Blepharoplasty surgery, or more commonly referred to as eyelid lift, is believed to be a rather straightforward procedure—just removing the loose skin and excess fat is enough to address the aging upper or lower eyelid. However, this is far from the truth, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
The list below shows the most common blepharoplasty surgery tips and traps, as explained by Dr. Smiley.
* Placement of the scar in upper eyelid. In an attempt to raise the corner of the eyelid, some inexperienced surgeons commit a grave mistake of carrying the incision too high and lateral, which of course results in visible scar.
Dr. Smiley believes that the upper eyelid scar should follow the natural curve of the lid fold and then stop there. If the scar lies precisely at the natural skin crease, patient satisfaction tends to be high.
* Conservative fat removal. In the past, the fat pads were removed entirely in an attempt to eliminate the under eye bags or “heavy” upper lid. However, this aggressive maneuver almost always results in disaster—the eyes look skeletonized. To avoid this problem, Dr. Smiley will always leave a little fat; sometimes, he even perform fat injection particularly if the patient has deep tear trough or abrupt transition between the lower lid and cheek.
* Conservative muscle resection. When done judiciously during an upper eyelid surgery, this technique can contribute to a more youthful, natural appearance.
However, some doctors have tried to replace muscle resection with “multiple pinpoint” cauterization technique (“burning off” the tissue) in an attempt to create a lifting effect. But this method has a serious caveat—it may create a thick band of scar tissue in the muscle that can pull the edge of the eyelid, leading to unnatural contour. For this reason, muscle resection remains the most predictable and safest approach.
* Meticulous physical exam. Dr. Smiley says that great surgeons put a high value on precise anatomical evaluation in which the “rebound” of the lower/upper lid skin, the length of the lid’s border, and the amount of loose skin and fat are scrutinized.
Dr. Smiley says that blepharoplasty is a highly meticulous procedure that it is often referred to as surgery by millimeters.
Some patients may even require vision tests (and other similar modalities performed by ophthalmologists). This is particularly true when health insurance requires proof that upper blepharoplasty is going to be used to improve a person’s peripheral view affected by loose skin or eyelid ptosis (drooping).