Excess upper eyelid skin is very common, and can lead to an undesirable saggy, tired appearance. Removing excess skin from the upper eyelids (i.e. upper eyelid blepharoplasty) is the most common of all facial cosmetic surgeries. Additional considerations for optimal eyelid crease and contour include proper incision choice, selective fat debulking, and eyelid crease reformation. Each patient is unique, and these considerations will be discussed at your pre-operative evaluation.
It is also critical to avoid removing too much skin: the upper eyelid requires a minimum of 20 mm of vertical skin in order to properly blink and close. If too much skin is removed, the eye will become dry and irritated, and the eyelid will appear unnatural. This often happens when a surgeon confuses eyelid and brow skin and misses the presence of significant drooping of the brows. It is important to discuss with your surgeon how the upper eyelids and brows interact, and how upper eyelid rejuvenation may require addressing the brows as well.
Another potential issue is a weakness of the eyelid opening muscles, which leads to a true “droop” of the eyelid, or “ptosis” (pronounced ‘toe-sis’). If this is present, it makes the eyelids look sleepy, and will need to be addressed. This surgery is sometimes covered by insurance if it covers the visual axis.
Dr. Kahana has a full arsenal of tools at his disposal and will provide a customized plan of care.