The eyes are the centerpiece of our face and where we turn to read each other's emotions and energy levels. Unfortunately, the eyes are also one of the first areas on our body to show our age.

Periorbital skin is thin, delicate and easily damaged. Between sun exposure, aggressive handling, and years of squinting and facial expressions, the skin on the eyelids begin to degrade and sag faster than almost any other part of the body. Crow's feet can begin appearing even in the teens or early 20s. Depending on your skin quality, eyelids may start to droop and tear troughs to deepen while you are otherwise still youthful. Older patients may develop such extensive sagging that their eyes begin to look hooded and vision may be impaired.

At the Cosmetic & Plastic Surgery Clinic, Dr. Julio Garcia, a Las Vegas plastic surgeon, has a full armamentarium of solutions to help you take control of or reverse aging of your eyes, from skin care and lasers to eyelid surgery (otherwise known as blepharoplasty).

How do you know if blepharoplasty is right for you? Let your eyes tell you:

What Do Your Eyes Say?


If the skin around your eyes has begun to sag and droop and/or if you've developed deep troughs or fat pads under the eyes, you could be perceived as tired, sad, depressed, un-energetic, sleepy, distracted, or just plain old.

First steps to remedy eye aging might be an anti-aging skin-care regimen with retinoids or retinol, laser therapy to tighten the skin and stimulate collagen, Botox to smooth out crows' feet, and hyaluronic acid fillers like Volbella and Restylane Silk to fill in wrinkles and tear troughs.

But, over time, these stop-gap treatments can become expensive. And if you've waited too long, the improvements they offer may not be sufficient. If your eyes are continuing to age you despite your best efforts, and if you are looking for a solution that can last up to 10 years or more, it may be time for cosmetic blepharoplasty.

What Do Your Eyes See?

In extreme cases of eyelid drooping, the skin of the upper eyelid falls so low over the eye that it actually impairs vision – a condition also known as ptosis. Ptosis may not always be age-related; it can be congenital as well and is often seen in young children and even babies. Hooded eyes may be exacerbated by a forehead or brow that has also begun to droop. If you are having trouble seeing due to eyelid hooding or drooping, you may benefit from a functional blepharoplasty.

In certain instances, a functional blepharoplasty may be covered by insurance. To qualify, you would need to present the results of a Visual Field Test performed by an ophthalmologist. While this is a necessary step, it is by no means a guarantee that your surgery would be covered under your plan.

What Is Blepharoplasty?


Blepharoplasty, or eyelid surgery, is one of the most commonly performed facial plastic surgery procedures. Among men, it is the number-one most performed plastic surgery procedures.

There are two types of eyelid surgery: upper blepharoplasty and lower blepharoplasty. Each surgery will tighten the skin and muscle around the eyes and remove excess skin and fat. Many patients are satisfied with one or the other, but performing both upper and lower blepharoplasties is also common. Blepharoplasty is often added on to a full-face plastic surgery rejuvenation, such as a facelift (rhytidectromy) and/or accompanied by a browlift to alleviate pressure on the upper lids.

Preparing for Your Blepharoplasty

After you have decided to rejuvenate your eyes with blepharoplasty, and have found a board-certified facial plastic surgeon to help you, it is time to prepare for your procedure.

If you wear contact lenses, you will be asked to switch to eye glasses for at least two weeks before your eyelid surgery to minimize the risk of irritation and dryness. Smokers will also need to cease smoking two weeks before and two weeks after surgery, so that the body can be fully devoted to healing.

Other lifestyle adjustments will include refraining from any medications or herbs that affect blood clotting, including anticoagulants, nonsteroidal antiinflammatories (NSAIDs), ginseng, garlic, ginger, cumin, St. John's wort, tumeric, and Vitamins C and E.

You may be recommended to take the supplements arnica and/or bromelain, which may help limit bruising after your procedure.

What Happens During Upper Blepharoplasty?


Upper blepharoplasty is usually performed using local, intravenous anesthesia. However, if you would prefer to be asleep, the Cosmetic & Plastic Surgery Clinic is able to accommodate you, as are most facial plastic surgery centers.

The incision is made in the eyelid crease, so the scar will be hidden once it heals. If excess fat is present, it is then removed. This is a crucial step in the procedure, as the removal of too much fat can be aging. Dr. Garcia understands facial and eyelid aesthetics and so uses a light hand during this step to be sure your eye area looks youthful after the procedure.

If your ptosis is caused by sagging muscle as well as skin, the levator muscle will be tightened with tiny sutures. Once the muscle has been tightened and the excess fat removed, the skin is stretched and excess skin is trimmed away. The eyelid is then closed with fine sutures along the incision line in the eyelid crease.

What Happens During Lower Blepharoplasty?

A lower blepharoplasty is usually performed in an incision that is made inside the lower lid. As with upper blepharoplasty, excess fat is removed but care is taken to leave a sufficient amount of fat to allow the eye to appear youthful. If you have hollow tear troughs, these may be filled with the repositioned eyelid fat or with fat previously harvested from some other area of your body. The skin is stretched to resolve sagging, excess skin is removed, and the incision is closed with fine sutures.

What Is the Timeline for Blepharoplasty?


Each blepharoplasty only takes about one to three hours to perform. After your surgery, you will not need any bandages, but should keep your head elevated for 48 hours and apply ice or cooling packs according to a schedule provided by your surgeon. Your stitches will be removed within a week. Full recovery will take several weeks.

Once you are healed from your blepharoplasty, you'll be amazed at how refreshed and rejuvenated your entire face looks. When well performed, upper and lower eyelid surgery makes you look rested, healthy and alert, not “done.” Nobody should realize that you have undergone facial plastic surgery, but expect plenty of compliments on your revitalized look!

Ready to Sparkle? Call a Las Vegas Facial Plastic Surgeon

If you are ready to learn more about how blepharoplasty can rejuvenate your face and make you look more energized and youthful, please contact Dr. Julio Garcia at the Cosmetic & Plastic Surgery Clinic, (702) 870-0058 or to schedule your consultation. You can also use our email form. We welcome patients from Las Vegas and around the world.


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