What is Blepharoplasty?

Blepharoplasty – Eyelid lift, Eyelid Tuck


We hear it all of the time – the “eyes are the windows to the soul.” Often, they are the first feature that people notice about you. Surveys show that two-thirds of adults consider their eyes to be their defining facial feature. Your eyes play a crucial role in expressing your mood, character, and feelings. For example, the shape of your eyes, whether they reflect sadness or happiness, and the presence of wrinkles, dark circles, or bags under your eyes, shape your facial expression and thus affect how you are perceived, and how others may interact with you.

Have you ever awakened from a good night’s sleep, feeling rested and refreshed – only to see a tired face in the mirror? This is a concern that I hear from many patients, who are otherwise in good health, but who have drooping upper eyelids, and bags below their eyes. They are annoyed when they are asked if they are tired! Fortunately, the option of eyelid surgery – or Blepharoplasty – can safely help them to regain the rested, energetic look of their younger days.

What Is Blepharoplasty?

Blepharoplasty, or Eyelid Lift, or Cosmetic Eyelid Surgery, is one of the top three cosmetic surgery procedures performed in the United States. Between 1997 and 2002, the number of patients undergoing Blepharoplasty increased by 44 percent because it is so effective. In 2005 alone, 231,000 patients underwent procedures to tighten drooping skin on their upper eyelids, remove the puffiness, or “bags” below their eyes – or both. Because the skin of the eyelids is so thin and delicate, the eyelids tend to droop before the rest of the face. Blepharoplasty surpasses facelifts, rhinoplasty (“nose jobs”), and forehead and brow lifts as a commonly performed procedure for “freshening up” a fatigued looking face.
Eyelid Surgery or Blepharoplasty can be both aesthetic, and functional. Sometimes, eyes are damaged by trauma, infection, inflammation, degeneration or by developmental deficiencies. Blepharoplasty can help the eye to be functionally normal. It also serves a cosmetic purpose, restoring and rejuvenating the appearance of the eyes for a more youthful and alert appearance.

Many men who would not otherwise consider cosmetic surgery do undergo Eyelid Surgery. In some cases, they feel it is a necessity to remain competitive in today’s challenging, and increasingly youth-oriented, workplaces. Also, many people will undergo Eyelid Surgery as a way to freshen their appearance while they delay having a Full Facelift.

What Causes Eyelids to Age?

Like so many of our features, the eyes are subject to your genetic history. How many times have you heard someone say that they look into the mirror and “see my mother looking back at me”? Other factors include sun damage, smoking, stretching from obesity, blinking and rubbing and just plain aging.

Consequently, the excess upper eyelid skin hangs over the normal lid crease and even starts to impinge on the eyelashes. This results in eyes that appear smaller and more tired looking. You might also feel heaviness and drooping in your upper eyelids after reading for a short time.

The medical term for the aging of the eyes is called Blepharochalasia which is characterized by excess eyelid skin, lax eyelid muscles, and excessively protruding fat pockets.

Blepharoptosis is another term which refers to the abnormal sagging or dropping of the upper eyelids, which gives people the appearance of sleepy eyes. Blepharoptosis is in fact a functional eyelid dysfunction characterized by the inability of the upper eyelids to keep open fully and to lift up when gazing up. Blepharoplasty is the surgical procedure designed to correct Blepharochalasia, or aging eyelids. It does not correct Blepharoptosis or sagging of the upper eyelids.

How about the lower eyelids? Usually, by a person’s late thirties or early forties, the thin skin of the eyelids begins to lose its elasticity. Collagen in the skin decreases, and the thinning of the skin causes the underlying fat to show. Additionally, the soft tissues of your cheek and of the middle of your face lose tone, and become subject to gravity. When this happens, imperfections in the lower eyelids become more noticeable, and bulges and bags appear.

Unlike the popular belief that lower eyelid bags only develop as a result of aging or sun damage; there are many young people who suffer from baggy lower eyelids or Blepharochalasia. In fact, these people are quick to show photos with the lower eyelid bags that they had as teenagers. This excess bulging of lower eyelid fat in a young person is not caused by aging, but is a congenital deformity commonly known as “herniated orbital fat” – or the hernia-like bulging of the fat out of the eye socket.

Are Eyelids Affected by Ethnicity?

There is a great variation in the character of the eyelids between people of different ethnicities and skin types. This affects the aging of their eyes.


Those of Anglo-Saxon heritage and who have very fair skin, are often more affected by the sun damage and tend to develop wrinkles and brown spots at a much earlier age. People of Mediterranean descent generally have thicker and oilier eyelid skin which stays firm longer. At the same time, men and women of Mediterranean and Middle Eastern descent tend to have more dark pigment in their eyelids, which makes their eyes look deeper or at times more tired. Asians and those of African heritage tend to have very thick eyelids with an abundance of underlying skin fat. While this keeps the eyes looking youthful at an older age, it can also cause more drooping of the eyelids due to the weight of the subcutaneous fat. This fat also “fills in” the eye socket giving the eyelids more of a slanted look; whereas Caucasians usually have deeper and narrower eye sockets which give them the appearance of having more “open” eyes.

During your consultation Dr. Younai will review your treatment options for Eyelid Rejuvenation Surgery or Blepharoplasty, including pros and cons of each procedure, potential risks and complications, recovery course, pre and post operative instructions, and esthetic outcomes. There are also many before-and-after pictures and high resolution images of Facial Plastic Surgery and Eyelid Surgery available in our photo gallery.

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Our center also includes the Regency Surgery Center which is a state-of-the-art outpatient surgery facility certified by Medicare and accredited by the Accreditation Association for Ambulatory Health Care (AAAHC) and the American Association for Accreditation of Ambulatory Surgery Facilities, Inc., (AAAASF).

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