Blepharoplasty procedure, or eyelid surgery, is not just about removing the redundant skin and under eye-bags caused by the excess fat around the eyes. A more important goal, according to Los Angeles plastic surgery expert Dr. Tarick Smaili, is to create a more rejuvenated appearance that looks natural.
Some patients require the surgery to improve their upper eyelid, lower eyelid, or both. Regardless of the surgical area, it is imperative to hide the resulting scar within the upper eye crease, close to the lower lash margin, and/or inside the lower lid.
Because of varying anatomies and cosmetic goals, blepharoplasty procedure always entails a comprehensive evaluation of skin, fat, eye shape, and other pertinent factors.
In upper blepharoplasty, the scar should always lie within the natural fold of skin to hide the telltale sign of the surgery. Through the use of incisions, doctors are able to remove the hooding skin that can sometimes impede with the patient’s vision, and possibly some excess fats.
However, removing the fats entirely rarely provides a natural-looking outcome due to the resulting hollowness or skeletonized appearance of the eye socket. A good rule of thumb is to preserve the youthful plumpness of the skin around the eyes.
Sometimes upper blepharoplasty requires the use of internal strands to tighten the levator muscle, which is responsible for raising the lids. On some occasions, the technique prevents the patients to close their eyes completely, although it will most likely resolve as the tissue relaxes over time.
When there is a need to remove some excess skin in the lower eyelid, a fine incision close to the lower lash line is used. But if the under eye-bag is only caused by the excess fat, doctors use a technique called trans-conjunctival in which a small incision is made literally inside the lower eyelid.
Instead of removing the excess fat entirely, most doctors excise just a little amount and/or redistribute it to make the lower lid and upper cheek of the same level.
Meanwhile, some patients can “escape” having an actual surgery although they may have to adjust their expectations. Possible alternatives to blepharoplasty include dermal fillers and laser skin resurfacing, which are only suitable for patients with no or very little excess skin around their eyes.
While dermal filler injections are commonly used to correct the hollowed or skeletonized eye socket, they are also helpful in concealing under eye-bags by creating a smooth transition between the lower eyelid and upper cheek.