Keeping the eyes looking fresh and age-less is an important part of the self-care goals of many of us wanting to look and feel our best. Eyes happen to be the most noticeable assets about a person but unfortunately the first place to show signs of aging. Eyelid surgery (blepharoplasty) is a popular cosmetic procedure to correct puffy eyebags under the eyes or droopy upper eyelids. In addition to eyelid surgery, many people often choose to also have other facial procedures like a brow lift or facelift for an overall enhanced effect.

Dr. Joel Kopelman’s podcast called ‘Beauty Doc’ gives some great insights into eyelid cosmetic procedures. Here are some really good take-aways from this leading oculoplastic surgeon’s candid conversation with his guest, Dr. Jonathan Hoenig who is a very popular facial and eyelid surgeon in Beverly Hills, Los Angeles.

According to Dr. Hoenig, “currently the number of eyelid surgeries performed all across the United States is 200,000 according to the American Society of Plastic Surgeons. But the actual number may be much higher because many eyelid surgeries are often performed as part of other facial surgeries.”

 

Common causes of puffiness in the eyes

 

Dr. Hoenig says that the eyes often get stretched and look dull “because of a tug-of war effect. This usually happens when our eye-to-forehead tissues get stretched due to our constant need to keep pulling our brows up whenever we are stressed out.” 

 

Also over time, our brows change shape because of all the squinting and squeezing that we do in one single day. They sort of get pulled up a little higher and give a hollowed look to the eyelid. The eye muscles also get stuck in particular shapes and positions, losing their natural elasticity. 

 

Reshaping the eye through mild surgical procedures can help reduce the puffiness by adding volume and bringing a natural fullness which is youthful. For this, most surgeons first try to determine the exact configurations of your eye. From understanding the exact shape of the brow to the presence of any extra skin, these doctors will have in-depth discussions with you before the actual surgery. 

 

Most women also want to know more about the crease and the area where they usually apply eye-shadow. Dr. Hoenig says that it is important for him to have discussions with his patients about how high or low that platform should be before actually performing the surgery. Leaving a little bit of a fold of skin, according to him, also works really well to hide the signs of incisions. 

 

The Blepharoplasty 

 

A blepharoplasty is cosmetic surgery of the eyelids and is not considered to be a very simple procedure. According to Dr. Hoenig “our eyelids are made up of many different layers- bone, muscles, fat and skin, aging can occur in any of those layers.” That is why using off-the shelf eye creams never work for more than a few days. Because these eye creams only scratch the surface (quite literally!).

 

Aging also tends to hollow out the skin under the eyes. Doctors use many technologies like laser, electric needle or blade, cosmetic surgeons to uplift the hollowed out part and reduce puffiness. This brings back the fullness to the eyes and gives them a refreshed look.

 

Dr. Hoenig talks about how he sometimes uses injectable Hyaluronic acid fillers, like Juvederm to bring a fulsome look to the hollows in the lid. These fillers work great. But the doctor also warns against using needles for injectables which can cause damage to the eyes. He says that most expert eyelid surgeons are actually using blunt straw-like cannulas, rather than sharper needles to inject fillers and also preserve your eyes and vision.

 

Cosmetic surgeons also use peels, lasers and topicals to brighten the dull, dead skin around the eyes and give them a smoothened, wrinkle free look. This part of the procedure depends on a lot of factors like the person’s skin quality, gender and even ethnicity.

 

Baggy Lower Lid Surgeries

 

Baggy eyelids can make you feel a little more tired than usual bringing your productivity down. They also make you look a lot older than you actually are. Sitting in front of computers for long hours of the day often leads to bagginess under the eyes. Dr. Hoenig says that “ under eye bags can either come from the extra skin around the eyes which festoons into layers, or even loose eye muscles.” 

 

Dark eye circles are probably just as common today as baggy eyes. The outer skin under the eyes can get darkened because it could be a little thinner. Or it can also come from the color of the underlying eye muscles which can become negatively affected by stress and other irritants. To remove these circles, Dr. Hoenig says, very specific surgeries combining all of these processes, are generally performed. Because everybody’s eyelids are very different, surgeons have to cater to the patient’s very specific needs. Dr. Kopelman also points out that “the exact procedure cannot be determined without prior consultation because it is important to exam the quality of the skin around the eyes.”

 

Some procedures are performed by adding small amounts of fat to the eyelid which is taken from fat pockets from the patient’s own body, helps to uplift the lower eyelid to bring back the freshness and reduce the puffiness. But most surgeons prefer not to add more fat in pre-menopausal women or younger men’s eyelids, because in their cases the faces are constantly changing shape and growing big or small in size. This can cause the fat in the lower eyelids to also grow and create other future eye problems. To solve such an issue though, surgeons often liquefy the extra fat.

Eyelids are very delicate and highly sensitive organs. Both doctors agree that a little goes a long way when it comes to eye-lid surgeries. In the case of having too much fat taken out of the eye in slightly more aggressive procedures, revisions can become necessary for the patient. The doctors also take care not to remove too much of the extra skin from the eyelid so the patients can close their eyes well, even when they are lying down in order for your eyelids to protect your eyes well. Ultimately, it is important that your eyelid procedure be performed by an expert.