Oak Vassar Medical Building
1330 Oak Lane, Suite 100
Lynchburg, Virginia  24503

Aesthetic eyelid surgery is performed on adults of all ages. Some people have eyelid surgery to correct problems that are a result of aging, while others have inherited traits that cause them to seek treatment as early as their 20s or 30s.

Best candidates for eyelid surgery
Any one or combination of the following conditions may indicate that you are a good candidate for eyelid surgery:

• excess skin obscuring the natural fold of the upper eyelids

• loose skin hanging down from the upper eyelids, perhaps impairing vision

• a puffy appearance to the upper eyelids, making the eyes look tired

• excess skin and fine, crepey wrinkles of the lower eyelids

• bags and dark circles under the eyes, often with a depression along the bony border of the lower eyelids

• droopiness of the lower eyelids, showing white below the iris (colored portion of the eye)

Aesthetic eyelid surgery can usually correct these problems, though other treatments may also need to be considered. For example, if the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of crow's feet may require chemical peeling or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with a bleaching solution or chemical peel. Your plastic surgeon can provide further information if you have an interest in any of these additional procedures.

Planning your surgery
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. You should come to the consultation prepared to discuss you medial history including previous surgeries, past and present medical conditions and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems or diabetes are among the medical conditions that may increase the risks associated with eyelid surgery.

Your plastic surgeon will want to know if you have allergies, especially if they affect your eyes. He or she may ask whether you have ever tried and were unable to wear contact lenses, you should bring them with you in case your surgeon wants to test your vision.

It will be necessary for your surgeon to know if you were ever told by an ophthalmologist that you have a condition called "dry eye" or if you have any other problems with your eyes.

The procedure
One of several surgical techniques may be suggested to improve the appearance of your eyelids. The particular technique that your plastic surgeon recommends will depend on may factors such as the amount of excess fat and skin in the eyelid areas, the position of your eyebrows, and the condition of muscles around your eyelids.

For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it will be well camouflaged when healed.

For lower eyelid surgery, often an incision is hidden just below the lower lashes. Through this incision, excess skin, muscle and fat are removed, or fat may be redistributed to eliminate puffiness or bulges. Other adjustments to correct special problems such as muscle laxity may be performed. As in upper eyelid surgery, the incision is well camouflaged by natural creases.

In some cases, you and your surgeon may decide that the best approach for removing excess fat is through an incision placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. A laser may sometimes be used in conjunction with this method to tighten the lower eyelid skin.

For upper eyelid surgery, an incision is generally hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. For lower eyelid surgery, often an incision is hidden just below the lower lashes. Excess fat in both the upper and lower eyelids may be removed, or sometimes lower eyelid fat is redistributed.

Aesthetic eyelid surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

Getting back to normal
The results of aesthetic eyelid surgery are long-lasting, but they may be affected by your heredity and lifestyle factors. Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur.

The skin continues to age, however, and skin laxity along the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows which mimics a recurrence of drooping upper eyelids. if this happens, correction may require a forehead lift or a secondary eyelid procedure.