of beautiful eyes can help in planning for the appropriate surgical procedure. The most important advances in the recent years is the preservation of volume in both the upper and lower eyelids. These procedures avoid the hollow eye that accentuates the aging look.
THE PROCEDURE
Evaluation
of the upper lid must include the position of the eye brow. A
droopy eye brow accentuates the upper lid aging. In those situations
the eye brow must be positioned back to normal position. This
is done with a forehead lift or a brow lift.
Excess skin of the upper lid is then marked. The incision is positioned in the eyelid crease. The crease should be positioned at the right height from the lashes.
Excess
skin is then removed; fat is conservatively removed if any. Muscle
is spared and, a small slip of muscle is removed only in specific
cases. All these precautions are taken to prevent the hollow eye,
or the surgical look.
The lower eyelid can be rejuvenated in many ways. The indiscriminate removal of skin, muscle and fat, result in hollow look.
New concepts in lower lid rejuvenation accomplish a full smooth convex lower lid. Conservative approach can involve micro lipo injections in the lower lid. In some a Transconjunctival approach through the inside of the lower lid to redistribute the fat compartments. The skin is smoothened by laser resurfacing, removal or skin peels. Advanced laxity of the lower lid and excess skin and fat may require the traditional approach through an incision just below the lash line. The lid is tightened; fat is redistributed to fill the hollow lid-cheek junction. Excess skin is removed.
Recovery
is quick about one week. Swelling and bruises will completely
disappear in 3-4 weeks. Back to exercise in 3-4 weeks.
Risks
include infection, bleeding, vision changes. Inability to completely
close the eyes. In the lower lid persistent swelling and pulled
down lower lid.
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