Occidental upper eyelid surgery

We perform upper eyelid surgery in an outpatient surgery center. IV sedation is given to make patient comfortable, but awake enough so that the patient can open and close eyes when requested. This is only way to make sure that the shape and size is symmetrical.

We believe that there are several aspects of upper eyelid surgery in young people that is essential.

• The pretarsal show, that is the size of the supratarsal show should not be greater than 3mm. Greater than this size will make the upper eyelid appear heavy and puffy.
• The supratarsal fold should be crisp, but not be too deep. This results in unnaturally operated on appearance.
• The fat resection should be very conservative. Over resection of fat can lead to sunken in look of the upper lid.
• The outer edge of the fold should taper off gradually and not turn downward abruptly.
• In people with mild ptosis, plication of the levator muscle can open the eyes more.

The Asian blepharoplasty surgery techniques can be divided into two major categories.

• No incision/minimal incision technique: This is a good technique for younger patients with think skin, no excess skin to be removed, and no excess fat. There is less room for precision, but for patients that just wants a natural appearing crease, with minimal downtime., this is a good option. Under sedation, the upper eyelid is everted and from inside, suture is passed from the upper border of the tarsus to the dermis of the skin and the knot can be placed either on the inner side or just under the skin. Anywhere from 3-5 sutures are placed. This suture approximates the dermis to the levator musce thereby creating the crease. The patient is asked to open and close the eyes during surgery to ensure adequate symmetry and shape.
• Incisional Technique: The incision lines for eyelid surgery are designed for scars to be well concealed within the natural structures of the eyelid region. Droopy conditions of the upper eyelid can be corrected through an incision within the natural crease of the upper eyelid allowing repositioning of fat deposits, tightening of muscles and tissue, and/or removal of excess skin. The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better designed eyelid and surrounding region. Some patients find that the mild swelling persist for several weeks, while others may see swelling resolve in as little as one week.