Upper Lid Blepharoplasty can be a very powerful procedure to produce a more youthful appearance to the upper face and peri-orbital (around the eyes) region. It can also significantly improve peripheral vision when it is caused by drooping of the eyelids. As scars are well-hidden and downtime is minimal, this has become a very popular surgery for both men and women of various ages. A deeper dive into the anatomy of the upper lid reveals this procedure often involves correction of more than just skin.
- Dermatochalasis: This term refers to redundant upper eyelid skin that most patients notice as they age. This skin is always addressed during the procedure.
- Orbicularis Oculi Muscle: This important muscle serves to help close the lid for eye protection. This muscle becomes weaker as we age. The muscle also serves as volume for the upper eyelid. Due to this loss of fat volume with age, the eyes can take on a hollow appearance. Dr. Lefkowitz ALWAYS preserves the muscle during this procedure. He feels strongly that this muscle should be left intact and functional throughout a patient’s life.
- Nasal Fat Pad (fat closest to the nose): This fat pad plays a vital role in the aesthetics of the upper eyelid. Throughout life, this fat pad actually gets larger and more prominent. Patients will sometimes notice a “bulge” of their upper eyelid close to their nose. This is created by the nasal fat pad. Often times, this excess fat can be used to improve the contour of the eyelid, spreading it over the middle part of the eyelid to add volume to a hollowed appearance (see below).
- Pre-aponeurotic Fat (fat of the middle upper eyelid): This important fat layer is distinct from the nasal fat pad and also acts differently as we age. This fat lessens over time and loses volume during the aging process. This is a major reason why upper eyelids in youth are full with good contour and eyelids in older people look hollow and harsh. Because this fat is precious, Dr. Lefkowitz almost always preserves this fat pad to maintain youthful volume. In addition, he will often times use the nasal fat pad to augment volume in the middle of the lid due to the natural volume loss that occurs in this region with time.
- Brow Fat Pad: This fat is seen towards the outside and located on the lower aspect of the brow. With age, this fat pad descends downward and can produce a heavy and hooded appearance to the eyes. If this occurs, Dr. Lefkowitz can use sutures to help improve the position and to minimize the risk of further descent.
Dr. Lefkowitz will thoroughly review your concerns and help you design a treatment plan to best achieve your goals and optimize your outcome based on your individual anatomy.
