Dr. Lewis customizes every eyelid surgery based on your anatomy, condition, and goals. He uses the latest methods to not just remove excess skin and tighten the eyelids, but to make sure that the muscles of the eyes are intact and that you appear naturally younger in a way that is not obvious. He also works to preserve the shape of your eyes so that you will still look like yourself after your surgery.
A lower eyelid lift, in particular, requires a subtle and delicate approach, as there is little skin in this area, and it’s quite thin.
In both upper and lower eyelid surgery, excess skin and fat must be addressed. Historically, this meant removing substantial amounts of fat from the upper and lower lids; unfortunately, over time, this often led to a hollowed out appearance. More often now, Dr. Lewis will reposition your existing fat, remove any small area of unwanted fat, and in many cases, add fat to restore the volume that is lost over time. After this is done, the skin is carefully sutured in a tighter placement to preserve the musculature and the shape of your eyes.
Younger patients may show good skin tone, but prominence of the fat pads from within the eye socket. In these cases, more fat may need to be removed. This often can be performed through an incision from within your eyelid, leaving no visible scar.
For an upper eyelid lift, the incisions can usually be made in the creases of the eye so that the scar is hidden when the eyes are open. This incision will nearly always heal extremely well. It is usually hard to find this incision after it has healed for 3-6 months.
For lower blepharoplasty, the incision is made inside the lid or just below the lashes where the scar will also be hidden. The determination of the lower lid incision placement is individualized and based on your personal anatomy and goals. If there is excess skin or wrinkles on the lower eyelid, an external incision will be needed to remove the excess skin. Even with the need for an external incision, this incision heals very well and will usually be imperceptible after it has fully healed. If there is no skin excess or wrinkles, incisions within the eyelids can allow repositioning of the fat in the lower eyelids and avoid an external incision.