Upper Eyelid Lift

An incision is made in the natural crease of the upper eyelid, with a slight extension outward along a wrinkle.   Excess skin and muscle is then removed, before any fat that may be contributing to a puffy appearance is excised.  The incision is then closed, and the resultant scar is camouflaged in the fold of the upper eyelid.

Lower Eyelid Lift

If there is an excess of skin in the lower eyelid, an incision is created just beneath the lower eyelashes, with an extension outward along a wrinkle. This is termed a subciliary approach.  Using this incision, dissection to the patient’s cheek isolates the excess lower eyelid skin and exposes any fat deposits.  This fat can be excised, or repositioned to address hollowing and dark circles under the eyes.  Sutures are then used to repair the incision.

In patients that do not have an excess amount of skin in the lower eyelid, an incision can be made on the inner surface of the eyelid, termed a transconjunctival approach.  Similar removal, or repositioning of fat can be performed, and no incision can be seen on the skin surface.

Recovery from an eyelid lift is fairly rapid, with most people able to return to work in a week’s time.  Swelling and bruising may occur, and can be treated with cold compresses in the first few days after surgery.  It is also important that one maintains their head elevated while sleeping, by placing one or two extra pillows underneath their head and neck.  For patients with dry eyes, eye drops or eye ointment may be required to avoid unnecessary crusting.  Contact lens wearers will need to wear glasses until the initial healing phase is complete.

Patients are seen in the office within a week of surgery to assess healing, and to remove any sutures.  Final results will take weeks to months from the surgery, as swelling and bruising resolve, and scars begin to fade.

We believe in being preemptive to avoid any risks associated with surgery, but occasionally the following may occur:

Bleeding/Hematoma – A small amount of bleeding is common after surgery, but if severe enough, another operation may be required to stop it.  Bleeding can also form a collection, termed a hematoma, which presents as a swollen, painful fluid collection.  These require drainage to prevent secondary problems.

Difficulty Closing Eyes: Initial swelling may make it difficult to close your eyes, but in rare cases, this may persist requiring additional surgery

Ectropion/Entropion: An outward/inward rolling of the eyelid may occur, which requires additional surgery to correct.

Poor Cosmesis: This includes asymmetries between the right and left eyes, and poor incision healing.

Blindness:  Though extremely unlikely, these operations take place in close proximity to the globe of the eye.  Injury to the eye may result in a temporary or permanent change in vision, or blindness.

What causes eyelid skin to sag?

Due to the eye’s thin skin and connective tissues, it is one of the first areas of the face to show age.  Mechanical, environmental, and genetic factors all affect eyelid aging.  With each blink, the thin fibers of the eyelid skin stretch, showing fine lines and wrinkles.  Exposure to sun and smoke damages the elastic tissues preventing skin tautness, while genetics affects the amount of collagen that our tissues contain.

What is a functional blepharoplasty?

A cosmetic blepharoplasty addresses excess eyelid skin and puffiness to make someone look more youthful.  A functional blepharoplasty is a reconstructive procedure performed in someone whose eyelid skin has become so excessive that it interferes with vision.

Will scarring be evident?

All surgery results in a scar, but Dr. Castillo minimizes them through camouflage and appropriate surgical technique.  Upper blepharoplasty incisions are well-hidden in the natural crease of the eyelid, while lower blepharoplasty incisions are created either on the outside skin surface, just below the eyelashes, or on the inside of the eyelid, both of which are inconspicuous at conversational distance.