Upper and Lower Blepharoplasty in San Francisco

The face shows signs of aging more than any other part of the body. Because people tend to focus on one another’s eyes when speaking, the eyes play a key role in age perception. Men and women who want to improve the appearance of their eyes may undergo go eyelid surgery (blepharoplasty) to achieve a youthful look or make their eyes seem slightly bigger or wider.

Wave Plastic Surgery offers both upper and lower eyelid surgeries, as well as specialized Asian eyelid surgery. Patients who are interested in eyelid surgery have an extensive initial consultation with a Wave Plastic Surgery specialist. Specialists always carefully go through patients’ expectations to determine a proper procedure plan.

Upper Eyelid Surgery

Upper eyelid surgery is one of the most popular facial plastic surgeries performed at Wave Plastic Surgery. People who suffer from a drooping upper eyelid or sagging skin can appear older and tired, angry, or sad when they really are not. Upper eyelid surgery is performed using the following steps:

  1. Incision. A discreet incision is made along the natural folds of the upper eyelid.
  2. Tissue excision. Excess skin and tissues are carefully removed to improve dropping or sagging of the lid.
  3. Closure. The incision is carefully closed using special sutures.

Patients may return home shortly after their procedure. Recovery may be a bit uncomfortable at first, but patients have no regrets when they see their results in the mirror. The drowsy, aged look is gone and in its place is a younger, brighter appearance.

Asian double eyelid surgery is a modified version of the upper eyelid surgery. Patients of Asian descent who are looking for a larger, wider appearance of there eyes may be candidates for the procedure. For more information, please visit our Asian Blepharoplasty page.

Lower Eyelid Surgery

The lower eyelid is one of the first places that changes as natural aging process occur. Problems that can be treated using lower eyelid surgery include the following:

  • Bags beneath the eyelid
  • Protruding fatty deposits
  • Deep, dark circles
  • Depression of the lower lid border (tear trough)
  • Rounded contour of the lower lid margin
  • Lack of lower eyelid muscle protrusion

Lower eyelid surgery is one of the most common procedures that is equally performed on men and women. Men who undergo the procedure usually have a more severe and noticeable condition than women.

Removing Protruding Fat Beneath the Eyes

There are three separate compartments where the orbital fat resides. As we age, the tissues holding the orbital fat become attenuated and as a result, the fat becomes more visible as it protrudes out more. Depending on the severity and whether there is a depression in the lower portion of the lower lid rim, each individual’s treatment will be different.

If excess fat is the only issue, we can remove it using a transconjuctival approach (inside the eyelid). This prevents unnecessary external scars, and there is less of a chance of disrupting the tissues that can cause evertion of the lower eyelid. The removal of the fat must be conservative to prevent unwanted hollowing.

If the fat is not too significant, but does exist, the tissues holding the orbital fat can be simply tightened. This is called a septal reset. If there is hollowness in the lower lid rim, called a tear trough, the fat can be mobilized and repositioned to the bony rim margin. This helps with the removal of the protruding fat as well as filling in the defect of the tear trough.

Smoothing Wrinkles and Depressions in the Tear Trough (the Lower Lid Margin)

Older men and women may also be facing problems with wrinkles or depressions in the tear trough (the area below the lower lid).

Factors that can be causing this condition include:

  • Thinning of the lower eyelid skin
  • The skin’s attachment to the bone becomes tighter
  • The fat in the cheek descends, leaving a hollowed area below the eyes
  • The orbital fat above becomes more pronounced

In this case, if only the orbital fat is removed, it may cause even more pronouncement of the tear trough depression. Instead, we transfer the orbital fat to the lower lid rim to fill in this area. We have found that, at times, fat is not enough and therefore may need to lift the malar soft tissue with an endoscopic mid-facelift using Endotine.

Reshaping the Lower Lid Margin

A youthful lower lid margin should have a relatively straight, horizontal direction, with a slightly upward tilt towards the end. However, as we age, the lower lid margin tension becomes weak and stretched. This results in a very loose margin, giving the eye a more rounded appearance. Tightening and straightening the margin can achieve a more youthful appearance of the eyes.

The technique used to reshape the lower lid margin is called a lateral canthopexy, where the lateral tendon of the eyes is fixed to the orbital bone. This will provide for a better shape of the eyes and helps to protect against post-surgical ectropion (margin of the eyelid being pulled down), which can occur after removing excess skin.

Sculpting the Orbital Muscle in the Lower Lid

One of the prominent features of a youthful lower eyelid is the prominence of the orbital muscle just underneath the lower eyelashes. As we age, this can appear less pronounced. We may recommend Alloderm dermal matrix or a fat transfer to sculpt the orbital muscle and restore a youthful appearance.

Schedule Your Eyelid Surgery Consultation

Customized treatment plans designed to meet or exceed the expectations of patients ensure maximum results.

Please fill out the form on this page to schedule your consultation at Wave Plastic Surgery in San Francisco or call us at (866) 552-0803 today.