Your Eyes Without A Face: Eyelid Rejuvenation for the Young at Heart

I have a soft spot for the 1980’s.  This decade defined my childhood.  Tunes such as this Billy Idol song really take me back to a great place.  Let’s face it, which other time in history could mix peg-leg pants, neon pink tee-shirts and super-mullet haircuts? Ahh…those were the days.

Over the last several years, I have seen many patients who share my same age.  A common request they have is rejuvenation of the eyes and face.  Many patients have said: “I look so tired all of the time…and I can’t stand these bags under my eyes.” As a plastic surgeon in San Diego (and a guy in his 40s), I share similar concerns.  I woke up the other day (after a not so restful night with my infant daughter) and looked in the mirror.  I didn’t quite recognize the guy staring back at me: puffy lower eyelids, dark circles and a scruffy beard (ok…maybe the beard isn’t so bad?)

Fortunately, there are many options that plastic surgery can accomplish to get you back to looking like you did in the 80s (the eyes and face that is, not the hair or clothes!).  Cosmetic surgery of the eyelids can recreate that natural and youthful appearance of the face….without the need for a facelift.  Your “Eyes Without a Face” is a true reality.

The most common characteristic of aged eyelids is the lower eyelid bulge caused by fat herniation from the eye socket.  This gives the lower eyelids a “puffy” appearance.  Furthermore, the deepened valley which appears below this, known as the “tear-trough” creates a very unnatural separation between the lower eyelid and cheek.  If you have puffiness of the lower eyelids, with minimal laxity of the skin, a transconjunctival blepharoplasty can be a very effective procedure to reduce the bulge and re-contour the lower eyelid.  In this procedure, a small amount of fat can be removed from the inside of the lower eyelid.  Using no visible incisions, this fat can also be re-draped in place of the tear-trough to recreate a youthful transition between the lid and cheek. The procedure is minimally invasive and swelling is usually very mild.

If your eyelids also have excess skin and the corners of your eyes are very loose, then a more advanced procedure may be required. In these scenarios, a transcutaneous blepharoplasty may be required. During this procedure, the fat is removed and redraped through an extended incision that is hidden underneath the eyelash line.  The outside corner of the eye may need some additional tightening to keep its position long-term.  This procedure, known as a canthopexy, is performed at the same time as the blepharoplasty or eyelid lift.  Swelling and postoperative recovery are a bit more advanced, but the procedure does a wonderful job of maintaining the natural shape of the eye, while reversing all of the signs of aging.

The bottom line is simple (insert 80s synth-pop riff): If you are in your 40s and desire rejuvenation of the face, starting with cosmetic procedures of the eyelids can truly be the best “bang for your buck”.  You may not require a facelift at all.  Eyelid rejuvenation and blepharoplasty are some of the most effective and satisfying procedures that I perform here in San Diego.  If you are interested in turning back the clock and looking younger, feel free to give us a call….

Yours in neon,

Salvatore J. Pacella M.D., M.B.A., F.A.C.S.