Eye Lift | Face Surgical Procedures | Dr. Sheila Nazarian
The eyes are a major focal point on the face so when they don’t radiate vitality, it can make you look and feel tired, even when you’re not. A blepharoplasty or eyelid surgery is a surgical procedure to improve the appearance of your upper eyelids, lower eyelids, or both. As one of the most commonly performed facial cosmetic procedures in this country, eyelid surgery is often a patient’s induction into the surgical side of aesthetic plastic surgery.
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When considering any kind of aesthetic procedure, whether surgical or non-surgical, it is important that you first be assessed in person. During your in-office or virtual consultation at her Beverly Hills office, Dr. Nazarian will listen to what bothers you about your eyes. She will inquire into your medical history, family history, skin care regime, diet and exercise routine and whether or not you have had any prior procedures including Botox, fillers and lasers. Then, she will perform a thorough physical examination to assess your:
amount and location of excess skin and/or fat in the upper lid
upper eyelid ptosis, if any
loose skin in the lower eyelid
bulging pockets of fat under the eye
transition between the undereye area and cheek
dark circles or hallows beneath the eyes
heaviness in the brow
Together, you will discuss the best procedure or procedures for your unique anatomy and goals. Blepharoplasty can be a stand-alone procedure, but Dr. Nazarian will often combine it with other procedures such as a facelift, AccuTite, FaceTite, Pelleve, neurotoxin, fat transfer, PRP, or fillers.
The skin around the eyes is extremely delicate which makes it susceptible to certain lifestyle choices like sitting in the sun and smoking as well as environmental factors such as freezing temperatures and pollution. This is to say that there is no “right” age for eyelid surgery as every person ages at his or her own rate. The ideal candidate for a blepharoplasty is any man or woman who is in good overall health, does not smoke, and is bothered by:
hanging, loose skin in the upper lid
pockets of bulging fat beneath the lower lid
loose skin and muscle in the lower lid
an uneven transition between the eyes and the cheek
a heaviness in the upper eyelids that makes you look tired
Men, who may often be more averse to surgical procedures as they don’t like to deal with the downtime, love eyelid surgery because it’s a quick and easy way to look more refreshed, more relevant and more vital. AccuTite is also now available as a no-scar option for those patients who only require skin tightening.
If you are finding that friends, family and colleagues keep asking you if you are tired, even though you slept 8 hours the night before, then it may be time to consider an upper blepharoplasty. With age, the skin and tissues of the brow start to sag. This can create a “heavy” look to the upper eyelids as well as folds of excess skin. For some, it can become so severe that it may impede their vision. Upper eyelid surgery is a simple procedure that is performed under local anesthesia in our Beverly Hills office while you are comfortably awake. Dr. Nazarian will make an incision in the natural crease of your eye through which she will remove the excess skin and fat, if necessary, while still maintaining the integrity of the shape of your eye. Her goal is to make you look refreshed, not different. The incisions heal extremely well, leaving a barely perceptible scar that is easily hidden in your natural crease where no one will see it unless you decide to show them. Alternatively, for patients who only require skin tightening, AccuTite can be performed. This is a minimally invasive procedure in which radiofrequency (RF) energy is administered through a needle poke. The energy heats the underlying tissues, promoting the skin to produce more collagen and elastin. The end result is tighter, more lifted looking skin. Also performed while awake, this is a great option for patients who only need tightening on the upper lid as it leaves no traditional upper eyelid crease scar.
In patients who have excess skin in the lower eyelids, Dr. Nazarian will make an incision at the lower lash line through which she will tighten and remove the excess skin. Any subsequent scar is hidden by your lower lashes. Through the same incision, she can also tighten loose muscle or reduce bulges of excess fat under the eyes, if necessary. She prefers patients to be asleep for lower eyelid surgery. Alternatively, with AccuTite, Dr. Nazarian can tighten the lower eyelid skin with no scarring in patients who do not require fat reduction and muscle tightening. With this technique, radiofrequency (RF) is administered under the skin through a needle poke, and can be performed while you are awake. All of these options will be discussed with you in detail during your initial consultation. The procedure may take anywhere from 1-2 hours. During your lower eyelid surgery, Dr. Nazarian may:
tighten a loose or weak muscle
reposition the fat pad beneath the eye
remove part of a bulging fat pad
add fat to the tear trough and/or cheek/lower eye transition
For patients with drooping upper lids as well as bags or loose, gaping skin under the eyes, Dr. Nazarian will perform both an upper and lower blepharoplasty. The end result is a refreshed, energetic, younger looking you — all while looking completely natural.
Are you awake during a blepharoplasty under local anesthesia?
Yes. I am typically chatting with my patients about our lives as I refresh their eyes. The local anesthetic injections completely numb the area so you won’t feel a thing. And the nice thing about doing this procedure awake is that there is none of the grogginess that patients often feel with general anesthesia. It also makes the surgery faster. For patients who are anxious at the idea of being awake, we give them a little something before surgery to take the edge off. However, if I am combining eyelid surgery with another procedure such as a facelift that requires you to be asleep, I will perform both under general anesthesia.
Does a blepharoplasty hurt?
The procedure itself is pain-free. You won’t feel anything thanks to the local anesthetic. After surgery, you may experience some discomfort. The extent is going to depend on what exactly you have done as well as your individual pain tolerance. Honestly, most patients find this recovery to be comfortable. They don’t even take narcotics. We are happy to prescribe pain medications, but, typically, icing is enough.
Can I use fillers to address my under-eye issues or do I need a lower blepharoplasty?
Without assessing you in-person or at least seeing a photo, it is impossible to say. Fillers can help to improve that hollow look beneath the eye and/or camouflage or smooth the transition between your lower eyelid and your cheek. My best advice would be for you to schedule a consultation to be assessed in-person. Your eyes are such a vital part of your personality that you want to make certain that you are choosing the right procedure for your needs.
I don’t want to look fake. How do I guarantee that I will still look like myself?
We’ve all seen pictures of celebrities who no longer look like themselves after eyelid surgery. Although I believe that plastic surgery is a personal choice, my goal is never to change the look or shape of your eyes. They will simply look more lifted, bright and youthful. My best advice for ensuring a natural looking outcome is to see a surgeon whose aesthetic matches your own so check out his or her before-and-after photos.