Doctors Edward Buckingham and Erin Smith offer Blepharoplasty solutions for patients in Austin & Sunset Valley, TX. Commonly referred to as eyelid lift surgery, upper and lower blepharoplasty are performed by a facial plastic surgeon to address extraneous tissue around the eyes that detracts from a person’s appearance. The surgery can reshape the eye area through the manipulation of underlying muscles and fat and the removal of extra skin. Blepharoplasty successfully addresses hooded eyelids, under eye bags, and local wrinkles to restore vitality to a patient’s appearance. Dr. Edward D. Buckingham of Buckingham Center for Facial Plastic Surgery in Austin, Texas, specializes in the blepharoplasty procedure.
Blepharoplasty Before and After Photos
Types of Blepharoplasty (Eyelid Surgery )
While both upper and lower lids can be treated with blepharoplasty, some patients are merely concerned with the appearance and function of the upper eyelids. In such cases, Dr. Buckingham may opt to perform upper blepharoplasty to treat prolapsed fat pockets and redundant skin of the lid. When excess loose, hanging skin results in eyelid ptosis, the muscle that controls eyelid movement can be tightened for best results.
Typically, an incision is hidden in the natural eyelid crease so the doctor can access the tissues below the skin’s surface. He can view the tissues that create the look of a puffy or creped upper eyelid to make the necessary adjustments with a thermal scalpel. Upper blepharoplasty has evolved, and Dr. Buckingham judiciously approaches fatty pockets to prevent over-reduction, which can lead to a hollowed appearance of the upper eye area. Finally, the doctor can trim away extra skin, tighten remaining tissues, and suture the surgical incisions.
As the title of the surgery implies, lower blepharoplasty is performed to address cosmetic concerns underneath the eyes. As people age, the fatty tissue of the lower lid shifts forward and interacts with fat of the upper cheek area, which forms shadows that appear as dark circles. This accumulation of fat can also cause under eye bags.
During lower blepharoplasty, under eye bagginess and extra skin are surgically altered to rejuvenate the eye area. An incision is created, typically under the lower lash line or inside the lower eyelid, which is referred to as the transconjunctival method. The doctor can then redistribute, trim, or remove the fat pads that cause puffiness and modify muscle and skin of the area.
In patients who have always noticed the appearance of a full under eye, the fat pad will likely be removed altogether for the best results. In other individuals, the protruding affect is caused by gravitational descent of the cheek fat pad, which then covers the lower eyelid bone. It often forms a curved groove under the eyelid referred to as a tear trough. In these cases, the tear trough also must be addressed through transconjunctival incisions. Oftentimes, an autologous fat transfer (transferring fat harvested from the lower body) is utilized to maximize the result of lower eyelid blepharoplasty. Please see our fat transfer section for more information.
Adhering to the doctor’s postoperative plan minimizes potential post blepharoplasty complications and creates a more comfortable healing process.
Dr. Buckingham may prescribe an antibiotic cream to apply topically to the affected area, anti-inflammatory medications, and the use of a cold compress for 2-3 days. Both pain and swelling are expected to subside within a few days following blepharoplasty surgery, but it can take a month or longer for the final results to present. Patients can return to their regular schedules within a week following blepharoplasty.
Ideal Candidates for Eyelid Surgery
It is often aging individuals wishing to rejuvenate their appearance who have experienced changes to the eyelids caused by sun damage, gravity, and other natural elements of aging who request the procedure.
They may also find that blinking has become uncomfortable due to the extra or misplaced tissues. Extra upper eyelid skin can also obstruct a person’s vision, in which case blepharoplasty may be a medical necessity.
It is common for blepharoplasty patients of all ages to explain that their eyes emote a sad or tired look, which does not express their true emotions. While eyelid lift surgery is more commonly performed on patients in the middle to later years of their life, genetics in younger individuals may create similar issues. Bulky tissues around the eyes can contribute to premature aging concerns.
Candidates for the surgery must be healthy enough to undergo the procedure as it does require anesthesia and in most cases light sedation. Prospective blepharoplasty patients should be informed of the extent of changes the procedure can create, possible risks, and the aftercare process. Because blepharoplasty will directly impact tissues of the eye area, certain skin or eye diseases may preclude someone from this form of cosmetic treatment.
Additional Plastic Surgeries
Blepharoplasty is generally performed as an outpatient procedure under local anesthesia in one to two hours, and patients can return home when the surgery has been completed. The doctor may require additional anesthetics and time if combinations of facial treatments are performed. In many individuals, the eyes may not be the only facial feature to display unwanted signs of aging.
Blepharoplasty can be combined with an endoscopic forehead lift or midface lift to achieve lasting changes in the underlying structures of the forehead or midface area. Dermal injections and skin resurfacing treatments can also restore vitality to various areas of the face without surgery.
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 appearance. Dr. Buckingham often combines lower blepharoplasty with autologous fat transfer and a chemical peel for the lower eyelid skin to maximize the aesthetic results and address crow’s feet (smile lines) around the eyes.
During a consultation with Dr. Buckingham, patients can learn about the various facial cosmetic procedures available for a tailored treatment plan.
Why to Choose Buckingham Center
About Dr. Buckingham
- B.B.A. in Accounting from Southern Methodist University in Dallas.
- Completed his pre-medical coursework achieving a perfect 4.0 grade point average at the University of Texas in Austin.
- Received his medical degree from the University of Texas Medical Branch in Galveston.
- He was elected to the Alpha Omega Alpha medical honor society as a junior medical student and served as the organization’s vice-president and later president.
- Graduating medical school in the top 2% of the class with highest honors, Dr. Buckingham received the Donald Duncan Memorial Scholarship in Anatomy, the Edward Randall Medal for Academic Excellence, and the Merck Manual Award.
- He then performed a general surgery internship and Otolaryngology residency at UTMB and was a nominee for the UTMB overall-outstanding resident.
- Additionally, he served as president of the UTMB House Officer Association and served two years on the Graduate Medical Education Advisory Committee and Executive Committee.
About Dr. Smith
- Dr. Smith completed her undergraduate education at the University of Mississippi with a double major in Biochemistry and Psychology.
- She completed a Masters in Science in Neuroscience from Tulane University in New Orleans, LA.
- Received her Medical Degree from the University of Mississippi School of Medicine, where she graduated in the top 5%.
- She then went on to complete a rigorous 5-year Head & Neck Surgery residency program at the University of Mississippi Medical Center where she served as Chair of the Chief Resident Council.
- Also, she was appointed as the resident member of the Facial Plastic and Reconstruction Education Committee for the American Academy of Otolaryngology and Head and Neck Surgery Society.
- She treated patients from all over the world and gained expertise in facial paralysis surgery, primary and revision rhinoplasty, face and neck lift, lip lift, eyelid and eyebrow surgery, and skin cancer reconstruction.
- Dr. Smith has authored numerous peer-reviewed journal publications and book chapters and has presented her work at medical meetings across the country.
Common Blepharoplasty Questions & Answers
During your consultation for blepharoplasty, Dr. Buckingham will meet with you and perform a complete facial analysis to determine the best procedure to achieve your desired results. He will also be sure to answer any and all questions that you may have. The doctor may utilize digital imaging or provide photographic results of previous patients to enhance the experience.
Dr. Buckingham performs isolated upper eyelid blepharoplasty in the office with local anesthesia and mild oral sedation. Procedures involving the lower eyelid, forehead, brow or fat transfer are performed in an outpatient facility.
The incisions made for blepharoplasty and their resulting scars are typically hidden or well concealed, either within the natural creases of the upper eyelids or inside of the lower eyelids. As with all of his surgeries, Dr. Buckingham uses the smallest incisions necessary to perform the surgery and places them in discrete, well-camouflaged locations.
There is little to no discomfort during the blepharoplasty surgery as modern anesthesia techniques are used. While blepharoplasty may result in a temporary tight or sore feeling of the eyelids, Dr. Buckingham uses special surgical techniques to help minimize post-operative discomfort. Discomfort can be alleviated with medication if necessary.
Surface sutures are removed around 7 days after your blepharoplasty surgery.
Not all surgeons are comfortable performing double eyelid surgery in Asian patients. While we perform that surgery because of our patient population we do not perform it often. The surgery is very similar in many ways to conventional blepharoplasty however other techniques are necessary to create the eyelid crease.
Blepharoplasty is often performed with local anesthesia and other sedation or even general anesthesia if needed. The anesthesia used is based on the procedure chosen and other patient factors which will be determined during the consultation.
For upper eyelid blepharoplasty, Dr. Buckingham makes a very fine incision within the natural eyelid crease. He then removes excess skin and possibly fatty pockets of the upper eyelid, using a special thermal scalpel to treat the puffy regions. For the lower eyelids, Dr. Buckingham may remove excess lower eyelid fatty tissue through a hidden incision inside of the eyelid. For other patients, it may be necessary to address the tear trough beneath the eyelid puffiness which can be achieved through several different techniques.
The surgical time for blepharoplasty generally takes anywhere from one to two hours. Longer times may be required if including fat transfer or endoscopic browlit.
For upper eyelid blepharoplasty, a fine incision is made within the natural eyelid crease. For transconjunctival lower eyelid blepharoplasty, a hidden incision is made inside the lower eyelid. When addressing the tear troughs below the lower eyelids, other incisions may be necessary and this will be discussed during consultation.
The recovery after blepharoplasty can last anywhere from three or four days, to ten to fourteen days. Patients who receive additional skin resurfacing will have a more lengthy recovery. Bruising and swelling may occur and will fade after one to two weeks. The eyes may feel slightly dry at first, a condition that is relieved with artificial tear use. Usually the patient may wear glasses immediately and may read, however vision is at times slightly blurry. Contact use may be limited depending on the procedure.
Recovery after blepharoplasty can last anywhere from three or four days to as much as ten to fourteen days. Patients may be able to return to work within three to ten days and to their full social activities within one to two weeks. On average, patients are able to return to work within seven to ten days after their blepharoplasty surgery.
Light walking-type exercise can typically be resumed within one week after blepharoplasty. More strenuous activities may need to be postponed for about two to three weeks as vigorous activities can increase swelling, prolong healing, and risk bleeding.
A lower eyelid blepharoplasty is the usual procedure to remove eyelid bags. Often there is a teartrough or orbital hollow inferior to the orbital bag. This is usually filled with autologous fat or filler to improve the results.
Yes. A droopy eyelid appearance is caused from just excess skin or the eyelid itself may be low. The later is referred to as ptosis (silent “p”). In either case using different techniques the eyelid can be lifted to bring them into symmetry.
No. Eyelid surgery (blepharoplasty) is intended to improve the contours of the upper or lower eyelid. In upper eyelid surgery, redundant skin and potentially deeper tissue is removed to relieve the overhanging skin. In the lower eyelid surgery is used to remove eyelid bags and if needed the trough of the lower eyelid is filled in with autologous fat or fillers. Crow’s feet are a result of repetitive muscle contraction and skin aging. Therefore that is the treatment. The muscle activity is treated with Botox or Dysport and the skin is treated with a laser or chemical peel.
In general, our goal is to not change the shape of the eye from what it looked like in youth. If, however, the eye was closed due to significant redundant skin or the lower lid is pulled down due to involutional changes of the skin, then one would expect to see a positive improvement in the shape of the eye with intervention.
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 patients specific concerns will be addressed.
Prospective patients are encouraged to call the office to schedule an appointment at their earliest convenience.
Schedule your Consultation Today
Edward D. Buckingham, M.D. is double board certified by The American Board of Facial Plastic and Reconstructive Surgery and The American Board of Otolaryngology, and he is an expertly qualified facial plastic surgeon. Dr. Erin Smith is a Beverly Hills trained Facial Plastic and Reconstructive Surgeon who specializes in both cosmetic and reconstructive procedures. The philosophy is that a successful facial plastic surgery begins with a good rapport between the patient and the surgeon and his staff during the consultation and additional appointments. The consultation will include a complete facial analysis to determine the best procedure or combination of treatments to achieve the desired transformation. Patients’ questions and concerns will also be addressed.
Prospective patients are encouraged to call the office to schedule an appointment at their earliest convenience. Call (512) 401-2500 to request a consultation with Dr. Buckingham or Dr. Smith.
Those with busy schedules who prefer email communications can complete Dr. Buckingham’s Patient Contact Form.