The eyes are the first feature people notice about you, and many people say “the eyes are the windows to the soul”. Fines lines (crow’s feet), puffiness, sagging tissues, bags, dark circles, “crepe paper type” wrinkles, drooping eyelids, atrophied muscle around your eyes and excess skin obscure your eyes. If you want brighter eyes that are not hidden by extra skin and fat, Dr. Christopher Killingsworth, a double board-certified Atlanta plastic surgeon, recommend eyelid surgery.
Surgery of the Eyelids
Having extra skin and fat in the natural fold of your upper eyelid is a good indication that you may need eyelid surgery. At Atlanta Aesthetics, Dr. Killingsworth offers eyelid surgery to patients who want to correct eye imperfections to create a refreshed and youthful new appearance. Based on your individual signs of aging and facial anatomy, Dr. Killingsworth may recommend surgery on the upper or lower eyelids.
Eyelid Lift (Blepharoplasty)
Benefits of Eyelid Surgery (Blepharoplasty)
Both upper and lower eyelid surgery is offered at Atlanta Aesthetics. The goals of blepharoplasty differ slightly based on where Dr. Killingsworth determines correction is needed.
- Upper eyelid surgery removes excess skin and fat from the area above the natural crease of the eye. The procedure does not lift the eyebrows.
- Lower eyelid surgery addresses bags and puffy appearance under the eye. The surgery may also be recommended to correct sagging lower eyelids that expose too much of the lower eyeball and increasing the risk of eye infections.
Eyelid Surgery Evaluation
If you feel like eyelid surgery may be right for you, the first step is to call Atlanta Aesthetics and let us schedule your one-on-one consultation with Dr. Killingsworth. You should come to your first visit prepared to discuss your medical history, current health status, and your medication regimen including all of the medicines and supplements you take on a daily basis. It is important that you also mention any past eye or vision problems and whether or not you have had LASIK surgery. You will be asked to look in the mirror and point out what you wish to change about your eyes and eyelids and Dr. Killingsworth will examine your facial anatomy before making a recommendation about what type of surgery would best work for you.
The Blepharoplasty Procedure
Two common techniques for blepharoplasty include:
- Upper Eyelid Surgery: For upper eyelid surgery Dr. Killingsworth will make an incision that is hidden within the natural fold of the upper eyelid and extending slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, they will remove excess skin and fatty tissue. Because the incision follows the natural contour of the upper eyelid, it is usually inconspicuous.
- Lower Eyelid Surgery: For lower eyelid surgery, Dr. Killingsworth will make an incision hidden just below the lower lashes. Through this incision, they will remove excess skin, muscle, and fat or for some patients: the fat may be redistributed to eliminate puffiness or bulges. Other adjustments to correct special problems, such as muscle laxity, may be performed, and since the placement of the incision is in natural crease lines, any scars normally heal in an inconspicuous fashion. In some cases, Dr. Killingsworth may decide that the best approach for removing excess fat is through an incision placed inside the lower eyelid and this technique requires no external incision however it cannot be used to remove excess amounts of skin. In addition, a laser may sometimes be used in conjunction with lower eyelid surgery to tighten the lower eyelid skin.
Eyelid Surgery Options
In the past, many surgeons basically performed the same eyelid operation on every patient; removing skin, fat, and sometimes muscle from the upper and lower eyelids. Fortunately, today surgeons know that genetics and sun exposure contribute to how your eyelids age and for that reason: Dr. Killingsworth will customize your eyelid surgery to address your specific needs.
This means they may suggest surgery on all four eyelids or just the upper or lower eyelids depending on your condition. Aesthetic eyelid surgery itself can correct many eye problems, and various techniques can be used on one eyelid or another, however, in some cases, combining additional treatments may be necessary to achieve the most aesthetically pleasing outcome.
A youthful lower eyelid has a slight convex appearance on profile, and when excess fat moves forward with aging (commonly called “bags”), the convexity becomes excessive and can even cause shadows on the eyelid that make it look darker. Dark circles under the eyes are caused by dark pigmentation and some people respond well to dermal fillers, however, when the dark shadows are caused by fat protrusion, a lower lid blepharoplasty will tighten the fat and membrane holding the orbital septum and/or remove the excess fat. The appearance of the lower eyelid can also be significantly affected by the loss of soft tissue volume (mostly fat) of the inner cheek near the nose and just under the lower eyelid and this flatness tends gives an elongated, “washed-out” appearance. For decades, a lower lid blepharoplasty always included the removal of fat, but since people lose volume as they age, the techniques used today preserve volume for patients who have lost fat by moving (not removing) the fat pads. In patients with a loss of volume in the lower eyelid that causes a hollow appearance or a deep “tear trough”, lower eyelid blepharoplasty is designed to restore the slight youthful convexity by adding volume and common techniques including moving part of the fat pad into the “tear trough” (fat transposition) or moving upper cheek fat into the horizontal hollow of the lower eyelid.
Often, an upper eyelid blepharoplasty consists of a conservative removal of excess skin to re-create the upper eyelid crease, and, in some cases; a small amount of fat and muscle may also be removed. Lost volume is a major factor in aging and continues after eyelid surgery so instead of removing a lot of upper eyelid fat, Dr. Killingsworth will sometimes tighten the membrane that holds the fat in place. This repositions the fat so that it no longer protrudes. If your brow has become much lower, and your eyebrows are sagging from age, instead of only removing tissue from the upper eyelids, your upper eyelid blepharoplasty may be combined with a brow lift at the same time to achieve the best results. For some people, smoothing out “crow’s feet” can be accomplished with BOTOX®
or a chemical peel, and although these treatments are temporary, they are effective when combined with eyelid surgery.
As you can see, there are many options available to correct the cosmetic problems that have changed your eyes and during your consultation, Dr. Killingsworth will provide information on any and all of the cosmetic procedures available that would be the most beneficial to your circumstances. For most patients, eyelid surgery is performed as an outpatient procedure using a local anesthetic and intravenous (IV) sedation, but general anesthesia may also be an option. Blepharoplasty usually takes 30 to 90 minutes to perform and if you are having both upper and lower blepharoplasty, your surgery will take longer.
It is important to understand that the amount of time it takes for recovery from eye surgery varies greatly from patient-to-patient. For the first few days after your surgery, you should rest quietly with your head elevated and you may be instructed to apply cold compresses to your eyelids. Initially, you may feel a tight sensation around the eyes and any discomfort can be controlled with medication. During the first 48 hours following surgery, most patients experience varying degrees of swelling and bruising and for some the mild swelling may persist for several weeks while for others the swelling subsides in as little as one week. Your vision may be somewhat blurry for a few days and your eyes will be temporarily sensitive to light so you may want to wear dark sunglasses to protect your eyes from wind and sun irritation. Straining, bending and lifting should be avoided during the early postoperative period and most patients resume normal activities within 10 days or less.
Since the healing process for blepharoplasty is gradual, you should expect to wait at least several weeks to appreciate the final outcome of your aesthetic eyelid surgery. Results are usually long-lasting, and the removal of fat from your eyelids is permanent although as your skin continues to age, skin laxity along with the fine wrinkling of the eyelid area may at some time return. Even though eyelid surgery cannot stop the aging process, at Atlanta Aesthetics our patients are happy to look forward to enjoying their younger appearance for many years to come. The goal of Dr. Killingsworth and the entire staff at Atlanta Aesthetics is to make your surgical experience as comfortable and rewarding as possible so please call today for more information about eyelid surgery or any other cosmetic procedure you may think is right for you.
Atlanta Eyelid Surgery (Blepharoplasty) Cost and Financing Options
In some cases, eyelid sagging can interfere with sight, so the procedure may be covered by your medical insurance. We will be able to advise you as to the medical necessity after your consultation. If the procedure is not covered by the insurance, you are responsible for the full cost versus a portion under insurance. We accept payment by cash, personal check, credit card and CareCredit® financing
Puffy upper and lower eyelids not only make you look older and tired, but the condition can also interfere with your eyesight. If you notice puffiness and other signs of aging around your eyes or if you notice that you struggle to keep your eyes open when you are well-rested, you may benefit from blepharoplasty (eyelid surgery). Contact Atlanta Aesthetics to schedule a private consultation at our Atlanta location.