An eyelid lift is a really vague term that refers to opening up the eyes so they look refreshed and less tired. But how exactly is that accomplished?
It turns out there are many ways of rejuvenating sleepy, tired, baggy eyes and dark circles underneath. First comes the most important step: a careful evaluation of what the issues are. There could be a number of contributing factors. It is very common to develop loose rolls of crepey skin in the upper eyelid. This is due to aging, loss of collagen, heredity, and worsened by smoking, sun exposure, chronic rubbing, and certain medical conditions like allergic swelling or fluid retention or thyroid problems. Brow tissue dropping over the eyes often worsens this bunching of upper eyelid skin. The fat pads moving forward can resemble growths or lumps. The opening eyelid muscle may detach to various degrees causing the lid to drop down over the eye covering the pupil. When severe and blocking vision, a muscle tightening surgery is sometimes covered by insurance to improve vision, make driving safer, and restore reading enjoyment. The lacrimal gland in the upper outer lid sometimes comes forward and needs to be tucked back in as well. For dark circles under the eyes, the most common cause is a separation of eye and cheek fat pads which casts a dark shadow under the eyes. Less often there is actual pigmentation darkening of the skin itself.
When mild, some of these issues respond beautifully to neuromodulators such as Botox, Xeomin, or Dysport. Small amounts of these drugs placed judiciously can soften muscle activity to lift the brow or to open the eyes wider. Filler can also help restore lost volume in deflated tissues. We actually lose bone and fat from our midface as we age. Approximately a teaspoon of fat disappears from around our eyes by the age of 50.
A filler that does not hydrate or attract a lot of fluid is desirable around the eyes to avoid swelling of these thin tissues. These in-office treatments have no downtime in that patients can resume work and social activities the same day.
When moderate to severe changes are present, surgery is needed in order to reshape the tissues. Brows can be raised with a number of different approaches depending on forehead length, forehead wrinkles, hairline growth, and hair thickness. Lid skin and muscles can be tightened, and fat can be repositioned from bulging areas to hollow areas in order to smooth out dark circles and bags. Most people take 7 to 10 days off of work and social activities when recovering from these surgeries.
Fortunately, there are a few things you can do to slow down the aging around your eyes. Getting adequate sleep, avoiding salt and alcohol, eating lots of fruits and vegetables, and drinking lots of water can go a long way to keeping thin eyelid tissues well hydrated and avoid swelling or puffiness. Using large sunglasses and hats to keep collagen damaging UV rays off the eye area helps maintain skin quality and thickness, and prevents growths on the skin. A quality eye cream can keep thin eyelid skin soft and supple. Make sure it is specifically formulated for the eyes since regular face creams can irritate or cause small bumps on the eyelid. Lastly, avoid rubbing your eyes. Mechanical trauma does damage this delicate tissue. And surgery is not always able to undo this damage. See your eye doctor to find out if you have dry eyes or allergies that are causing you to rub. Best wishes for graceful aging!
Vivian Schiedler, MD is an oculofacial plastic surgeon, specializing in the support structures of the eyes as well as facial rejuvenation. For appointments, call (541) 708-6393.