The eyelids are frequently the first to show the signs of aging - resulting in a tired, sad appearance. This is very apparent because the eyes are the first structure that we notice in a person's face. The problems we confront with the eyes are really two-fold. First, there may be excess skin in both the upper and lower eyelids. The excess skin of the upper eyelids may also be caused by sagging of the forehead and eyebrows. (A Browlift should always be considered when evaluating the upper eyelids.)
The second problem is the accumulation of fat which causes "baggy" eyelids. This is frequently present in both the upper and lower eyelids. Initially, the bags are noticeable only on awakening in the morning. As the problem becomes more severe, this puffy look persists throughout the day. This tendency is inherited and may appear very early in life, even in the teens and twenties before the aging process becomes obvious.
In the upper eyelids, we make the incision in the folds of the upper eyelid. Excess skin is removed and tiny stitches are placed (for six days). In the lower eyelid, the incision is made in the natural crease immediately below the eyelashes. (Again, the stitches remain for six days.) In cases where only fat has to be removed from the lower eyelid, we make the incision on the inner surface of the eyelid, with no external incisions. In this procedure, the patient avoids the temporary inconvenience caused by the healing of the skin incision. Allow seven to ten days for all bruising/discoloration to disappear. No bandages are required. After one week, our patients can use makeup to camouflage any residual bruising.