Rejuvenate Your Look with Lower and Upper Eyelid Surgery in the Philadelphia Area
The eyes and area around the eyes make up what is arguably the primary focal point of the face, especially when two people are engaged in conversation. Unfortunately, this is also an area that, for many people, shows signs of aging beyond that of the rest of the face or body. Eyelid surgery, known as blepharoplasty, at the Philadelphia area's Cross Plastic Surgery, is a sophisticated procedure that can restore a more youthful look to the eye area.
Blepharoplasty surgery can also address sagging lids that intrude into a patient's field of vision.
An important concept to understand when considering blepharoplasty is that eyelids that look older or more tired often look this way for a combination of reasons. Not only do youthful eyes have a minimal amount of extra skin, but they typically also have good volume. Since the face loses fat, thins, and sags over time, the eye area loses much of this volume as it ages.
Dr. Kevin Cross equates this volume to high tide. When the tide is high, the rocks, stones, and irregularities on the beach underneath are not visible. As the tide recedes over time, the poor underlying contours are revealed. For many patients, restoring volume is the equivalent of bringing the tide back in.
Too often, surgeons performing blepharoplasty procedures remove fat and skin, but don't recognize the importance of restoring youthful volume. Dr. Cross feels that achieving the optimal result for blepharoplasty must include customizing the procedure to the individual patient's anatomy and needs.
Upper Eyelid Surgery
When examining the upper eyelids before blepharoplasty, Dr. Cross always starts his exam with the eyebrows. With age, eyebrows often descend and rotate down toward the outer region of the eyelid. This leaves excessive hooding over the eyelids of many patients. When this occurs, the eyebrows must be corrected, using one of many hooded eye surgery techniques that Dr. Cross outlines on the brow lift page. In some cases, ignoring the contribution that the brow makes to the eyelids will leave the patient with hooding, even after the eyelids are corrected with blepharoplasty.
Not all eyelids require surgery to look more youthful. Many times, Dr. Cross will recommend chemical peels, lasers, and volume restoration with fillers or a patient's own fat to replenish what has been lost. When upper eyelid skin is excessive, or fat is bulging, however, a blepharoplasty procedure is likely necessary. Dr. Cross positions the incision necessary for upper eyelid blepharoplasty surgery within the natural crease of the eyelid. This hides the incision, making it essentially imperceptible once the healing process is complete.
From this incision, Dr. Cross can remove excess skin and tailor the appearance of bulging fat pads. Everyone has these fat pads, but they can push forward and become more pronounced with age, creating puffiness under the skin and an appearance of excessive tiredness. By trimming and tucking the fat pads during blepharoplasty surgery, Dr. Cross achieves a more youthful shape and arch to the eyelid.
*Results May Vary
Before & After Photo Gallery
See for yourself the patient transformations that can be achieved by Dr. Cross and his team.
Lower Eyelid Surgery
Dr. Cross explains that, for many youthful people, the lower eyelid naturally blends with the cheek—often making it difficult to tell where the cheek ends and the eyelid begins. With age, the lower eyelid frequently becomes elongated and shadowed, with areas of darkness and significantly more wrinkled skin. A very noticeable transition between the cheek and eyelid becomes apparent.
As with the upper eyelids, Dr. Cross will often recommend non-surgical options instead of blepharoplasty for patients with certain types of changes in the lower eyelids. Resurfacing the skin to improve its quality and texture, along with correcting shadows and dark areas with volume restoration, will improve the appearance of many patients and help to blend the eyelid/cheek transition region.
When blepharoplasty surgery is recommended, Dr. Cross often performs rejuvenating procedures for the lower lids through an incision placed on the inside of the eyelid—involving no external incisions or scars. In cases where external incisions are necessary, Dr. Cross hides them in a natural position just under the eyelashes, making their appearance unnoticeable.
He then uses the incisions to reposition and trim bulging fat pads, eyelids that have started to droop and sag, and excess skin. He will often harvest fat that is excessive and bulging in one area, then move it to another area where it is depleted to help smooth and equalize the contours. This blepharoplasty technique can help to blend the regions in areas where there are shadows and depressions. When extra fat is needed, Dr. Cross uses a number of fat grafting techniques to ensure the result looks natural and even.
General Blepharoplasty Details
Blepharoplasty surgery may involve specific techniques used on one or both upper lids, one or both lower lids, or all four. The overarching goal of any lower or upper eyelid surgery is to rejuvenate the eyes and eye area, as well as to create a balanced and symmetrical look. A blepharoplasty procedure can also improve a patient's ability to see, since sagging upper lids can interfere with an unobstructed field of vision.
Most blepharoplasty surgeries can be performed with the patient under a "twilight" anesthesia or a deeper anesthesia—though a breathing tube is rarely necessary. Our anesthesiologists now use a technique called "TIVA" anesthesia that is very effective in preventing any nausea or vomiting.
Dr. Cross has made a number of advancements to help reduce bruising and swelling after blepharoplasty surgery. This includes a formulation in his numbing medicine that stops bruising before it has a chance to develop.
Patients are able to go home a few hours after completion of their blepharoplasty procedure. They will be given a regimen of prescription drops and ointments to use during the first week after eyelid surgery to help reduce swelling and speed their recovery. Exercise is avoided for one to two weeks, but all other normal activities can be resumed right away.
Patients return to the office five to seven days after their procedure. At that time, any remaining post-blepharoplasty bruising and swelling is addressed with a number of in-office treatments. Dr. Cross's goal is to get patients feeling comfortable in light social situations in less than one to two weeks after their blepharoplasty surgery.
Facial Procedures Beyond Blepharoplasty
Signs of aging lower on the face also involve sagging tissues, which can change the overall facial shape from a youthful "heart" to a boxy square. Dr. Cross uses a facelift or neck lift to remove and reposition fat, excess skin, and other tissues as necessary.
Patients who want to address signs of aging in the area, such as crow's feet, but who do not want surgery, can choose BOTOX®. Known as a "neuromodulator," this injectable keeps wrinkle-forming muscles at rest for months at a time. Other neuromodulators available include Dysport® and Xeomin®.
Dr. Cross will work with you, starting at your consultation, to determine which treatments or procedures can work together to rejuvenate your overall face so that no one area draws attention for looking aged or overly youthful