Blepharoplasty Beverly Hills

Blephoroplasty Overview

Blepharoplasty is the comprehensive terminology for the description of eyelid rejuvenation surgical procedures. These include:

Upper Blepharoplasty (upper eyelid)

• Removes the excess upper eyelid skin
• The incision follows the natural crease of the eyelid, and upon healing, the scar is virtually undetectable
• Often performed with concomitant fat resection or fat transfer to volumize the peri-orbital and return youthful fullness

Lower Blepharoplasty (lower eyelid, outside)

• Removes the excess lower eyelid skin and fat pockets
• Often performed with fat resection to correct under-eye bags or injectable dermal fillers to correct hollowing or tear trough deformities

Lower Eyelid “Skin Pinch” Blepharoplasty

• Removes the excess lower eyelid skin
• Does not remove fat
• The incision follows the lower lash line, and upon healing, the scar is virtually invisible

Transconjunctival Blepharoplasty

• Removes fat, and skin when necessary, to treat pseudo-herniation of fat bags around the eye

It is important to note that blepharoplasty cannot lighten dark under-eye circles, eliminate lower eyelid fine wrinkles, or diminish or eliminate crow’s feet.

Procedure Walk-Through

1. Preparation: During the pre-operative consultation, Dr. Vallecillos will assess your eyes and review your medical history. Please bring the following to your consult:
   • Results of any recent eye tests from your ophthalmologist
   • Contact lenses or glasses if you wear them
   • Relevant health records related to the conditions above.

   To prepare for blepharoplasty, you should discontinue the use of blood-thinning vitamins, herbs, and medications for two weeks before the surgery. If you smoke cigarettes, you should quit for at least two weeks before and after surgery. If you are over the age of 45, medical clearance by an independent physician may be required before undergoing surgery.

2. Anesthesia: Depending on the type(s) of procedures being performed, a local anesthetic, IV sedation, or a general anesthetic will be administered.
3. Enormous strides have been made in blepharoplasty, with a trend towards conservatism. Excess fat is carefully resected and in appropriate cases, repositioned throughout the eye to impart a youthful fullness to the eye. Muscle is typically spared, avoiding dated techniques that left patients with an inanimate, unnatural expression. In general, the procedure lasts anywhere from 45 minutes to two hours. Often, patients who present with sagging over the eyelids in fact need a brow lift instead of blepharoplasty. Brow lifts are almost exclusively performed by an endoscopic approach, allowing for minimal incisions and precise repositioning of the brow to its more youthful state. Several ancillary procedures exist that can augment the results of your blepharoplasty. Dr. Vallecillos will discuss beforehand which option is best for you, given your specific diagnosis and circumstances. Some of the more commonly performed eyelid procedures are as follows:

Lateral Canthal Suspension Technique

The goal of these techniques is to strengthen the structural elements of the outer corner of the eyelids (lateral canthus) hence lending to better support of the lower eyelid. These eyelid suspension techniques employ various specific sub-procedures, depending on the precise nature and requirements of the particular eyelid. They include canthopexy, canthoplasty, tarsal strip resuspension, inferior and lateral retinacular suspension techniques. Canthoplasty and canthopexy procedures are often times described interchangeably by surgeons, but are entirely different in their indication and nature.

A Canthoplasty procedure reinforces the lower eyelid support by detaching the lateral canthal tendon from the orbital bone and reconstructing it. Conversely, a Canthopexy procedure is much less invasive and essentially stabilizes the existing lateral canthal tendon without removing it from its normal anatomic attachment. In rare and severe cases, as with significant lower eyelid retraction (ectropion), a concomitant midface lift may be recommended to lend to caudal support of the lower eyelid. In these cases, insurance coverage may be possible, depending on the carrier, especially if the patient is at risk for dry eye syndrome or keratoconjunctivitis secondary to profound lower eyelid retraction.

From an aesthetic standpoint, these procedures are employed to correct an unappealing lower eyelid shape, such as an overly round eyelid shape, a pulled down eyelid (ectropion) or a sagging lower eyelid with too much “white” of the eyeball showing (scleral show). These eyelid problems may be resultant of the previous eyelid or midface surgery, senescence, and other hereditary factors.

Botox Injections are often performed in the peri-orbital rejuvenation to shape and lift the brow, minimize crow’s feet, and soften under-eye wrinkles. Fractionated Laser or IPL Rejuvenationis routinely utilized by Dr. Vallecillos in conjunction with eyelid rejuvenation procedures to add to the overall effect of the result. In fact, in most cases, Lumenis Total FX peri-orbital resurfacing is included in the eyelid lift procedures, allowing for superior results.

We also offer Asian Eyelid Surgery a procedure that creates a pretarsal crease in upper eyelids.

Frequently Asked Questions