Posts Tagged ‘eyelid lift’

Your Age Defying Questions Answered: Secrets to Defying the Aging Process

facial-rejuvenation-emailAging is a part of life. And yes, your appearance will change as you get older. But that doesn’t have to be a bad thing. Aging gracefully is about allowing the best version of yourself to shine through, and there are countless facial rejuvenation tools and treatments to help you do just that.

During our live chat on Tuesday, July 19th, Emory Aesthetic Center plastic surgeon, Dr. Felmont Eaves, answered all of your questions about helping to defy the aging process. Dr. Eaves discussed everything from skin care products to injectable treatments to cosmetic surgical options, such as Botox®, facelifts and eyelid lifts.

Below are just a few questions we were unable to respond to due to the large number of questions we received. For a full listing of questions and answers, please read our chat transcript. It is full of useful tips and answers that may be relevant to you. You may also visit emoryaesthetic.org for a full list of services and treatments offered by the Emory Aesthetic Center.

Question: How do I minimize dark circles beyond getting more sleep?

Dr. Eaves: There are two reasons that we may develop dark circles under the eyes. The first reason is that there is a dark tone to the skin itself. That is a difficult problem to treat, as currently we don’t have a great solution to dark circles. Sometimes bleaching creams containing hydroquinone can help, but that isn’t always successful. And chemical peels typically don’t work in this situation.

The other reason for dark circles, however, is the shadowing caused by bulging fat pads of the lower lids. Either surgery to remove or reposition the lower lid fat, or an injection of filler into the depressed area underneath the prominent fat – can soften or eliminate that shadow.

Question: What’s the best way to help with my lower face sagging without injecting a bunch of fillers?

Dr. Eaves: In the right patient, fillers can be great, but when the face truly begins sagging (not just deep folds by the mouth), then surgery is required to make truly significant changes. With a lower face lift (which typically includes tightening the neck as well) the jowls can be reduced, the cheek contours can be improved, and deeper folds/wrinkles around the mouth can be softened. It can provide dramatic, long lasting results, and recovery is generally relatively quick.

Question: How can you stop sagging eyelids?

Dr. Eaves: Sagging eyelids are generally treated with a blepharoplasty (an eyelid tuck and eyelid lift). Blepharoplasty can be used to treat the upper eyelids, the lower eyelids, or both, and are often combined with other areas of facial rejuvenation, such as a facelift, neck lift, and brow lift. Sometimes a sagging upper eyelid also has a component of malposition, where it isn’t just saggy skin. In those cases the lid can be repositioned while the blepharoplasty is being done.

Brow Lift Versus Eyelid Lift: Which One Do I Need?

eye-checkAre you tired of looking tired? As we age, excess skin or drooping brows can cause our eyes to lose their sparkle, leaving us looking chronically fatigued. You may assume that the problem is excess skin on your eyelids—and you might be right. However, sometimes the reason is more complex. If your eyebrows have drooped, they may be causing your eyelid skin to bunch up and even crowd your eyelashes.

So, do you just have to go through life looking exhausted? Fortunately, no. Eyelid lifts and eyebrow lifts are two options that can immediately enhance the appearance of your eyes and bring back your natural sparkle. Emory Healthcare cosmetic surgeons can help you determine if you’re a candidate for an eyelid lift, a brow lift or a combination of the two.

Do I Need an Eyelid Lift?

If the issue is skin excess in your upper lids alone, without any need for change in brow position, an upper eyelid lift may be all you need. This is a relatively simple and low-downtime, cost effective way to improve the brightness of your eyes. In some cases, it can even be performed under local anesthetic.

Do I Need an Eyebrow Lift?

You may be wondering how you can tell if your eyebrows have drooped. Well, ideally, a woman’s eyebrow should start in a gentle curve above the top of her nose and rise above her orbital bone (brow bone) until it peaks at the outer edge of her eyelid. Then, the brow should gently curve out and slightly downward. The entire course of her brow is preferred to be at, or slightly above, her brow bone and both brows should be relatively symmetric.

Many people hold their eyebrows up to compensate for drooping, without even realizing they’re doing it. In order to assess if this is the case for you, stand in front of a mirror and close your eyes. Take a deep breath in and out and purposely relax your brows and forehead. Open your eyes slowly, taking care not to raise your forehead, and look at your eyelids and brow position. If your brows seem to have dropped lower than you thought they were, it’s likely that you inadvertently hold them up and may benefit from a brow lift.

Although a brow lift may sound invasive or complicated, the procedure is actually not particularly high-risk or painful.

How Will I Look After an Eyebrow Lift?

To imitate the effect of a brow lift, watch in a mirror as you take your fingers and place them between your eyebrows and hairline. Gently lift a little to see how your brow position changes and if excess skin on your eyelid is reduced. If doing this improves the skin excess at your eyelids and makes a favorable change in your appearance, a brow lift may be the right option for you. If there is still excess skin on your eyelids, even as you’re gently pulling, your surgeon may recommend a combination of eyebrow and eyelid lifts for best results.

What Can I Expect?

Satisfaction rates for brow and lid lifts are high and the downtime can be as little as five to 10 days, depending on your individual surgery. Results usually last many years and don’t often need to be “tucked up” in the way that some other plastic surgery procedures require.

Eye Enhancement at Emory Aesthetic Center

If you’re considering rejuvenating and improving the appearance of your eyes, come see one of the board-certified physicians at Emory Aesthetic Center for a complimentary consultation. We can discuss your goals and determine what treatment is right for you.

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Ask the Doctor: What is the Difference Between a Forehead Lift and a Brow Lift?

looking-upIt is not surprising that cosmetic surgeons are often asked what is the difference between a brow lift and a forehead lift. After all, both descriptions involve the same area of the face, and both imply a lift. The brow is considered the hairy part right above the eyelids – the eyebrows, and the forehead is the area between the eyebrows and the scalp. Most patients, and even plastic surgeons, may use these terms interchangeably. Both of these terms describe a procedure intended to smooth and lift the skin of the forehead, and to lift and reposition the brows. How this works, however, is different for each of the areas.

In order to highlight these differences, it can be helpful to compare a brow lift or forehead lift to a facelift. When a facelift is performed, the pulled skin stretches fairly evenly, with the effect seen over the entire length of the face. It is similar to pulling a rubber band that is anchored on one end. In the forehead, however, the skin is thicker and less elastic. When the forehead is pulled, there is much less stretching of the skin.

In order to smooth and lift the skin of the brow/forehead, your surgeon will first gently create a separation between two of the tissue planes of the forehead, allowing them to glide on each other. Your surgeon will also release the attachments of the brows so that they can more freely be moved to the desired position, and then the tissues are then fixed in their new position.

So far, so good . . . but you may be asking, if the forehead skin is not stretched out very much, why do the wrinkles in the forehead get better? That is an interesting question, and the answer is equally interesting. The horizontal wrinkles in the forehead are not static – rather, they are dynamic. In other words they result from the activity of the underlying muscles that work to lift the brows. When the brows are lifted by surgery, then these muscles calm down and become less active because the stimulus to lift the brows is reduced. In addition, a brow/forehead lift often removes the muscles that are between the eyebrows. These muscles, called the corrugators, are the cause of the vertical wrinkles – also known as the “11s”. The corrugators and the muscles that lift the forehead tend to work against each other, so when the corrugators are weakened, the muscles that create the forehead wrinkles tend to work less, also helping the wrinkles to fade.

There are many different brow/forehead lift techniques that you and your cosmetic surgeon can consider depending on your individual needs. In most instances, an endoscopic approach allows for very small incisions hidden in the hairline. But there are some instances where an endoscopic approach can be combined with an incision in the eyelid performed along with an eyelid lift. And although not as common, an incision hidden along the hairline can actually lower the forehead while the brows are being raised in patients who have very high foreheads.

While we tend to use the terms brow lift and forehead lift synonymously, there are procedures where the brow is directly lifted but the forehead is not. A direct brow lift is rarely done, but works by removing a strip of skin along the upper border of the brows. This creates a scar in this area, however this technique can be used in the elderly as these scars may fade well. Another technique is to perform a browpexy, where sutures are placed using an eyelid incision to sew the undersurface of the brow to the bone. This can create a nice elevation of the brow, although it is less powerful than a full brow/forehead lift. As you can guess, this latter technique is most often combined with an upper eyelid lift.

The terms brow lift and forehead lift are used practically to describe the same thing. But what is more important than the terms, is the need to consult with your surgeon to make sure the strategies and techniques they use are best suited for your goals and anatomy. At the Emory Aesthetic Center, our multi-disciplinary team of board-certified physicians can help you navigate all the terms and decisions to come up with a treatment plan custom tailored just for you.


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About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

What is the Difference Between an Eyelid Lift, Blepharoplasty and Ptosis Surgery?

BlepharoplastyI am often asked by patients during a consult – “What is the difference between an eyelid lift, blepharoplasty and ptosis surgery?” and “Which one do I need?” These are both great questions to address. As we age, we become more aware of the puffiness around our eyes, the extra eyelid skin, the wrinkles and the droopiness (ptosis) that slowly become apparent over time. But many of us are not sure exactly what can be done to reduce this or what the right terminology is to address it. Let me help to clarify each of these terms and what they treat.

Eyelid lift is a generic term that can mean blepharoplasty and/or ptosis surgery. The term conveys the end result of the procedure being performed. Based on the name, it rightly gives the impression that tissue can be lifted, trimmed and/or repositioned to lift the eyelid. It is, however, not the technical name of any procedure that surgeons employ.

Blepharoplasty is the actual term used for eyelid surgery to trim away extra skin and either remove or reposition the fat to reduce the puffy appearance in eyelids. In the upper lids, blepharoplasty gets rid of the excess skin that can overhang on lashes, and it reduces unwanted fullness. It is a similar operation in the lower lids as well. The only difference here is that many surgeons don’t just excise the unwanted fat in the lower lids but instead moves it to an area in the cheek that is hollow to further improve on the results.

Ptosis surgery applies to lifting the upper eyelids generally by manipulating the eyelid muscle tendon that has gotten “stretched out”. Risk factors for weakening of the eyelid muscle tendon include advancing age, gravity, contact lens use, and post lasik or cataract surgery. When ptosis surgery is performed, excess skin and fat can be trimmed at the same time so it is all still one procedure.

A key element of choosing the procedure that is best for you is a thorough exam and evaluation performed by a cosmetic surgeon. The highly-skilled oculo-facial surgeons at the Emory Aesthetic Center offer multiple options to improve the appearance of the eyelids, brow and orbital area (eye socket). Depending on your age, degree of and signs of aging, and goals, we can recommend the right solution for you.

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About Dr. Hayek

Brent Hayek, MD

Brent Hayek, MD, areas of expertise include both reconstructive and cosmetic procedures. He addresses “droopy” (puffy) or malpositioned eyelids, treats Graves disease or thyroid problems as they affect the eyes, and orbital problems including tumors around the eye and fractures that affect the protective bony walls. Dr. Hayek also handles tearing problems that involve obstruction, infection or other issues of the tear drain system. Dr. Hayek performs a number of eyelid and facial cosmetic services include Botox®, facial fillers and peels, upper and lower blepharoplasty, midface and endoscopic forehead lifts.

Dr. Hayek’s research interests include eyelid and orbital tumors, as well as various implants suitable for long-term eyelid reconstruction. He has published articles in peer-reviewed publications, book chapters and has presented at regional, national and international meetings.

Eyelid Surgery: Lower vs. Upper Eyelid Lifts

Eyelid LiftEyelid lifts are a great way to rejuvenate our appearance. Our eyes and mouth are the two most common aspects of ourselves that people focus on. Think about that the next time you speak with a friend or family member – it’s unconsciously driven.

The eyelids are also one of our most defining features. One of my earliest oculoplastic surgery mentors once told me, “The eyelids are the most beautiful part of a person.” I at first thought this strange, but over the years I really have come to appreciate this thought and try to implement this concept with all my eyelid lifts.

Eyelid lifts are one of the most common cosmetic surgery procedures preformed to help rejuvenate our face. A few reasons for this include:

  1. Great result with relatively minimal surgery;
  2. Out-patient procedure – with no need for general anesthesia (if preferred);
  3. Mild post-operative recovery;
  4. Typically, imperceptible incision lines; and
  5. Long-lasting results—may not ever need repeating.

Upper Eyelid Lift: One of the most common complaints an individual may have is that with age and gravity they have noticed extra skin and fullness pushing their eyelids down, creating an aged look. Women often stop using mascara because it smears with the extra skin. An eyelid lift can address these issues by removing some of the extra skin and usually some fat that is contributing to the problem.

Lower Eyelid Lift: As we age, our cheeks slowly deflate as youthful fat is lost and begin to sag. Our lower lids develop more wrinkles and puffiness, typically developing underneath the skin. There is generally a hollow look between the cheek and the eyelids making us look older than we feel. Three main contributing factors include:

  1. Lower eyelid puffiness—usually fat;
  2. Loss of elastin and collagen in skin with wrinkle formation; and
  3. Separation of the eyelid and the cheek—remember when we are young, our lower eyelids and cheek blend together creating a youthful appearance.

To address these issues, fat is not sculpted back but is instead used to blend the cheek and the lids to create an even younger appearance than the more traditional lower lid lifts.

The surgeons at the Emory Aesthetic Center are trained to treat people of all different races and genders. Approaches may change depending on these factors and our patient’s goals. A thorough understanding of these anatomic relationships and how to tailor them to each person’s individual needs is critical. The physicians at the Emory Aesthetic Center will consult with you to help determine your needs and provide you with an optimal result.

About Dr. Hayek

Brent Hayek, MD

Dr. Hayek’s areas of expertise include both reconstructive and cosmetic procedures. He addresses “droopy” (puffy) or malpositioned eyelids, treats Graves disease or thyroid problems as they affect the eyes, and orbital problems including tumors around the eye and fractures that affect the protective bony walls. Dr. Hayek also handles tearing problems that involve obstruction, infection or other issues of the tear drain system. Dr. Hayek performs a number of eyelid and facial cosmetic services include Botox®, facial fillers and peels, upper and lower blepharoplasty, midface and endoscopic forehead lifts.

Dr. Hayek’s research interests include eyelid and orbital tumors, as well as various implants suitable for long-term eyelid reconstruction. He has published articles in peer-reviewed publications, book chapters and has presented at regional, national and international meetings.