Eyelid Surgery (Blepharoplasty)

Physicians with combined training in opthalmic plastic surgery and opthalmology have enhanced ability to perform delicate procedures around the eyes. Because of their specialized training, they can repair many problems interfering with the normal patient's appearance.

“Functional” surgeries are necessary to restore the normal protective function of the eyelids and restore a full field of vision, i.e., may be considered medically necessary.

Cosmetic surgery is generally perceived as a "beautification" procedure rather than as the repair of a physical flaw and is not covered by insurance.

Ptosis is a medical term for a droopy upper eyelid, which covers part of the cornea and interferes with peripheral vision. Much like a window shade pulled part way down blocks the upper part of the window, a droopy eyelid can block the upper part of your vision. Surgical repair to elevate the eyelid (much like lifting up the window shade) can restore your peripheral vision. Many times this is covered by insurance.

Baggy eyelids can cause a person to look tired, run-down, older, and even angry. They can also interfere with vision and comfortable use of the eyes. Blepharoplasty consists of removing the excessive skin, muscle, skin folds, and sometimes underlying fat pads in the upper and lower lids. This is done not only for improvement of a person's appearance, but in many cases is done to improve vision, particularly when the upper eyelid has hooding skin which obstructs vision or causes fatigue. The intended effect of the surgery in the upper eyelids is the creation of a new, normal-appearing lid "crease" and elimination of the hooded, puffy appearance.

Before and After Images of After Brow Lift and Lower Eyelid Surgery
(mouse over image to see change)

Before
After	(note: upper eyelids were not operated on)

There are some people who may require more than the usual surgical procedure to produce these desired effects. These extra surgical adjustments can be performed at the same time as the usual surgery. This additional surgery may be necessary in people who have an unusual laxity or looseness of their eyebrows, so that they droop over the upper-lid area; if this is the case, a brow lift or brow fixation can be performed at the same time as the upper-lid blepharoplasty, and it produces a much better effect in the upper-lid area.

In the lower lid, there may be extra laxity of the tendon, allowing an out-turning of the lower lid, or there may be so much laxity of the cheek tissue that it pulls the lower eyelid down. If so, tightening of the tendons of the lower eyelid and even elevation of the cheek tissue may need to be done in order to put the lower eyelid back into its proper position to allow better closure of the eye. Because the eyelids affect vision, a surgeon specially trained in opthalmic plastic surgery best performs these procedures.

Dr. Bunin's extensive 17+ year of experience and specialized training in the tissues of the face, eyelids, eyes and skin, set her apart from other doctors. Her unique expertise helps each patient obtain his or her best aesthetic results.

Before
After	upper eyelid blepharoplasty

In the lower eyelids, an "invisible" approach can be used to remove the fat bags from inside the eyelid, requiring no stitches. The excessive skin can then be removed using laser resurfacing, rather than being cut off and closed with stitches, leaving a smoother, non-baggy appearance.

Before
After	before and after invisible eyelid surgery lower eyelids

© Lisa S. Bunin, M. D. All Rights Reserved.