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Blepharoplasty Los Angeles Eyelid Surgery -Eye lid Lift Beverly Hills

The eyes are the first to be affected by aging. The eyelids skin are thin and delicate, the skin can wrinkle, bag, and fat protrude. Depending on the genetics involved, this aging process can begin at a disconcertingly young age, but it is usually somewhere in the early thirties that people begin to notice changes (earlier with sun exposure).

Cosmetic eyelid surgery is evolving right along with the rest of facial plastic surgery. At its simplest, blepharoplasty involves the removal of excess fat and excess eyelid skin, either through an external incision just under the lash line or just inside the lower lid in the conjunctiva. (Remember the kid in grade school who used to turn his eyelids inside out and scare everybody? That's the transconjunctival incision area.) However, there's much more than that to modern occuloplastic surgery.

With endoscopic brow lift and skin resurfacing most of the signs of aging in the upper eyelid area can be corrected without a traditional upper eyelid surgery. "Rejuvenating the eyes with an endoscopic browlift is a wonderful breakthrough for many reasons," believes Dr. Simoni. The eyelid skin is very specialized. It's thin and delicate and irreplaceable. Removing this lid skin in an upper lid lift can impair the blink function since what's now moving over the eye is thicker brow skin. Dry eyes can also be exacerbated, affecting reading, photography, and a whole host of pleasurable activities.

"Lower lid blepharoplasty has made exciting advances as well," says Dr. Simoni. "We're able to reposition fat and simultaneously tighten the skin, all without visible incisions." Those protruding pouches of flesh under the eye are most noticeable in the morning, when fluids are retained. But Mother Nature didn't give anyone an over abundance of  eye fat. Traditional techniques of fat removal eventually lead to a hollow, sunken look. So instead of taking it out, the surgeon can use the fatty tissue to hide the bony orbital rim. Through an incision hidden inside the lid the fat is repositioned and sutured into place. The result is a smooth, scar-free lower lid.

Sometimes an external incision is necessary, but excess skin can often be addressed with a mild TCA solution (20-25%) of the periorbital region. All but the deepest creases will be erased.

Frequently Asked Questions

Q: I have rather prominent epithelial folds below my eyes; would liposuction give them a flatter and less prominent appearance?

A: The epithelial folds under the eyes can be caused by a number of factors. Long-term squinting (eg, growing up in the sunbelt) can cause hypertrophy of the obicularis muscle around the eye very early, look at Gwyneth Paltrow. Wearing your sunglasses can prevent cataracts and muscle-bound lids! Chronic allergies or herniation of fat as the eye ages can also cause prominent epithelial folds. In our practice the herniated fat is re-suspended, not removed. Putting it back where it belongs gives the eyelid region a smooth, youthful contour. Taking the fat out through a traditional eyelid surgery tends to skeletonize the eye area. The eye may look better without the fat and folds, but it won't look any younger.

Q: Will a cosmetic eyelid surgery fix the lines around my eyes?

A: The fine lines of the lower eyelid skin can be addressed with either a TCA peel or laser resurfacing. The upper layers of the skin are removed causing new skin to re-grow over the area of injury. A newer method to repair the fine lines involves non-ablative lasers. These lasers use light which passes through the upper layers of the skin without destroying the tissues. The laser light causes some mild thermal (heat) damage to the undersurface of the skin, encouraging the body to respond by forming new collagen. The new collagen makes the lower eyelid skin thicker and less wrinkled.

Q: Is eyelid plastic surgery safe?

A: Overall, eyelid surgeries is a very safe procedure with consistent results. There are over 500,000 blepharoplasties performed in the US every year. Vision loss is extremely rare. In our practice the emphasis is on rejuvenation, helping patients look younger and better. Our first choice is an endoscopic brow lift rather than upper blepharoplasty. Use your fingertips to elevate the eyebrows and you'll notice that the 'excess' eyelid skin disappears. Surgically restoring this youthful brow position often corrects any upper lid redundancy and avoids sacrificing any of the highly specialized lid skin. As an added bonus an endoscopic browlift leaves no visible scars.

Q: Five years after my upper lid lift at age 41 I am noticing some overhang, I use Botox and my forehead has very few wrinkles; What next?
A: An upper eyelid lift doesn't elevate the brow; if anything it pulls it down a little lower. What you may be noticing is the continuing descent of your forehead skin as the muscles beneath it relax and stretch. Botox, if administered horizontally across the forehead, will contribute to this significantly by relaxing the brow muscles that normally elevate the brow skin. Whether or not you can have an endoscopic browlift will depend on how much lid skin was removed in your previous surgery. Do the test we use in our office. Try putting your fingers above your eyebrows and elevating the skin. This will simulate the surgical result of an endoscopic browlift. Gently close your eyes while holding the brows up. Can you fully close your lids without straining? You may have to wait until you have even more tissue relaxation before having another surgery. We do not recommend repeating the blepharoplasty.

Q: A year ago at age 30+ I had my lower lid bags removed and how have rounded eyes where the whites show and hollows which make me look worse; what can help?

A: You are describing what sounds like a 'hound dog' or 'round eye' deformity. To avoid these complications of traditional lower eye surgery, we are extremely conservative with lower eyelid fat or skin. We prefer to re-suspend the orbital fat which eliminates the fat herniation ('bag') and avoids exposing the bony orbit around the eye ('hollow look'). The ideal subconjunctival (inside) incision keeps the lid from scarring down and exposing the sclera (white). Suggestions to pull on the lid skin will not work, nor will the fat return on its own. Depending on the nature and severity of the deformity, a canthopexy (re-suspension of the lower lid), mid-facelift, and/or microlipotransfer of fat may help correct it. Revision surgery is tricky, though, and is of paramount importance that the lid function (a proper blink) is preserved or restored. This will be the deciding factor behind how much can be done to improve the appearance of the eyes.

Call us today to schedule your consultation!

Contact us for eyelid surgery in Los Angeles and Beverly Hills, California at (310) 360-1360. Dr. Simoni offers a wide variety of cosmetic procedures for the face and body, both surgical and non-surgical, to fit your every need and desire.

Please check out our before and after photos eyelid surgery above, as well as our video of Dr. Simoni explaining how eyelid surgery works. Eyelid surgery is generally a very safe surgery with over 500,000 procedures performed each year. The eyes are generally the first facial feature to be affected by aging due to the delicate tissue surrounding the eye. Having corrective surgery to reduce this affect can make a noticeable and lasting difference.

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