What Type of Eyelid Surgery is Best for You?

The eyes are “the window to the soul”. They convey emotion, and let the inward beauty shine through to the world. Eye contact is very important, as it often influences social situations and relationships.

As we age, wrinkles, stress, scars, sagging, and other effects of time can begin to change the appearance of our eyes. Some people feel as if this makes them feel older, or look older. Many women also feel insecure about the shape of their eyelids, even from a young age. Also, health conditions that come as a result of aging can also impact vision, and eye health if left unchecked.

Eyelid surgery is a great way to rejuvenate the skin around the eyes, or reshape your eyelids in order to feel younger and more beautiful. Depending on the part of your eyelid you need work on, and the look you are going for, there are a few types of eyelid surgery.  In this article, I am going to review the 3 types of eyelid surgeries so you can learn which one is best for you.

3 Types of Eyelid Surgeries

If looking in the mirror, you notice the signs of aging around your eyes such as:

• Tired or droopy eyes

• Puffiness, or bags under your eyes

• Forehead wrinkles

• Heavy or lowered eyebrows

• Frown lines

• Other lines or wrinkles on the forehead or brow

Eyelid surgery may be appropriate for you. For women looking to brighten the appearance of the eyes, eyelid surgery is one of the best options. Depending on which one of these signs of age you are trying to improve, one of three types of eyelid surgery may be best for you.

1. Upper Eyelid Surgery

Do your upper eyelids look wrinkly or droopy or old?

Upper eyelid surgery, also called upper blepharoplasty, rejuvenates the area of your eyes right below your brow to help:

• Reduce wrinkles

• Get rid of excess skin

• Lift droopy eyelids

• Achieve a youthful contour

• Brighten the appearance of the eyes

Upper eyelid surgery is typically a quick office procedure that can be performed under local anesthesia. The recovery time is typically short lasting a few days up to a week.

Here is a brief overview of what you can expect during upper eyelid surgery:

Common Reasons to Undergo Upper Eyelid Surgery:

• Aging Eyes: The most common reason people undergo upper eyelid surgery is to rejuvenate aging eyes by removing excess upper eyelid skin, which is a condition called dermatochalasis. Upper eyelid surgery is commonly performed along with lower eyelid surgery to brighten the eyes.

• Obstructed Vision: When severe enough, having excess upper eyelid skin can interfere with vision. In these instances, upper blepharoplasty can relieve the visual obstruction by removing the skin that is interfering with eyesight.

• Droopy Eyes (Ptosis): Sometimes with age the upper eyelid becomes droopy or sagging, a condition called ptosis. When ptosis occurs, the upper eyelid appears droopy and the eyes small because the upper eyelid cannot be held upward in its normal position. Ptosis occurs when the levator muscle that is responsible for lifting the upper eyelid is stretched, weakened, or damaged due to getting older (or, in some cases, due to trauma, genetics, or nerve damage). Upper eyelid surgery including ptosis repair can tighten or repair the damaged muscle, lifting the droopy eyelid upward so that the upper eyelid can be held in its natural position.

2. Lower Eyelid Surgery

Are you suffering from bags under your eyes? Or perhaps your eyes make you look tired because you have dark circles or wrinkles under your eyes.

Lower eyelid surgery, also known as lower blepharoplasty, can help restore a firmer, more youthful appearance to the eyes by contouring fat pockets under the skin, firming the muscles and support tissues of the eye, and removing sagging skin.

The procedure can help to:

• Reduce bags or puffiness under the eyes

• Reduce hollowing under the eyes

• Reduce dark circles under the eyes

• Reduce wrinkles under the eyes

• Restore a more youthful and refreshed appearance to the eyes

Lower eyelid surgery is typically a quick outpatient procedure that can be performed under local anesthesia or twilight sleep. The recovery time is typically short lasting a few days up to two weeks.

Nonsurgical Alternative to Lower Eyelid Surgery: For some patients, particularly those who are younger with milder signs of aging, the lower eyelids can be rejuvenated using a nonsurgical approach combining filler treatments, Botox treatments, and skin treatments such as laser, IPL, and chemical peels. Unlike surgery, however, the results from nonsurgical treatment are temporary in nature and require regular maintenance treatments. You can learn more about nonsurgical treatmetnts for the lower eyes here.

Here is a brief overview of what you can expect during lower eyelid surgery:

Common Reasons to Undergo Lower Eyelid Surgery:

• Aging Eyes: The most common reason people undergo lower eyelid surgery is to rejuvenate aging eyes. Lower eyelid surgery can reduce lower eyebags, hollows, and wrinkles to achieve a more youthful contour to the eyes. Lower eyelid surgery is often performed together with upper eyelid surgery to brighten the eyes.
• Lower Eyelid Malposition: Lower eyelid surgery can also be performed to help people with abnormal lower eyelid positions such as ectropion, a condition in which the lower eyelid rolls outwards from its normal resting position, or entropion, the opposite condition in which the lower eyelid position rolls inwards towards the cornea. Both conditions can cause chronic pain, discomfort, irritation, and inflammation of the eye. Lower eyelid surgery can help restore the lower eyelid to its normal position reducing discomfort and irritation.

3. Asian Double Eyelid Surgery (aka. Asian Blepharoplasty)

A common ethnic feature of people of Asian descent is the absence of a distinct upper eyelid double fold (monolid or hidden double lid). Many women and men enjoy this distinct ethnic feature, but others find it frustrating because the absence of a distinct double fold makes the eyes look smaller and therefore less attractive (and sometimes even tired appearing). Asian double eyelid surgery is very popular for enhancing the beauty of the eyes and is even a rite of passage for some.

Asian double eyelid surgery, also known as Asian blepharoplasty, can help create larger, more attractive eyes by creating a double fold and, in some instances, by enhancing the shape of the corners of the eyes (epicanthoplasty).

Asian double eyelid surgery is typically a quick office procedure that can be performed under local anesthesia. The recovery time is typically short lasting a few days up to two weeks.

Here is a brief overview of what you can expect during Asian Double Eyelid Surgery:

Eyelid Surgery vs. Brow Lifts

One last thing to touch on before speaking more about who are the best candidates for eyelid surgery - how does eyelid surgery compare to a brow lift?

Upper eyelid surgeries remove droopy skin from the upper eyelid to create a more youthful appearance to the eyes. For many patients with excess skin or droopy eyelids, an upper eye lift is the only procedure that is needed.

However, for some patients, drooping of the forehead and eyebrows can also be a problem. In this situation, additional brow lift surgery must also be done to lift and smooth the eyebrows and forehead.

Who Is Eyelid Surgery Best For?

Eyelid surgery is best suited for people who are unhappy with the appearance of their eyes. Most commonly, this is due to changes such as wrinkles, sagging, dropping, eyebags, hollows, and discoloration that occur as part of the aging process and cause the eyes to look old, tired, or droopy.

In these instances, eyelid surgery can help brighten the eyes are restore a younger, more rested, and more youthful look to the eyes. 

Here are the most common eyelid conditions that cause people to undergo eyelid surgery:

1. Excess Upper Eyelid Skin

Excess upper eyelid skin, a condition called dermatochalasis, produces hooding of the upper eyes that causes the upper eye to look old or baggy. Typically as the eye ages the elasticity and underline structural support of the skin weakens which stretches out the skin and causes it to droop. This can interfere with your ability to put on makeup as well as inhibit your eyesight as it worsens with time.

2. Droopy Eyes

Droopy eyes, also called ptosis, are a condition in which your upper eyelids sag a little or even cover your pupil. Droopy eyes may occur in one or both eyelids. The condition usually isn’t painful, but it can block your eyesight. In some instances, droopy eyes can be caused by injury or disease that weakens the muscles, ligaments, or nerves that raise the eyelids. In most cases, however, drooping is caused by aging. The skin and muscles around the eyes stretch or weaken. Upper eyelid surgery can correct this condition.

3. Eyebags & Dark Circles

Eyebags cause your eyes to look puffy or tired and sometimes creates dark circles. Eyebags can be a feature that is inherited (and seen as early as your 20’s or 30’s), but it more commonly develops with age due to protrusion of fat pockets (“fat herniation”), loss of skin elasticity, loss of tissue volume, and sagging of the eye and cheek. Lower eyelid surgery, as well as injectable fillers and laser treatments in some cases, can help improve the condition.

4. Tired Eyes

The eyes can look tired from a combination of sagging skin, droopy eyelids, and eyebags. Upper and/or lower eyelid surgery can help rejuvenate tired eyes.

5. Blocked Vision Due to Hanging Skin 

Severe hanging upper eyelid skin can sometimes block vision. In these instances, upper blepharoplasty can relieve the visual obstruction by removing the skin that is interfering with eyesight.

6. Abnormal Lower Eyelid Position 

Some people have abnormal position of the lower eyes such as ectropion, a condition in which the lower eyelid rolls outwards from its normal resting position, and entropion, the opposite condition in which the lower eyelid position rolls inwards towards the cornea. Both conditions can cause chronic pain, discomfort, irritation, and inflammation of the eye. Lower eyelid surgery can help restore the lower eyelid to its normal position reducing discomfort and irritation.

7. Absent or Hidden Upper Eyelid Double Folds 

Absent or hidden upper eyelid double folds is commonly seen in people of Asian descent. Asian double eyelid surgery can create or enhance double folds to enhance the beauty of the eyes.

How Can You Learn More About Eyelid Surgery?

Are you considering an eyelid surgery, but still looking for more information to determine if the procedure is right for you?

No problem. My name is Dr. Larry Fan. I’m a Harvard educated, Board Certified Plastic Surgeon who has been named One of America’s Top Plastic Surgeons for the past 10 years running, and the founder of 77 Plastic Surgery in San Francisco.

I believe in educating and empowering my patients, so I created a quick Cosmetic Self Evaluation that you can take online in as little as 30 seconds to help you learn if you are a good candidate for eyelid surgery.

What Type of Eyelid Surgery is Right for You? 

Click this link to take the Cosmetic Self Evaluation, Cosmetic Self Evaluation.