Marina,
Thanks for your question regarding upper eyelid blepharoplasty. Blepharoplasty has very good longevity. It is possible that you might see enough age related changes that you could need a slight touch-up in the future, but it can also be life-long. It also somewhat depends on your current anatomical situation. If you have a forehead and brow that is not likely to descend over time then a blepharoplasty may be all you need and it could be the only time you ever have one. If your forehead and brow are not in need of a forehead lift currently, but descend enough in the future, you may need to have a brow lift down the road. It is also possible that you just develop some additional skin laxity over your life that could be improved by a secondary blepharoplasty. There are also laser treatments such as Fraxel that can be performed on the upper lids to improve skin tone. I hope this helps.
Ed Buckingham
Marsha,
Lower eyelid blepharoplasty may be perfomed either by going through the skin or by going inside the eyelid (internal or transconjunctival incision). Under most circumstances we prefer to make the incision inside the eyelid. We do that not so much to hide the incision, as a blepharoplasty skin incision if done correcty can be hidden completely, but because we do not believe that excision of skin in most cases is necessary to produce a great result. Also, skin excision in blepharoplasty carries with it a higher risk of eyelid malposition ie. the eyelid is pulled down showing too much of the white part of the eye and changing its shape. When we perform blepharoplasty we believe that the groove under the eyelid at the junction of the cheek is more important that the eyelid fat contouring. A youthful eyelid must be short in length from the lashes to the junction with the cheek. In order to produce a youthful eyelid the groove under the eyelid must be filled in essentially elevating the cheek and shortening the appearance of the eyelid. This filling can be done during blepharoplasty by repositioning the fatty tissue of the eyelid to a lower position to fill in the groove and elevate the cheek or by using an autologous fat transfer. It can also be done non-surgically in the office by using Restylane or other fillers. We often tighten the skin of the lower eyelid with a chemical peel to reduce the skin wrinkles and add to the result of the blepharoplasty.
I hope this has been helpful. Please feel free to review our before and after photos and of course call us with any further questions or to schedule a consultation. We would love to meet you.
Ed Buckingham
