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Patients commonly report concern that their eyes appear tired all the time when they are really well rested. This common complaint results from age and sun related changes of the eyelids and surrounding regions including the forehead and cheek. A simple procedure can correct this tired look, provide a considerable uplift in one’s spirits and also favorably impact public perception. Surgery of the eyelids, or blepharoplasty, is often performed as a single outpatient procedure or in combination with a brow/forehead lift or midfacial lift.
In upper eyelid blepharoplasty the goal is to remove the redundant skin of the upper eyelid and possibly fatty pockets that contribute to the tired appearance. It is important to address the fatty pockets judiciously as over-reduction may lead to a post-surgical cadaver-like appearance. This is always avoided in our practice. The procedure is performed using a fine incision made in the natural eyelid crease and a special thermal scalpel is used to treat the puffy regions. The incision heals in just a matter of days. There is minimal bruising and swelling with blepharoplasty as an isolated procedure and the patient can usually return to social activity in a few days.
On occasion, the tired appearance of the upper eyelids has a large contribution from the forehead and brow. In those cases an endoscopic browlift may be indicated. More information is available in the browlift section of this website.
The tired appearance of the lower eyelid is a complex interaction of the fatty tissue of the lower eyelid which is often pushed forward with age and the fatty tissues of the cheek and the upper part of the cheek bone that surrounds the eye. This interaction acts to cast shadows on the lower eyelid leading to the appearance of tired dark circles. In some individuals the lower eyelids have been puffy since childhood. In that case the answer is to remove the excess lower eyelid fatty tissue, which is done with a hidden incision inside the eyelid referred to as transconjuctival. So there is no visible incision on the skin. In other individuals the puffiness is made worse by the gravitational descent of the cheek fat pad which provides covering to the lower eyelid bone. This descent often forms a curved groove under the eyelid puffiness referred to as a tear trough. In these cases this tear trough also must be addressed and can be done so with transconjuctival incisions.
The tear trough is corrected by using one of several different techniques that are dependent on individual patient factors and will be determined at the time of the consultation with Dr. Buckingham. Once again the goal of lower eyelid surgery is to produce a natural youthful contour between the lower eyelid and cheek. Overly aggressive surgery is to be avoided as it leads to an unnatural “done” look. Dr. Buckingham often combines this procedure with a physician’s peel for the lower eyelid skin to maximize the aesthetic results on the lower eyelids and the crow’s feet (smile lines) around the eyes. The surgery is performed in an outpatient surgical facility and the recovery varies from 3-4 days to 10-14 days depending on the necessity of skin resurfacing.
To determine if a patient is a good candidate for this procedure, Dr. Buckingham recommends a private patient consultation.
Dr. Buckingham feels that successful facial plastic surgery results from the development and maintenance of good rapport between the patient, the surgeon, and his staff during the consultation and future appointments. The consultation will include a complete facial analysis to determine the best procedure to bring about the desired results and all questions relating to the patient’s specific concerns will be addressed.
Prospective patients are encouraged to call the office to schedule an appointment at their earliest convenience.
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