About Laser Eyelid Surgery, Traditional Eyelid Surgery And Asian Eyelid Surgery

Main Category: Cosmetic Medicine / Plastic Surgery
Also Included In: Dermatology
Article Date: 29 Oct 2008 - 3:00 PDT

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From the 1970's through the 1990's cosmetic eyelid surgery consisted primarily of cutting out skin and fat from the eyelids and reconnecting the skin for a tighter look. However, as time went on, these patients' eyes began to look hollow. More recent eyelid plastic surgery procedures have moved toward preservation and redistribution of the precious eyelid fat. By preserving the fat and redistributing it throughout the eye area, a plump, smooth, youthful look can be achieved, which lasts much longer.

New Eyelid Surgery Procedures and Their Advantages

In the youthful face there is a smooth, flawless, convex connection between the lower eyelid and the cheek. Recreating this smooth "lid-cheek junction" is the key to rejuvenating the eye region. As people age, there is a disruption of the smooth lid-cheek junction. The fat bags of your lower lids start to protrude during your fourth decade of life. Simultaneously a hollowing occurs below the bag creating a valley or trough, hence the term "tear trough." The result is a tired worn reflection on the face. "The area where we most commonly to see this hollowing effect take place, is in the tear trough, just below the bags on the lower lids," says Dr. Gilbert Lee, of Changes Plastic Surgery in San Diego, CA. By plumping up that area, with either fat injections or fillers such as Juvederm and Restylane, you can achieve a flawless transition from eyelid to cheek.

If tiny lines and wrinkles around your eyes are your problem, an alternative to fillers is to treat the lines with lasers. The laser treatments, in effect, cause the skin around the eye to shrink and contract, smoothing out those tiny lines. If the contour irregularities are more pronounced, then an eyelid procedure (blepharoplasty) is necessary to redistribute the fat from the bags and use that fat to fill the tear trough. A tightening of the eyelid muscle and skin layers is done simultaneously.

If your lower eyelids aren't hollowing or bulging, perhaps it's your top eyelid which is sagging and slowly covering your eye, making it difficult to apply make-up. Some of this may be attributed to excess fat and skin in the upper lid, while it could also be a weakening of your Levator Muscle. The levator muscle, lies within the eyelid and is responsible for opening your eye. As it contracts, the muscle pulls your eyelid into a crease (the supratarsal crease), forming the skin fold above your upper eye lashes. As you age, the levator muscle can weaken, creating sagging in the eyelid. By making a small incision on the natural crease of the upper eyelid, the excess skin, muscle and underlying fatty tissue can be removed and the levator muscle can be repaired if necessary.

Important Factors in Successful Eyelid Surgery

Dr. Lee, voted San Diego's top plastic surgeon for 2007 and 2008, says that by using preservation techniques and combining procedures (fat injections, fillers, and fat relocation) that meet the patients' specific objectives, plastic surgery for eyelids has become much more natural and lasting. Additionally, Dr. Lee and his staff use local anesthesia and oral sedation for eyelid surgery. "This is unique," says Dr. Lee. "Using local anesthesia keeps plastic surgery costs down for the patient and is much easier on the body than general anesthesia. Patients often comment that their eyelid surgery was a 'neat experience' under local."

Best Approach for Asian Eyelid Surgery

Asian eyelids differ from Caucasian eyelids in that they lack a fold or skin crease above the upper lashes. One of the most popular procedures for Asian patients is the creation of an eyelid fold, commonly called an Asian blepharoplasty or a double fold procedure. The change to a "double fold" eyelid is considered by many to open up the eye, creating a wider more beautiful appearance. There are two common techniques for Asian eyelid surgery: the suture technique or incision technique. The suture technique is a type of quilting stitch that is used to attach the skin of the eyelid to the underlying muscle, creating a crease. This technique is quick and easy, but less reliable than the incision technique.

As reported by Dr. Lee, 30-40% of sutures can release over time leading to the loss or weakening of the upper eyelid crease. On the other hand, the incision technique leaves a permanent and crisp fold in the eyelid. No matter which technique is used, the key is to create a youthful, attractive eyelid, which maintains its Asian character. "Many surgeons inadvertently make the Asian eyelids look Caucasian. They often make the fold too high or remove too much fat," says Dr. Lee, who is also a top Asian blepharoplasty surgeon in San Diego. "What you want to do is maintain the natural ethnic features of the eye and create enhanced, attractive Asian eyelids, and not try to convert them to Caucasian eyelids."

Quality Eyelid Surgery Cost in the U.S.

Blepharoplasty - Upper and lower: $5000-$7000
Blepharoplasty - Upper or lower: $3000-$5000
Restylane: $600/treatment

Dr. Gilbert Lee is triple board certified, including certifications by the American Board of Plastic Surgery, and the American Board of Surgery. He has been one of the top plastic surgeons in San Diego in 2007 and 2008 (voted by the San Diego County Medical Society). Find more information on eyelid surgery by Dr. Lee in San Diego, Changes Plastic Surgery San Diego, eyelid surgery before and after images at www.changesplasticsurgery.com.

Written by Constanze Scherer