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Micro-Blepharoplasty (micro cosmetic eyelid surgery)-Less is more.

Published on November 7, 2014


Upper Eyelid Surgery (Micro-Blepharoplasty)

Are you thinking about having upper eyelid surgery? You know what you don’t like about your eyelids, but does your potential surgeon think about your eyelids the way you do? This is a critical question that you need to have answered before committing to surgery and a particular surgeon.

Generally, Dr. Steinsapir finds patients put too much trust into their potential eyelid surgeons. This often leads to unexpected or surprising results. This occurs when there has not been enough pre-operative discussion regarding what the potential eyelid surgery patient is looking for and what they can expect from surgery. Patients generally have a very specific conception of what upper eyelid surgery should accomplish. This is basically their youthful eyelid. That means a bright open eye with a well-defined upper eyelid platform. The upper eyelid fold should be little changed to accomplish these things. People do not come to the office asking for all of the eyelid skin to be removed (think Renee Zellweger). Unfortunately many surgeons think that is their job when they are asked for an upper eyelid cosmetic surgery.

Upper Eyelid Surgery Before & After SurgeryMicro-Blepharoplasty (micro cosmetic eyelid surgery) before and after

When the upper eyelid fold is over resected, a number of unwanted and surprising things can occur. First, too often the surgeon makes the upper eyelid incision too high. This incision becomes the upper eyelid crease. The effect is the hollowing of the upper eyelid. This robs the upper eyelid of fullness. One does not want too much fullness but over-resection of this tissue hollows the upper eyelid and also induces the eyebrow to fall crowding the upper eyelid space with the eyebrow. Hollowing the upper eyelid space effectively skeletonizes the upper eyelid and can expose the contour of the eye. Rather than helping you look younger and better, these changes make you look older. Second, if the surgeon did not perform an anchor blepharoplasty procedure, which is a surgical step that anchors the upper eyelid crease to the levator aponeurosis, the skin on the eyelid platform can be loose and crepey. This can be controlled using the anchor blepharoplasty that snugs the eyelid platform skin and muscle much like one snugs a bed sheet and blanket on a bed. This smooths the eyelid platform skin which is very important if you want to hold makeup on the eyelid.

In talking with a potential surgeon, you need to hear from them regarding where they plan to leave the upper eyelid fold, how much eyelid platform will be exposed, where the eyelid crease will be placed (should be less than 10 mm from the eyelashes), will the surgeon attach the eyelid platform skin and orbicularis oculi muscle to the levator aponeurosis (the tendon for the muscle that raises the eyelid)? Do you have upper eyelid ptosis (upper eyelid heaviness that makes the eyelid look droopy) and will this be corrected by the planned surgery? Do you have eyelash ptosis and what will be done about this? Do you have dry eye and what steps will the surgeon take to minimize worsening of the dry eye condition? To answer these questions, the surgeon needs to sit down with you and speak to you about your goals. They need to do detailed measurements of the eyelids and eyelid tissues. This takes time. If the surgeon simply looks at you from across the room and says that you are a great candidate for eyelid surgery, this is not adequate as a basis for surgery and it is very likely you will be disappointed with the surgical outcome.

Finally, ask if you are going to be under general anesthesia. Some surgeons like general anesthesia because, frankly, they don’t have to deal with you during surgery. However, general anesthesia means you are completely out during surgery. That makes it impossible for the surgeon to have you open and close the eyes during surgery to assess the effects of surgery. Dr. Steinsapir prefers to have his patients under light intravenous sedation. There is no breathing tube needed for the airway because you always are breathing on your own. Placing that tube is very stressful on the body. The drugs used for intravenous sedation are very short acting. That means that after surgery you are not hung over. During surgery, the sedation can be lightened so that you can cooperate with opening an closing the eyes during the procedure. This makes for much more accurate eyelid surgery. This allows very precise removal of less eyelid tissue to effect significant improvement. This way you get amazing eyelid results that don’t look surgical. Less is more when it comes to eyelid surgery. This is what micro-blepharoplasty is all about.

About Dr. Steinsapir

Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculofacial plastic surgery and cosmetic surgery in Beverly Hills where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician or surgeon and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.

To learn more about procedures and treatments performed by Beverly Hills | Los Angeles Facial Plastic Surgeon, Dr. Kenneth Steinsapir, contact us at 310-274-7422

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