Blepharoplasty - Browlift - Gary D. Hall M.D.

BLEPHAROPLASTY/BROWLIFT

More than any other facial feature, you eyes are the most revealing. When someone first meets you your eyes are the first things that they notice. Puffy, drooping eye lids or eyebrows give a fatigued, angry look. Eyelid surgery can remove the excess fat and drooping skin of the eyelids giving a more alert and rested appearance. Sagging (ptosis) of the eyebrows occurs as a person ages just as the rest of a persons skin. This eyebrow ptosis not only causes a tired angry appearance itself but also causes the appearance of excess upper eyelid skin and "crows feet" wrinkles lateral to the eyes. Many patients need the eyelids and eyebrows addressed at the same time.

Before After

This is a 45 y/o female who underwent brow lift surgery and full face Ultrapulse laser resurfacing and lower lid blepharoplasty. Patient is shown here 2 months postop.

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AM I A CANDIDATE FOR EYELID OR BROWLIFT SURGERY?

Eyelid and brow lift surgeries are performed on men and women of all ages who want to improve their appearance. These surgeries are usually performed to minimize the effects of aging.

     You may be a good candidate for:

     Lower eyelid surgery if you have:
         -excess skin and wrinkles of the lower eyelids
         -puffy "bags" under your eyes
         -sagging lower eyelids

     Upper eyelid surgery if you have:
         -excess skin hiding the natural fold
         -skin hanging over eyelid margin
         -puffiness of the upper eyelid

     Browlift surgery if you have:
         -inherited low set eyebrows
         -sagging eyebrows that give the appearance of excess upper eye lid skin
         -"crows feet" wrinkles lateral to your eyes
         -forehead wrinkles

Some medical problems can affect the eyelids and need to be taken into consideration if eyelid surgery is planned:

         -thyroid problems
         -abnormally dry eyes
         -glaucoma or detached retina

THE CONSULTATION

A personal consultation and exam is very necessary for someone considering eyelid or brow lift surgery to access the multiple factors involved and explore the various options and possible medical problems. You should be prepared to provide complete past medical information including previous surgeries, medical problems and medications.

During the consultation we shall evaluate the skin quality, fat pads in the eyelids and tone of the eyelids. I shall manipulate the eyebrows and eyelids with you looking in a mirror to evaluate what procedure gives you the result that you desire.

THE PROCEDURE

     Lower Eyelids: Usually an incision is made just beneath the eyelashes. With this incision excess skin and fat can be removed. Occasionally the fat is not removed, just repositioned in areas of hollowness. If only excess fat is to be removed this can sometimes be done with an incision inside the lower lid called a "transconjunctival blepharoplasty.

      Upper Eyelids: An incision is made that follows the natural lid crease about 1/3 of an inch above the eyelashes. Excess skin, muscle and fat can be removed with this incision. By following the natural lid creases the incision is camouflaged when it heals.

      Browlift: The browlift procedure can be done with 4-5 small incisions hidden in your scalp and using an endoscope to do the required surgery at the eyebrows. This endoscopic technique works very well in many patients. Some patients with very lax skin I feel have a better long-term result with the classic "open" technique, which utilizes an incision across your scalp. Both methods can have excellent result in the appropriate patient. Neither approach requires shaving of hair.

RECOVERY

The eyelid surgeries and browlift surgeries are done as outpatient procedures. You may have bruising and swelling early on. Using ice packs over the eyelids for the first 1-2 days may help as well as keeping your head elevated. I usually see patients the day after surgery to check the healing process. Eyelid sutures are usually removed in about 3 days and scalp sutures after about a week. Around two weeks after the surgery most all of the swelling and bruising have subsided.

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