1) How do I know if I need an upper eyelid lift or a browlift? It depends on the position of the brow. During the initial consultation to evaluate the upper eyelids, the plastic surgeon uses his hands to raise the patient's forehead skin to an appropriate level. When the forehead skin is raised, if most of the upper eyelid skin disappears, a patient would most likely benefit from a forehead lift. If raising the forehead skin has little or no effect on the upper eyelid skin, an upper eyelid lift (blepharoplasty - bleff-ar-oh-plasty, the technical term for eye lid lift) may be all that is in order. If improvement is noted when the sagging brow is lifted and excess skin remains on the eyelids, a combination of browlift and upper eyelid blepharoplasty may be recommended to achieve a more youthful appearance.
2) Will I still look like "me" after eyelid lift surgery? Many of our patients report that, upon return to work and routine daily activities, friends and acquaintances make the following remarks: "Gee you look great. Did you change your hairstyle?" or "Have you been on vacation?" Retaining your uniqueness is the sign of a successful plastic surgery procedure. Although the change may be significant to you, it's not uncommon that friends and family don't really notice the specific changes.
3) Yes, but I want to dramatically change the appearance of my eyes. Can I do that? This is an excellent question because it leads to evaluating realistic expectations. This question can only be answered on an individual basis. A sign of a good board certified facial plastic surgeon is one who can tell the difference between realistic and unrealistic expectations and one who will provide a truthful picture about meeting each patient's desires. Our biggest referral source is from satisfied patients - ones who have had realistic expectations and were satisfied with results.
4) Will I have any incisions in my skin during eyelid lift surgery? For traditional lower eyelid blepharoplasty, it is common that an incision is made in the lower eyelid skin (photo a) with removal of excess skin and fat to achieve a refreshed look. Eyelid skin is one of the most "forgiving" areas of the body and these incisions typically heal extremely well.
An advanced technique that has been performed successfully for the past five years is the transconjunctival blepharoplasty (photo b). (Wow! That's a big word! The conjunctiva (con junk ti vah) is the pink inner lining of the lower eyelid.) With this approach, the eyelid lift incision is made just inside the lower eyelid and no external skin incision is required. Through the incision the offending fat (which is responsible for the "bags" or "circles" under the eyes) can be removed.
Occasionally blepharoplasty is coupled with some kind of skin resurfacing such as laser or peel to remove any fine textural face lines in the skin. Probably the most frequently requested procedure combines blepharoplasty with a face lift to remove the turkey wattle (that thing that hangs down on the neck of a turkey). Ask your facial plastic surgeon if you are a candidate for a transconjunctival approach for your eyelid lift surgery.