When Do I Do an Upper-Eyelid Blepharoplasty and How?
But should we always just add fillers or fat to the upper frame of the eyelid and never remove any tissues? The answer is no. If the eyelid skin is above the eyelash margin, I rarely if ever remove skin. Filling fat or fillers into the upper eyelid and soft-tissue of the brow is sufficient to make the eyelid look more youthful, even if this is not immediately intuitive. If the eyelid skin edge is crêpey in appearance or hangs low, a combination of some skin removal with fat transfer is ideal for the best results. However, if I had a choice based on a patient’s budget I would still rely on fat grafting as the principal method to make the upper eyelid better. Because I remove so little skin and never fat or muscle from the upper eyelid, the eyelid crease height should change very little from its current and youthful position (which preserves identity and enhances youth) but also the individual can still close her eyes. Unfortunately, I see too many individuals who have been subjected to traditional eyelid surgery that prevents their eyelids from closing, which can be dangerous especially when one is sleeping.
Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call (972) 312-8188. To Learn more about Dr Lams’ plastic surgery procedures or to ask Dr Lam a question please visit his plastic surgery forum