Eyelid Surgery before and after photos

Concepts of Beauty and the Evolution of Eye Surgery
Although the eyes consistently remain the most important facial feature, concepts of beauty and how beauty is expressed changes with the times. The entire history of cinema documents many changes in the popular appearance of the eyes in this century alone. Women throughout the decades have mimicked the standards of beauty set by Hollywood. Movie stars of the silent film era like Lillian Gish modeled wide-open innocent eyes. Later heroines of the early talkies sported a more sophisticated demeanor with their seductive eyes and low set brows that gave them a sinister, knowing appearance. In the 1930s, Marlene Dietrich popularized the seductive look of very sleepy "bedroom" eyes wherein painted upper lashes exaggerated the heaviness of the upper lids.

As women accepted a larger role in society other than homemaker, hairstyles and dress became more androgynous or boyish. The postwar generation of stars, while "wearing pants, and minimizing the curvy female figures of the 50's, retained and emphasized the eyes to express their femininity. Women like Twiggy and Goldie Hawn who modeled boyish haircuts and dress distinguished their appearance from boys with wide-open eyes and thick long lashes that accentuated their beauty and femininity.

Looking over the faces in the photographs, you may notice that although "bedroom" eyes are beautiful in their setting, they are meticulously staged to maximize the effect. The lids and lashes may change, but all of these faces are beautiful. What these photos have in common is the relationship of the eyes to the brows and cheeks. The rounding of the lids to the cheekbones with beautiful skin on both can make Marlene Dietrich's bedroom eyes change from a medical visual problem to something sensual.

Surgery for the eyes has evolved over the past 30 years. Extra folds of skin on the upper eyelids and drooping brows have always been signs of aging that make people look tired or angry even though they feel healthy and rested. Initially, eyelid surgery was very aggressive. The emphasis was placed on maintaining a large shelf for make-up application while minimizing bulging fat around the eyes. Incisions were made in the upper eyelid crease and underneath the eye, and skin and muscles were aggressively removed. This led to an occasional complication called ectropion (eyelids that pulled down slightly exposing more of the whites of the eyes). Such aggressive fat removal also led to a somewhat hollowed appearance to the eyes.

The next major breakthrough in eyelid surgery was the transconjunctival approach to the eyelids, which decreased risk of ectropion. This advanced technique prevents surgeons from having to make an incision underneath the eye to remove fat. Instead surgeons are able to make an incision through the inside of the eyelid to remove the bags. The muscle layer that divides the fat pocket from the skin pocket is now left intact. Also chemical peels and laser resurfacing may be used as a combined treatment with fat removal through this approach.

The next advent of technology was the laser. A combination of laser resurfacing with a small pinch of skin and removal of fat through the eyelids once again accomplished nice skin tone with removal of excess skin folds without violating that muscle layer.

The most recent development in lower eyelid surgery requires treating the eyes as a unit with the rest of the cheeks and face. Reassessing the relationship between the lower eyelids, the lower eyelid fat, and cheek fat has prompted surgeons to consider repositioning the cheek fat to help smooth the contour change between the hollow underneath the eyes and the bulge of sagging cheek tissue rather than removing a lot of lower eyelid fat. This procedure, called a mid-face lift, has changed the way the latest pioneers of eyelid surgery are approaching the eyelids.

Blepharoplasty
The aesthetic concerns involving the eyes go beyond concepts of beauty. The eyes are communication tools. In business and personal relationships, the eye contact communicates what words can't, which is why men and women need eyes that appear open-ready to interact.

Genetics and time change the shape of the eyes. Drooping upper eyelids and lower eyelid puffiness make you look tired and old. In some cases they may even obstruct your vision. Blepharoplasty (eyelid surgery) can restore open and alert eyes by reshaping the upper and lower eyelids.

Blepharoplasty is commonly done on patients in as early as their mid-thirties. Dr. Goldman can perform blepharoplasty on all four eyelids or just the upper or lower ones. After carefully discussing your goals and expectations, he can recommend the appropriate course of action for you.

Blepharoplasty best aids those with the following conditions:

• Excess or loose skin that hides the natural fold of the upper eyelids
• Excess skin and fine wrinkles of the lower eyelids
• Puffiness in the upper eyelids lending a drowsy appearance
• Puffiness in the lower eyelids or "bags"

Procedure information - Blepharoplasty surgery
Dr. Goldman uses the transconjuctival technique on the lower eyelids, which is a more advanced technique that requires no exterior incision to remove fat. Blepharoplasty is performed on an outpatient basis using local anesthesia with an intravenous sedative. You may feel some tugging or occasional discomfort, but will otherwise be anesthetized and relaxed. The procedure generally takes from 1 to 3 hours depending on the extent of the procedures.

• Incisions are hidden in the natural lines of the eyelids or inside the eyelid.
• Through these incisions, Dr. Goldman separates the skin from the underlying fatty tissue and muscle, removing excess fat, muscle, or sagging skin. Please note that in a transconjuctival procedure, excess skin is not removed.
• The incisions are finally closed with very fine sutures.
• After the surgery your eyes are lubricated with an ointment.

Post-Op - after Blepharoplasty surgery
After the anesthesia wears off, you can control any discomfort with prescribed pain medication although extra strength Tylenol is usually enough. If you experience severe pain, contact our office immediately. You'll be instructed on how to clean and care for your eyes. They may feel goopy from the ointment used to lubricate your eyes.

Most swelling and bruising may last from two weeks to a month. To reduce swelling and bruising keep you'll want to keep your head elevated and apply iced water gauze for the first 24 hours.

Q & A - Common questions about Blepharoplasty surgery
How long do the stitches stay in?
Surgery just to remove lower eyelid fat uses hidden stitches that dissolve by themselves. Stitches on the areas where skin is removed are taken out in 5-7 days.

When can I wear make-up?
After the stitches are removed small tapes called steri-strips are applied. These come off 3-5 days. Therefore, make-up then can be worn approximately 8-10 days after surgery.