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It is often said that the eyes are the windows to the soul. What would droopy, tired eyes imply? It is no wonder that rejuvenation of the periorbital region is one of the commonest aesthetic requests. A youthful and aesthetically pleasing upper eyelid region consists of well-positioned eyebrows, appropriate eyebrow-to-upper eyelid crease distances, crisp upper eyelid creases, appropriate degree of eye opening, and taut skin without wrinkles or pigmentary blemishes. These findings impart the image of an individual who is bright, attentive and confident.
Droopy eyelids manifest as tired-looking, small eyes. Often, the double eyelid crease disappears behind the loose eyelid skin. There is lengthening of the eyebrow-to-eyelash distance. Loose skin folds may droop over the pupil, causing varying degrees of visual obstruction.
Typically, excess skin folds first appear in the outer (lateral) margin of the upper eyelid and starts in the third decade of life. Individuals with droopy eyelids may develop horizontal forehead wrinkles from a subconscious effort to strain their forehead muscles to elevate their eyebrows to relieve the eye obstruction. The chronic strain may cause a sensation of tiredness, which worsens towards the end of the day.
Droopy eyelids may worsen towards the end of the day, resulting in more notable visual obstruction. In cases of droopy eyelids due to muscle degeneration (ptosis), the original eyelid creases may disappear and new creases appear at a higher level.
Droopy eyelids may be caused by:
The upper eyelid skin is 0.5 mm thick and is the thinnest skin in the entire human being. It contains the least amount of elastin and collagen fibers, and is most susceptible to age-related thinning and laxity. It manifests as loose and redundant upper eyelid skin that may cause visual obstruction (dermatochalasis).
In cases of eyelid ptosis, the upper eyelid elevator muscle becomes stretched and elongated with age and no longer effectively opens the upper eyelid. The muscle fibers may also become detached from the overlying upper eyelid skin, leading to loss of the double eyelid crease, or formation of new creases above the original one.
It is critical to differentiate between droopy eyebrows and droopy upper eyelids and individuals often have varying degrees of both. It is essential to treat the eyebrow before elevating the upper eyelid skin to avoid unnatural and suboptimal results.
Attaining exquisite and elegant results is frequently possible and requires a combination of accurate assessment, precise technical execution and an experienced practitioner.
The optimal management of droopy eyelids is tailored to the cause(s). Aging changes often affect the entire face, and it is common to have multiple causes of droopiness existing in the same individual. Successful upper eyelid rejuvenation surgery brings about significant functional and aesthetic improvement, and improves self-confidence and social functioning.
Brow lifts are the most comprehensive method of addressing all the components of ageing of the forehead and produces natural-looking and sustained rejuvenation. Brow lifts are ambulatory procedures performed under intravenous sedation or short general anaesthesia. Find out more about droopy eyebrows and the brow lift procedure.
The infrabrow excision is an effective method of reducing excess upper eyelid skin and shortening the abnormally elongated eyebrow-to-eyelash distance. The scar is well-concealed at the lower margin of the lower eyebrow and this procedure brings about significant relief of visual obstruction in many individuals. Infrabrow excision may be performed together with upper blepharoplasty and they work in synergism to improve the upper eyelid aesthetic and function. Infrabrow excision is an ambulatory procedure performed under local anaesthesia, with optional intravenous sedation if requested.
Individuals with normally-positioned eyebrows and with loose, excess upper eyelid skin are good candidates for eyelid lift. The best candidates for the eyelid lift procedure are individuals with eyebrow tattoos, as the tattoos are an excellent method of camouflaging the scars.
This procedure removes the excess loose skin over the upper eyelid to reduce the excessive distance between the lower margin of the eyebrow and the eyelash margin and restores the appearance of a youthful upper eyelid. The scar is sited within the lower margin of the eyebrow and is easily camouflaged postoperatively with an eyebrow pencil or tattoo.
In individuals with a puffy upper eyelid appearance, excess bulky muscle (orbicularis oculi muscle) or fat (retro-orbicularis oculi fat) may also be removed during the eyelid lift procedure, creating thin, beautiful eyelids.
Individuals are advised to stop herbal supplements and traditional medicine and start special medications 7 days prior to surgery to minimize bruising and swelling.
Infrabrow excision is a delicate procedure that strikes a balance between sufficient removal of redundant skin to reproduce a youthful upper eyelid and preservation of sufficient tissue to ensure complete eye closure and elegant results. A proprietary technique is used to determine the amount of excess skin to be trimmed.
The markings are performed and local anesthesia administered for optimal intra- and post- operative analgesia. An appropriate amount of skin, muscle and upper eyebrow fat is removed. The wound is then closed meticulously to deliver the best possible postoperative scar and aesthetic outcome.
Mild swelling is expected after the surgery, and most of it will resolve by the 7th postoperative day. The stitches are removed on the 5th postoperative day and most individuals are able to return to work after the stitch removal. their usual activities immediately following the procedure.
Postoperative swelling is reduced by remaining upright during the daytime and by elevating the head of the bed with extra pillows when asleep at night. An optional electromagnetic field device may be used for the first 5 days to accelerate wound healing and reduce swelling.
Strenuous activity should be avoided for the first two weeks to minimize bruising. Contact lens use is possible during the recovery period. Meticulous scar care is important in the postoperative period to ensure optimal scarring and to achieve ideal postoperative results.
Incisional upper blepharoplasty is a minor surgical procedure that delivers effective, comprehensive and sustained rejuvenation, and restoration of upper eyelid function. It is one of the most popular procedures in aesthetic surgery. The scar is well-concealed within the double eyelid crease.
Successful outcomes improve self-confidence and social functioning. Upper blepharoplasty is an ambulatory procedure performed under local anesthesia, with optional intravenous sedation if requested.
Individuals with normally-positioned eyebrows and with loose, excess upper eyelid skin are the best candidates for upper blepharoplasty surgery.
Upper blepharoplasty removes excess upper eyelid skin, excises protruding fat in the inner (medial) portion of the eye socket, and enlarged or droopy tear (lacrimal) gland in the outer (lateral) portion of the socket. Individuals with coexisting eyelid ptosis may also have this corrected during the same surgery.
This recreates the youthful appearance of the upper eyelid with crisp, taut skin and well-defined double-crease folds, smooth contour of the skin underlying the eyelids, and appropriate vertical eye opening. The scars are well-hidden within the crease lines and are inconspicuous.
Individuals are advised to stop herbal supplements and traditional medicine and start special medications 7 days prior to surgery to minimize bruising and swelling.
Upper blepharoplasty is a fine art that strikes a balance between removing sufficient upper eyelid skin for optimal aesthetic outcomes and preservation of sufficient tissue to ensure complete eye closure and elegant results.
The natural position of the double eyelid crease in youth is identified individually and preoperative marking is performed. Proprietary techniques are used to determine the extent of skin excision required. Local anaesthesia is infused for optimal intra- and postoperative analgesia and the incision made.
In cases where prominent fat protrusion in the medial eye socket is noted, a small incision is performed in the fibrous orbital septum to permit removal of this fat pad. Enlarged or droopy lacrimal glands may be partially removed and resuspended to the bony eye socket to recreate a beautiful upper eyelid contour.
Find out how cases of ptosis may require shortening and reattachment of the eyelid levator muscle.
Mild swelling is expected after the surgery, and most of it will resolve by the 7th postoperative day. The stitches are removed on the 5th postoperative day and most individuals are able to return to work after the stitch removal.
Postoperative swelling is reduced by remaining upright during the daytime and by elevating the head of the bed with extra pillows when asleep at night. An optional electromagnetic field device may be used for the first 5 days to accelerate wound healing and reduce swelling. Strenuous activity should be avoided for the first two weeks to minimize bruising. Contact lens use is possible during the recovery period. Meticulous scar care is important in the immediate postoperative period to ensure optimal scarring and to achieve ideal postoperative results.
Ptosis correction involves surgical correction of droopy eyelids due to laxity or detachment of the eyelid elevator (levator palpebrae superioris) muscle from the skin and the underlying cartilage (tarsal plate). It confers functional and aesthetic benefits to the individual.
The scar is well-concealed within the double eyelid crease. It is a commonly requested procedure and is performed as an ambulatory surgery performed under local anesthesia, with optional intravenous sedation if requested.
Individuals with eyelid ptosis may present with reduced vertical eye opening, loss of the double eyelid crease, or appearance of an abnormally high eyelid crease. Individuals with any of these symptoms or signs are candidates for ptosis correction.
Ptosis may affect one or both eyes. When both eyes are affected, it is usually more severe on one side than the other, often causing the ptosis on the milder side to be unnoticed. Correction of the more severely affected eye alone may lead to the unmasking of the ptosis in the less severely affected eye and a suboptimal result.
Accurate preoperative assessment by an experienced practitioner will help detect subclinical ptosis in the less affected eye so that the postoperative result will be natural, elegant, and functional in both eyes.
Individuals are advised to stop herbal supplements and traditional medicine and start special medications 7 days prior to surgery to minimize bruising and swelling.
Ptosis correction is a fine art that strikes a balance between tightening the eyelid muscle to improve eye opening while ensuring that sufficient muscle laxity still exists for complete eyelid closure. Mild ptosis may be corrected using a minimal-incision technique, which involves making 3 small incisions, about 1 to 2 mm each, at the level of the double eyelid crease.
Significant cases require incisional ptosis correction. Local anaesthesia is infused into the eyelid crease to ensure optimal intra- and post-operative analgesia. The incision is made at the natural double eyelid crease for optimal scar concealment. The levator muscle is exposed and the lax muscle is either tightened with stitches or trimmed off and reattached to the eyelid cartilage. The wound is then closed meticulously to deliver the best possible postoperative scar and aesthetic outcome.
Mild swelling is expected after the surgery. Individuals undergoing minimal-incision ptosis correction may expect most of the swelling to resolve by the 7th postoperative day. The stitches are removed on the 5th postoperative day and most individuals are able to return to work after the stitch removal.
Individuals undergoing incisional ptosis correction may expect most of the swelling to resolve by the 10th postoperative day. Most individuals are able to return to work by the 10th postoperative day and are able to return to work by then.
Postoperative swelling is reduced by remaining upright during the daytime and by elevating the head of the bed with extra pillows when asleep at night. An optional electromagnetic field device may be used for the first 5 days to accelerate wound healing and reduce swelling.
Strenuous activity should be avoided for the first two weeks to minimize bruising. Contact lens use is best avoided during the recovery period. Meticulous scar care is important in the immediate postoperative period to ensure optimal scarring and to achieve ideal postoperative results.
