The eyelids and brow form a dynamic portion of the face that not only changes as we age, but is also radically different between cultures and ethnicities. Skin thickness, fat content, bone structure, the presence of a crease or fold, and age-related gravitational changes are just a few of the factors that affect the cosmetic appearance of the eyes.
The discussion below focuses on age-related changes to the eyes that can be aesthetically improved with upper eyelid surgery. Please click on the hyperlink if you are interested in double-eyelid surgery, also known as Asian blepharoplasty. This surgery is often performed on younger individuals seeking a natural, harmonious change to the appearance of their eyes.
As normal aging occurs in the face, the eyelid skin may sag, and areas of preseptal fat may begin to protrude. Complicating matters is that overall fat in and around the eye may decrease with age, creating a more hollow appearance. The eyelids may appear to droop, with skin pressing down on the eyelashes. Occasionally, some of us develop a weakness in the muscle that opens the eyelid, creating a droopy eyelid on one side due to a condition called ptosis. This is a medical condition and corrected with a separate surgery that should occur before an eyelid lift, or blepharoplasty, is performed.
In order to rejuvenate the upper eyelids, blepharoplasty involves the removal or repositioning of fat and excess skin. This alone is not always the answer to redundant skin above the eyes. Premature aging and sagging of the brow can cause a tired, angry look with frown lines and wrinkles. This is due to the pull of gravity over decades, lowering the eyebrows over the eyes. This is the reason that many women gradually pluck more and more of their eyebrows in order to maintain the “height” of the eyebrows in a more youthful and attractive place. In addition, both men and women often develop horizontal lines and wrinkles across the forehead as a result of constantly raising the eyebrows to their original (youthful) position. In order to enhance the appearance of the eyes when not only the eyelids, but also the brow, have drooped, an endoscopic brow lift can be performed together with the upper eyelid surgery.