Superior and Inferior Blepharoplasty

The superior eyelid frequently leads to so-called "hooded eyelid" formation. Its etiology is flaccid musculature, redundant skin, or protruding fatty tissue. The consequence is a fatigued or sad appearance. This can be remedied by upper (lid) blepharoplasty.

A cutaneous incision is placed directly under the lid fold, so that it will be inconspicuous. The result is a radiant, bright gaze. Even patients with bags under their eyes are bothered by their tired look. This can be corrected by lower lid blepharoplasty.

When it makes sense to have upper or lower lid blepharoplasty

Patients with hooded lids, which are disturbed on a daily basis by excess skin of the upper lids, are appropriate candidates for superior lid blepharoplasty. Pronounced symptoms will compromise lateral vision. This is diagnosed by the ophthalmologist's visual field examination prior to the operation.

Operational procedure

Upper lid/superior blepharoplasty: Prior to the operation, and after photographic documentation of the preoperative status, careful planning and demarcation of the existing excess skin is performed. Blepharoplasty is carried out under local anesthesia. First, the previously clearly marked redundant skin is resected, then – if needed – so are portions of the lid closure, or orbicularis oculi muscle. The orbital septum, which lies underneath (a connective tissue layer) is tightened as needed, or small fat pads are removed.

Lower lid/inferior blepharoplasty: The incision is placed inferior to the eyelashes or inside the connective tissue. Fatty tissue is then removed through this incision. Wound closure is done with a subcutaneous plastic surgery suture technique. Thread is fastened lightly to the skin at the exit point.

Follow up care

The eye region should be cooled after surgery in order to avoid potential hematomas or swelling. The same holds true for the first two to three days after the procedure. Stitches are removed after five to seven days. Swelling and possible ecchymotic discoloration resolves after seven to ten days. One can expect to see final results in three months.

Prospects for success of blepharoplasty

Upper and lower lid plasties are esthetic operations with excellent cosmetic benefit. They often result in a marked rejuvenation of the face after the operation due to enhanced opening and clarity of the gaze. The scar is concealed in the superior lid fold and is very delicate and inconspicuous. 

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