Thursday, May 20, 2010

Eyelid Lift

A patient came to our office today requesting advice on her upper eyelid and brow region, which she feels gives her an aged appearance more so than any other area of her face. She said she had seen another doctor who had recommended a browlift and was wondering whether this was the best approach for her features. In looking at her, she has a nice, full upper eyelid and brow region, meaning she has not had a great deal of volume loss in this area which is common in most people her age group (mid-60s). She also has a nice shape of the brow hairs, with the inner portion beginning at the bony rim of the brow, arching upward toward the temple, and then descending back down to the bony orbital rim so that the beginning and end of the brow is essentially on a horizontal plane; what frequently occurs is that the outside or temporal side of the brow hairs begin to drop downward toward the cheek with age. That really is not the case with this patient today. She does however have a moderate amount of skin excess of the upper eyelid and I told her this was the main thing that I would recommend that we address. She was relieved that we did not feel that she needed a browlift, as she did not want to disturb her hairline and while I told her that there was a type of browlift which would not move the hairline backward, we again do not feel that she needs this type of browlift either.

The type of discussion above is one that I have had numerous times with patients, where we educate them about the state-of-the-art approach to the upper eyelid and brow region, which is that of maintaining a more full and natural brow such as that of Brooke Shields and other models who do not have high brows at all, but rather have brows as described above. It is important to emphasize the need for not just skin removal from the upper lid, (blepharoplasty), but also to stress the importance of replacing the volume of the upper eyelid and brow region that we all lose with age. Replacement of this volume is best done with fat transfer, also called lipotransfer, and to see examples of fat transfer to the eyelid region, please take a look here.

To see before and after pictures of patients that have had the excess skin removed please click on this link.