Eyelid Surgery

Blepharoplasty and Brow Lift

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Blepharoplasty

Blepharoplasty (eyelid surgery) represents one of the most delicate cosmetic and functional procedures involving the face. Designed to restore a more youthful appearance to the eyes, subtle changes, when executed correctly, can be transformative in an area that conveys so many emotions.

As with all facial surgery, blepharoplasty requires a customized approach, meticulous surgical skills and the ability to identify and balance all the variables involved in the aging process: skin elasticity loss, muscle weakening, fat prolapse and bony asymmetry, in order to restore the natural anatomy of the eyelid. Our oculofacial plastic surgeons expertly identify each patient’s unique problems, then individualize the surgical plan to achieve the desired results.

Upper eyelid blepharoplasty has evolved into a sophisticated multilayered surgery extending beyond antiquated techniques that “cut out extra skin” and left patients with tightness and abnormal eyelid function. Eyebrow positioning, soft tissue distribution, bony asymmetry and muscle tone are critical parameters to be identified and addressed in the operating field to achieve a natural and aesthetically pleasing outcome. In select cases, reinforcement of weakened muscles from the undersurface of the upper eyelid can improve functional outcomes and recreate an open and youthful appearance.

Lower eyelid blepharoplasty is often performed to address lower eyelid fat prolapse “eyelid bags” and orbitomalar hollow shadowing “tear trough dark circles.” In the lower eyelid, transposing prolapsed fat pads across the bony orbital rim through hidden incisions (transconjuctival approach) can have a powerful rejuvenating effect by smoothing the lower eyelid contours and eliminating hollowness. This may be combined with excision of excess skin and tightening of the outer structures of the eyelid (canthoplasty or canthopexy) to increase tension strength and balance tissue distribution in the outer angle of the eye. Reinforcement of the muscle layers can counteract the impact of muscle laxity on the lower eyelid compartment and offset the longterm gravitational changes of aging.

Eyelid surgery may be performed under local anesthesia supplemented by oral or intravenous sedation. Swelling and bruising following eyelid surgery lasts up to two weeks, but complete healing takes a few months. Complications are rare and usually minor and will be discussed in detail with all patients considering blepharoplasty. 

Eyebrow Lift

One cannot overemphasize the role that the eyebrows play in nonverbal communication, cosmetic appearance, and even vision-blocking eyelid droop. As we age, the forehead descends and the brow fat pads deflate, causing a characteristic eyebrow droop that is most prominent in the outer third or “tail” of the brow. Although the use of muscle modulators (botulinum toxin) and volumizing agents have revolutionized the way we treat the aging forehead, surgery achieves better control of tissues and results are longer lasting. Medical brow lift surgery is performed by making incisions just above the eyebrow hairs or in the mid-forehead. While effective, this surgery leaves visible scars. Hidden incisions are used in cosmetic brow lift surgeries.

Endoscopic brow lift is a minimally invasive rejuvenating procedure that counterbalances sagging and volume redistribution in the aging eyebrow. The procedure is performed with the use of a telescopic device-camera, inserted via small incisions hidden behind the hairline. The endoscopic lift is customized to suit individual aging features such as soft tissue redistribution, ligament tension, bony contours and muscle interplay. By releasing, repositioning and fixating tissues across surgically controlled vectors, the entire forehead is revitalized and balanced with the lower face, without leaving a visible scar.

Pretrichial brow lift is recommended for patients with a long forehead who would benefit from simultaneous brow lift and forehead shortening. An extended incision is made across the entire hairline, the forehead and brows are lifted as one unit, and excess forehead tissue is removed thereby shortening the distance between the brows and the hairline.

As an integral part of the surgical armamentarium, brow lift surgeries are usually performed in conjunction with blepharoplasty and facelift surgeries to create a balanced rejuvenative effect across the face. Nevertheless, it can address isolated gravitational descent, create symmetry of facial features and also improve functional imbalance following facial palsy.

Cosmetic brow lift surgery is performed under intravenous sedation or general anesthesia. Sutures and/or staples require removal in the office. Swelling and bruising following brow lift surgery lasts up to two weeks, but complete healing takes a few months. Complications are rare and usually minor and will be discussed in detail with all patients considering brow lift surgery.

Schedule your consultation with one of the skilled providers of Cascade Eye and Skin Centers today, (253) 848-3000.
Cascade Eye and Skin Centers
5225 Cirque Dr W #200, University Place, Washington, 98467 United States | Telephone: +1 253-848-3000 $$$


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