Eyelid Case Study Beverly Hills

Eyelid Surgery

Procedure: Eyelid Plastic Surgery

Cosmetic Concern: 33-year-old woman with upper heavy eyelids and lower eyelid fullness.

Diagnosis:

1. Heavy brows are a feature she has had since childhood. The lower eyelids demonstrate a slight fullness from fat.

Treatment:
Upper and lower blepharoplasty. The goal here was to remove enough skin in the upper eyelids to accentuate the upper eyelid platforms without removing too much of the fullness of the upper eyelid which is an important feature of her face.

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Procedure: Eyelid Ptosis Surgery

Cosmetic Concern: 27-year-old with a droopy right upper eyelid.

Diagnosis:

1. Right upper eyelid ptosis. Notice the heavy right upper eyelid lid

Treatment:

1. Right upper eyelid ptosis surgery

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Procedure: Cosmetic Anchor Blepharoplasty and Ptosis Repair

Cosmetic Concern: 28-year-old woman concerned with eyelid symmetry. In talking with her, her primary concern is that the eyes are both heavy but the right eye looks heavier than the left eye.

Diagnosis

1. Bilateral upper eyelid ptosis with facial asymmetry. Note that her right eye sits lower in the face than the left globe. Recognizing this fact determines the limits for what will be possible surgically.

Treatment:

1. Bilateral upper anchor blepharoplasty
   Bilateral upper eyelid ptosis repair

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Procedure: Eyelid Plastic Surgery

Cosmetic Concern:
46-year-old woman with uneven upper eyelids and full lower eyelids.

Diagnosis:
Mild dermatochlasis of the upper eyelids with greater heaviness in the left upper eyelid. The lower eyelids demonstrate herniated eyelid fat that creates the fullness and appearance of fat eyelids.

Treatment:
Upper and lower blepharoplasty. The key here was to create as natural a look as possible. This was accomplished by balancing the work in the upper eyelids. Fat was removed from the lower eyelids with no skin incision. This type of eyelid surgery is called a transconjunctival blepharoplasty. To avoid wrinkling in the lower eyelids after the removal of fat, a lower eyelid chemical peel was performed. The procedure is gentle and the work was accomplished in the office under local anesthetic.

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Procedure: Asian (Double Fold) Eyelid Surgery

Cosmetic Concern: 32-year-old woman desires a double eyelid fold.

Diagnosis:
She has a rudimentary crease in the upper eyelids. This leaves her with no place to apply eyeliner on the upper eyelid.

Treatment:
Asian eyelid surgery is not about westernizing the eyelid. Rather it is about conserving normal eyelid structure while at the same time providing complementary eyelid definition to produce the desired result. Typically this type of surgery involves about a week of downtime.

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Procedure: Fullness in the lower eyelids

Cosmetic Concern: 59-year-old man bothered by the fullness in the lower eyelids.

Diagnosis

1. Herniated lower eyelid fat
2. Lower eyelid wrinkles
3. Sun damaged skin

Treatment:

1. Transconjunctival lower eyelid surgery
2. Lower eyelid chemical peel

Discussion:
Lower eyelid surgery reduced the fullness of the lower eyelid by removing eyelid fat. This tends to deflate the lower eyelid and slightly increase the lower eyelid wrinkles. The chemical peel performed at the time of the lower eyelid surgery, helps to firm the lower eyelid skin and reduce this tendency and avoids the need for surgery to remove the excess lower eyelid skin.

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Procedure: Cosmetic Eyelid Surgery

Cosmetic Concern: 22-year-old man bothered by the fullness in the lower eyelids.

Diagnosis:
The fullness in the lower eyelid is due to orbital fat that is visible because of a descent of the cheek fat pad. Classically transconjunctival surgery to remove lower eyelid fat would be offered to an individual with this set of issues. However, due to the descent of the cheek fat, removal of the lower eyelid fat without addressing the descent of the cheek fat would only accentuate the hollow under the eyes.

Treatment:
An arcus marginalis surgery was performed. This conserves the lower eyelid fat, which is rotated out of the lower eyelid space and onto the top of the cheek fat softening the lower eyelid hollow. Recovery is typically 8-10 days. Surgery can be performed in the office procedure suite under local anesthesia.

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Procedure: Cosmetic Eyelid Surgery

Cosmetic Concern:
73-year-old woman who feels that she can’t see her eyes any more. She is interested in cosmetic eyelid surgery to improve her appearance.

Diagnosis:
Dermatochlasis of the upper eyelids and eyebrow ptosis. She has heavy wrinkling around the eyes and in the crows feet areas. The lower eyelids demonstrate herniated orbital fat.

Treatment:
Upper and lower cosmetic eyelid surgery. The lower eyelid surgery was performed from behind the eyelid avoiding a skin scar. She has achieved her goals with a significant improvement. Her down time lasted about 10 days.

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Procedure: Cosmetic Eyelid and Forehead Surgery

Cosmetic Concern: 54-year-old woman who feels her appearance makes her look tired. She wants to refresh her appearance but wants the results to look very natural.

D”agnosis:

1. 1. Hooding of the upper eyelids
2. 2. Bilateral eyebrow ptosis
3. 3. Full lower eyelids due to herniation of the orbital fat
4. 4. Lower eyelid wrinkles
5. 5. Midface ptosis

Treatment:

1. Bilateral endoscopic forehead lift
2. Bilateral upper eyelid anchor blepharoplasty
3. Bilateral lower eyelid transconjunctival blepharoplasty
4. Bilateral midface lift
5. Bilateral lower eyelid chemical peel

Discussion: In this instance, a very detailed approach was needed to comprehensively improve her eyelid area. Pushing a single approach too far causes an over-operated appearance. Her appearance is very natural because of the detailed problem oriented approach to addressing her aesthetic concerns.

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Procedure: Cosmetic Surgery

Cosmetic Concern: 50-year-old woman with a prior history of four eyelid blepharoplasty. Her heavy right upper eyelid bothers her. She is also concerned about the under eye hollows and nasolabial fold.

Diagnosis:

1. Prior eyelid surgery
2. Bilateral, asymmetric upper eyelid ptosis, right worse than left
3. Under eye circles
4. Nasolabial folds

Treatment:

1. Bilateral upper eyelid ptosis surgery
2. Under eye Deepfill™ Restylane® treatment
3. Juvederm® implant for the nasolabial folds

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Procedure: Eyelid Surgery

Cosmetic Concern: 45-year-old desiring improvement of her face.

Diagnosis

1. Midface ptosis
2. Herniated lower eyelid fat
3. Lower eyelid rhytids

Treatment:

1. Lower eyelid transconjunctival blepharoplasty
2. Arcus marginalis release
3. Lower eyelid chemical peel