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TriBeCa Plastic Surgery

Sydney R. Coleman, MD  |  David L. Cangello, MD  |  Mary Lombardi, PA-C

Eyelid Surgery

Cosmetic eyelid surgery is designed to correct drooping, excessive skin and fat of the upper and lower eyelids. It does not correct crow’s feet or the fine lines at the outer aspects of the eyes (Botox can help with this). You may choose to correct your upper eyelids only, your lower eyelids only, or they may be done simultaneously.

As we get older, the fullness that we had in our upper eyelids diminishes. This causes an apparent excess of skin of the upper lid, which can fall forward toward the eyelashes, fold backward and make a deeper crease, or cause additional creases to form. Sometimes all that is needed is to augment the eyelid skin with some fat from another part of your body. Often, however, a small amount of skin needs to be removed to improve the contours and the fold. The trend now is to leave as much of the fat in place in the eyelid as possible and to only remove excess fat if it is really bulging. This prevents a hollowed out upper eyelid, which makes you appear older.

Eyelid surgery will not correct crow’s feet or dark circles under the eyes, but the placement of fat beneath the skin can often diminish the appearance of these problems. In addition, BOTOX® Cosmetic can help significantly with crow’s feet.

The upper eyelid procedure involves making an incision in the crease (which is essentially hidden when the eyes are open) and removing the excess skin and/or fat. On occasion, we will actually add fat back to the area at the same time. The incision is closed with very fine sutures. After everything has healed, it is usually difficult to find the scar. We often do this procedure in the office with only oral Valium and pain medication, if the patient is agreeable. As an alternative, if you have only a very small amount of extra skin, you may be a candidate for tightening of the skin using the non-invasive technique Thermage. We will discuss whether you are a candidate for this procedure.

In the lower eyelids, the problem is usually either excess skin and/or fat creating additional folds or wrinkles, hollowing creating shadows, or both. If the problem is excess skin or fat, surgery to remove the excess is usually required. If it is a problem of only a very small amount of excess skin, you may be a candidate for tightening of the skin using the non-invasive technique Thermage. We will also discuss whether you are a candidate for this procedure.

During the surgical procedure, an incision is made just beneath the eyelashes and extended into one of the lines in the “crow’s feet” to remove the excess skin and/or fat. The incision is closed with very fine sutures and the scar is usually concealed along the lash line. If the lower lid is “bowed” or if there is a desire to elevate the corner of the eye, a canthopexy (lid tightening) or canthoplasty (lid shortening) may be performed.

In addition to the traditional eyelid surgery that involves incisions, if there is hollowing of the lower eyelid near the nose (tear trough), you may be a candidate for fat grafting to this area to restore fullness, smooth contours, and diminish the appearance of dark circles.

If you are interested in eyelid surgery, please call TriBeCa Plastic Surgery to schedule a consultation with Dr. Cangello at (212) 571-5200 or fill out our online contact form today. As a highly skilled and knowledgeable plastic surgeon, Dr. Cangello looks forward to meeting you during your initial consultation and helping you achieve beautiful, natural-looking results.