Eyelid Rejuvenation

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Everyone, this is going to be my first podcast. Well, I did one last week, but it was one that I was being interviewed by a Crystal Clear Media. But I thought, you know, this is a great way to communicate my ideas. So we’re going to talk today about eyelid rejuvenation. Last week I was at the American Academy of Facial Plastic and Reconstructive Surgery in San Diego. I learned a ton of things and I did a short one minute clip about eyelid rejuvenation for a Real Self. And I thought, man, it’s really hard to communicate what I want in one minute. So I thought I’m going to do this slightly more expanded message about eyelid rejuvenation. So first of all, eyelid rejuvenation is just meant to make eyelids or your eyes look a more youthful, brighter, less tired, more rested, more attractive, all those elements. So the way that you can do it is you can approach it non-surgically you can approach it surgically.

But before we talk about the avenues by which you can do this, I want to talk about philosophy. So we’re gonna break down the upper eyelid and then the lower eyelid and we’re going to exclude wrinkles for the moment because although botulinum toxin or Botox or neuromodulators are very, very important toward rejuvenation as an integral component, I don’t want to spend too much time on that because I think it’s going to confuse the issues. I want to just focus on design. So let’s talk about the upper eyelid first. The easiest analogy for me to explain to people who are considering upper eyelid rejuvenation is it’s like a balloon that deflates. So what does this mean? So if you go back and look at your photos when you were much younger, you will see that your eyelids are actually fuller. So when a balloon deflates, what does it look like?

It looks sagging and hanging. So then the ideas that I must have a brow lift, I must have skin removal. I actually haven’t done a brow lift in many years because I think the majority of people don’t need to have their brows elevated. They just look like they need to have their brows elevated. And then if people say, well, you know, I liked how Botox lifts my brows up a little bit. Why don’t you just go ahead and do a formal surgical brows lift? The reason is oftentimes brows don’t look good when they’re elevated. But the reason of Botox brow lift looks good is it suddenly elevates it. But then the natural question is, if that’s the case, why don’t you just do that? And the answer to the question honestly is that if it is deflated and you lifted a little bit, it looks better.

But if you fill it in, it actually replicates what’s youthful. So something that’s deflated, looks sagging, and the temptation is I just need to have that area removed everything removed. So when I oftentimes do is just add a little volume there. And so the nonsurgical method is to do a little filler in that brow. And it just makes it look really, really nice the way to do. The way I focus it on, and I call it an asymmetric triangle, where when I look, I can really see the inner brow is the area of the greatest importance. And the reason for that is that the inner brow is, if you think about the outer brow sort of sagging down, if you can just frame in that inner brow, it can really make this look beautiful. And you can do that with fillers in the office or you can do it with fat, the upper eyelid procedure, instead of having these massive long recoveries that people talk about.

Because it takes skin fat muscle away, I really believe all you need to do is just take a little bit of skin from the upper eyelids. So if you think about that balloon deflating analogy, when you reinflated the balloon, sometimes there’s still that that sort of crepey edge that doesn’t look so great and you may just need to take a little more skin away through an upper blepharoplasty. But I can do that completely awake. You actually don’t feel barely anything and most people are quite shocked by that. So we’ll probably do a separate um, podcast just talking specifically about that to alleviate some of the fears or concerns. But if you think again of that brow, like a balloon deflating and you just need a little bit of volumization, it really can go a long way. And it’s shocking. It’s almost counterintuitive as exactly the opposite of what you think you need because you think, you know what all I need is some skin removal.

And that may be the case. I do that. But oftentimes it’s just slightly deflated. You put a little filler there, it looks great. And fillers really over time build last very last very well for the lower eyelid. It’s again the sort of tension between too much and too little because a lot of people think all you got to do is remove, remove, remove. Other people think all you’ve got to do is fill in, fill in. And for me it’s a little bit of both depending on the situation. So if someone is coming to me and let’s say in their mid thirties, forties, and they don’t have much of an eye bag so to speak, they just have a little bit of hollowness. A little filler can go a long way in making that look better. You can also do fat grafting if you want a surgical correction of this as well.

So a little bit of fillers or fat can cover this, but what happens when that [inaudible] bag is too big? Then you need to take the bag out. And the way that I do it is through a no incision approach. Now why do I make an incision on the upper islands and not on the bottom Island? Because when I take a little extra skin from the upper eyelids, you actually need that too. You need that removed and the incision is very well hidden. But for the lower eyelids, the real problem with this is that if you take skin away from the lower eyelids or make an incision, the eyelid can change shape. And this is a huge thing. When the eyelid looks different and it’s slightly altered, it doesn’t look like yourself or it looks on natural. So I call this, trying to avoid canthal distortion.

What this means in plain English is that where the upper and lower eyelids join near the ear, if that is slightly pulled back or down, it doesn’t look natural. Now, why would that eyelid shape change if you make an incision? The reason is that when the Island is weaker, okay, when the eyelid is weaker, then you have to tighten it. And at that tightening is too much or too little, it can change your eye shape. So I don’t remove skin. I don’t cut on this, on the lower eyelid skin. I think the risk is greater than the reward. I like to keep and preserve the natural eye shape, which also preserves function. So this transconjunctival approach also limits recovery. So these are all nice things. But as I said, sometimes a little bit too much, a little too little, I can either just add fat or I can also add or I can take the eye bag out or, and, and usually in combination.

So it really, this is the element of design. And to tighten it the extra loose skin, I just use a fractionated co2 laser. Now I know this is a very detailed discussion of all these things. It’s all of this is found on my website. And as we start to break these podcasts more into details, I’ll be more than happy to go into a little bit more detail into each of these components because otherwise I can speak for hours on the subject of it. This is a short podcast, about seven minutes long. I just want to get across some of the ideas of natural beautiful rejuvenation that can be done non-surgically minimal surgery or even sort of “bigger” surgery. But as I said, even the bigger surgery, there’s really no cutting or on the skin on the lower would. So I hope, you come in for consultation. I hope this is a good background to what I do. I practice in Plano, Texas, which is just North of Dallas, Texas. I’ve been in practice 17 years, and I hope to see you in my office.

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