In performing an eyelid lift, called a blepharoplasty, the surgeon lifts the lids by removing sagging eyelid tissues. This procedure can be performed on both the upper and lower eyelids. After an eyelid lift, the eyes are unburdened of excess skin and fat that have distorted their shape, and the result is a more rested, youthful, and alert look.
Most darkness under the lower eye is from the shadow effect from the fat bulging underneath the eyes. Note that an eyelid lift alone is not intended to correct fine lines or wrinkles around the eyes. This explains the necessity of combining eye lift procedures with other rejuvenation procedures such as browlifts and skin rejuvenation treatments such as laser skin resurfacing. Also, an eyelid lift will not correct dark circles under the eyes if the circles are caused by the muscle and other tissues showing through thin skin. These distinctions can be defined during the consultation.
Upper Eyelid Lift
For the upper eyelid lift (blepharoplasty), the incision is hidden in the eyelid crease. This crease is hidden when our eyes are open. Excess skin and fat are removed proportionally to restore the original shape and contour. The upper eyelift does not ‘open’ your eyes, it recreates the eyelid depth. A brow lift reopens the eyes. In most people seeking eyelid rejuvenation, eyelid procedures are combined with brow lifts and/or laser skin resurfacing to achieve natural, balanced, and complete results. This is especially true of people over 45.
Lower Eyelid Lift
A lower eyelid lift can be accomplished by a procedure that has two distinct variations. The older procedure for a lower eyelid lift is transcutaneous/subciliary, which means the incision is through the external skin underneath the eyelashes, while the other is transconjunctival, on the inside of the eyelids.
Although the subciliary approach can tighten the skin without the need for adjunct procedures such as laser resurfacing, this type of incision can exacerbate dry eyes and alter eye shape. This is why the preferred approach in most people is transconjunctival, with the incision invisible on the inside of the eyelids.
More importantly, this technique avoids creating an incision through the muscle that supports the eyelid, necessary in a subciliary procedure, to access and alter the bulging fat.