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Upper and Lower Eyelids Article 1

Principles of Youthful Restoration in Upper and Lower Eyelid Surgery

The upper eyelids and the relative skin excess in this area must always be evaluated in relation to brow position. Brow position should be corrected first before upper eyelid skin removal is considered. In many patients, brow lift can eliminate the need for upper eyelid surgery. However, in the majority of patients with facial aging complaints, patients should receive both upper eyelid surgery and a brow lift.

Brow lift is not being performed as commonly as it was only a few years ago. Coronal, endoscopic, temporal, and direct brow lift may be good options in the appropriate patient. Dr. Hughes will help you sort these issues out during the consultation.

In the upper lid, there should be a well-defined lid crease. Surgery helps to restore this crisp fold. In addition, hooding at the lateral aspect of the upper eyelid can be corrected as well. Those patients with fullness medially in the upper eyelids can have some of the fat pads removed.

In the lower eyelid, removal of the some of the fat often makes a reduction in the appearance of bags or fullness in the lower eyelids. In addition, skin wrinkles can be improved by removing some of the skin of the lower eyelids. Finally, it may be necessary to restore the tone of the lower eyelids. If this is not done, the patient may have a sad appearance or look older. In addition, the patient may be at risk for lid malposition. Dr. Hughes will discuss with you during your consultation if your tone needs to be improved with a technique called lateral canthopexy or lateral canthoplasty.