I see more patients asking for an eyelid lift alone than any other rejuvenating facial procedure.  It is in fact one of the first facial areas that get to the point where only surgery can address unwanted changes such as lower eyelid “bags,” and excess skin that folds in the upper eyelid causing a “tired” appearance.  If caught early, careful use of muscular denervating agents such as Botox can give the eyes a more “open” appearance by weakening a portion of the muscle that causes squinting and “crow’s feet” and even elevating the lateral half of the eyebrow.  But ultimately, most people arrive at a stage where only surgery will address their issues. 

When performing eyelid surgery, I try to remove as little fat as possible around the eye in order to prevent a “hollowed out” appearance later in life.  Rather than removing fat, I try to reposition the fat and the lower eyelid muscles so that they don’t droop.  I think that this gives a better and more long lasting result that removal of fat from around the eye.

Often, I feel that lifting the cheeks, when they too have started to droop, provides for a more congruous rejuvenated appearance in the lower eyelids.  I don’t perform cheek lifts through the incisions necessary to perform upper and lower eyelid lifts.  In order to have this done at the same time, a short scar face lift incision is necessary.  This is optional, but can sometimes provide a much more dramatic yet natural appearing result.