Before: 62-year-old female bothered by heaviness in her upper eye lids and puffiness in the lower eye lids giving her a tired appearance. This is caused by excess skin in her upper and lower eyelids, excess fat in the lower lids, but also due to loss of volume along her cheeks and under the eye lids. A balanced approach needs to be taken. Remove too much upper eye lid skin can create a hollow unnatural appearance. Similarly, removing all the excess lower eye lid fat will create hollowness of the lower lids. A newer approach is to remove less skin in the upper eye lids and leave the upper eye lid muscle intact. In the lower lids, a conjunctival approach is taken to remove the excess fat. Skin is tightened with Fraxel laser resurfacing. Most importantly, volume around the lower lids is replaced to give a balanced more youthful, natural appearance.
After: 1 year after upper eye lid blepharoplasty, lower eye lid transconjunctival blepharoplasty (stitchless) and toning of the lower eye lid skin with Fraxel Re:pair laser resurfacing. Hollowness along the lower lids was filled in with 2 syringes of Restylane.