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What are the Different Types of Eyelid Surgery?

Close up of a young woman’s eye and upper and lower eyelids

Widely regarded as the windows to the soul, your eyes are one of the first features people notice about you. In fact, according to a study conducted by Dr. Daniel Gill, senior lecturer in Psychology at the University of Winchester, a person’s eyes are more important than other facial features when men and women are looking for romantic partners.

Naturally, the features surrounding the eyes—including the upper and lower eyelids—play a role in how attractive the eyes appear. Sunken or droopy eyelids can make your face look tired and sad. And since the skin of the overall eye area is extremely delicate, the signs of aging (including fine lines, fatty deposits, and sagging skin) can be more pronounced in this area. In contrast, smoother and well-contoured eyelids can project a youthful, happier, and more attractive appearance.

Unfortunately, not everyone is born with smooth and well-defined eyelids. Aging can also take its toll in this area. To rejuvenate the eyelids, patients can undergo an eyelid lift or blepharoplasty.

What is Blepharoplasty Surgery?

Eyelid surgery addresses common eyelid concerns caused by aging, including fatty deposits, heavy eye bags, droopy skin, as well as fine lines and wrinkles. Sagging skin, in particular, creates folds in the eye area and disrupts the natural contour of the eyelids. Aside from giving the person an aged, grumpy, and tired appearance, sagging upper eyelids can also hinder vision.

Depending on the patient’s specific concerns, blepharoplasty can be performed on the upper or lower eyelids or on both eyelids.

Upper Blepharoplasty

An upper blepharoplasty addresses issues with the upper eyelids, such as droopiness, puffiness, and wrinkling. These undesirable features can make an individual look aged, exhausted, and sad.

To improve the appearance and functionality of the upper eyelids, your surgeon will make strategic incisions within the natural crease of your eyelids, making the incisions less visible once healed. Depending on your needs, tiny eye muscles will be appropriately tightened, sufficient skin will be removed, and fat will be repositioned to ensure the most natural-looking results.

Upper eyelid surgery typically lasts about one to two hours, and the recovery time is about one to two weeks. Aside from improved vision, patients can expect a more rested and youthful appearance. What’s more, the effects of the surgery should last at least eight years.

Lower Blepharoplasty

As we age, muscle elasticity under the eyes reduces and leads to baggy lower eyelids.
Unattractive dark circles and shadows may also appear, leading to an aged and haggard appearance. To combat this degradation, lower blepharoplasty can be performed. Your plastic surgeon will create an incision on the outer edge of your lower eyelid, just below the lash line. Excess eyelid skin and fat will then be removed and the incision will be closed with tiny stitches.

A lower blepharoplasty takes about one to two hours to perform, and recovery time is about 10 days to two weeks. Similar to an upper blepharoplasty, the effects of a lower blepharoplasty should last eight years or more.

Bilateral Eyelid Surgery

Alt text=“A woman with a covered face, highlighting her eyes and eyelids”

Also referred to as a combined blepharoplasty, bilateral eyelid surgery combines both upper and lower blepharoplasty. Your surgeon may recommend this procedure if you have swollen and sagging skin in both your upper and lower eyelids.

Microscopic incisions are made in the eyelid creases or lid lines. Loose skin is either tightened or removed, fat deposits are readjusted or removed, and muscles are re-contoured. This results in a refreshed look, as well as a more proportional and youthful appearance.

The procedure should take about one to three hours, and the eyelid surgery recovery time is between 10 days to two weeks. Post-surgery, patients are advised to wear sunglasses on their way home to avoid sun exposure, as well as avoid strenuous ocular activities, such as watching television or wearing contact lenses, for at least two weeks. For the first 24 hours following the surgery, patients are advised to apply a cold compress on the surgical area to lessen swelling.

Double Eyelid Surgery

Sometimes referred to as the “Asian eyelid surgery” due to its popularity with East Asians, the double eyelid procedure is a type of eyelid surgery for patients with monolid eyes (i.e. eyes that lack a crease on the eyelid).

While many people of Asian descent have monolid eyes that complement their facial features, others opt for double eyelid surgery to enlarge their eyes. The procedure aims to create supratarsal creases (or natural-looking folds) in the lids. The result is a permanent crease that makes the eyes look bigger, brighter, and more appealing.

Methods to create the double eyelid include the full-incisional technique and the suture technique.

Full-incisional technique

Using this technique, your surgeon will make precise incisions on your eyelid. He will then carefully remove any excess fat, skin, and other soft tissues before attaching the skin and muscle to the tarsus or the dense connective tissue found in the eyelid.

The amount of skin to be excised will depend on the desired height of the crease. The incisions, meanwhile, will be hidden in the crease of the lid, making them virtually imperceptible once healed.

Suture technique

Also known as the double suture and twisting technique (DST), this approach involves the strategic placement of sutures on the eyelids to compress the upper lid structure and create a more natural-looking crease.

Transconjunctival Eyelid Surgery

Performed to address the excess fat pockets around the eyelids, transconjunctival eyelid surgery aims to make the eyes look less puffy and swollen. Many patients undergo this procedure because their eyes make them look prematurely aged.

This procedure directly approaches the deep plane and allows very precise adjustments to the orbital fat. For patients with great skin elasticity, this type of blepharoplasty is all that is needed for the successful removal of eye bags.

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