The Eyes Have It!

Breast augmentation, Botox®, nose jobs, face lifts… These are the procedures that come to mind when you think of plastic surgery. What about rejuvenating the most important part of your face, the eyes? Dr. Lou Bucky of Philadelphia tells us how modern techniques in eyelid surgery can produce dramatic results in patients wanting to refresh their tired eyes.

By: Louis P. Bucky, MD
and Adam McMillon
ThePlasticSurgeryChannel.com

Easy on the Eyes

We all notices imperfections from time to time on each other’s faces, but what are we looking at most of the time? The eyes!  “There’s probably no procedure that makes a bigger difference with as little amount of surgery as an upper eyelid lift, or blepharoplasty,” says Dr. Bucky. “The analysis of the upper lids is simple, you’re just talking about extra skin of the eye lid, or potentially a little droopiness of the brow that contributes to the extra skin. An upper lid blepharoplasty is a 45-minute procedure that’s just doing the true nip and tuck of the skin. The operation is fairly simple and associated with an easy recovery.”

Smoothing Bags Beneath the Eyes

The most blatant sign of age and/or exhaustion are bags beneath the eyes. While an eyelid surgery doesn’t necessarily mean the bags will be addressed, Dr. Bucky believes the area between the eye and the upper cheek to be of most importance. “The lowerlid on the other hand is much more complicated. The anatomy is different. Sometimes, again, it’s just extra skin, but often times there’s fat components that needs to be addressed. How you address them is vital. I like to take fat out when needed in a very conservative fashion, but not go through any muscle.

“Aesthetically, where the lower lid ends and the cheek begins is a bit arbitrary. So sometimes instead of taking the hills of the eyelid down, we’ll fill the cheek at the junction between the cheek and the eyelid.”

Surgeons like Dr. Bucky are turning to fat grafting to help resolve the hills and bumps between the cheek and eyelid. “It is very rare today for me to do a lower lid procedure and not try and blend it with the cheek and add some fat. Therefore, it’s a blending procedure,” says Bucky. “To just think of the eyelid alone and not think about the face is a bit naive. It leads to a separation of how one’s eyes look relative to their face. It’s not the goal of facial or eyelid rejuvenation.”

“The so called ‘tired eye’, often times associated with a bag or groove, it’s the junction between the eyelid and the cheek. We need to blend that. The typical lower lid patient has either a pinch of skin, maybe some fat removal, a bit of laser to improve skin quality, then use fat to blend the junction between the lid and cheek. This gives a harmonious, more natural result.”