Often patients will combine eyelid surgery with other cosmetic procedures to achieve a balanced rejuvenation. Since eyelid surgery only improves the upper and lower eyelids themselves, additional procedures may be needed if a patient would like to correct areas such as the forehead, brows, cheeks, lower face, or neck. While any of these procedures can be performed before or after a eyelid surgery, many patients choose to combine procedures, thereby combining recovery time. If you are concerned with rejuvenating other areas of your face beyond the areas targeted by blepharoplasty, you should discuss this with your surgeon. Your surgeon will be able to guide you as to which procedures are easily combined, which will give you the best result, and how your recovery will be affected. Below listed are the most common procedures combined with blepharoplasty:
Face Lift (Rhytidectomy)
While the words “face lift” seem to imply the entire face will be rejuvenated, the areas a facelift addresses are limited to the lower half of the face and the upper neck (if a submentoplasty or necklift is combined with the face lift operation). When aging changes are noticeable in these areas, a face lift may be a smart addition to blepharoplasty surgery. For a detailed explanation of the various types of facelift surgery, please visit www.faceliftstlouis.com.
Browlift (Forehead Lift)
Browlifts are commonly considered or performed along with upper blepharoplasty. While upper eyelid surgery can remove excess skin and fat from the eyelid itself, it cannot reposition a sagging brow. Women’s brows generally look best when they are above the bony eye socket rim, arching gently towards the outside corner of the eye. Men’s brows generally look best when the sit right at the level of the bony orbital rim, running pretty much straight across. Aging changes in both men and women usually allow the outside edge of the brow (the “tail) to sag, creating a “sad” or “mad” appearance and creating a hood of skin at the outside corner of the eyelid. In cases where upper blepharoplasty is performed together with a browlift, overall cosmetic results are generally superior. For more information on browlifts click here.
Chin Implant (Chin Augmentation)
Osteoporosis of the facial bones often produces a chin that apparently “shrinks” or recedes over the years. As the chin recedes, the structures of the lower face loose support, and jowling and neck looseness appear earlier than they should. In patients with a weak chin, a chin implant procedure can be the most powerful part of any facial rejuvenation journey.
Cheek Implant (Cheek Augmentation)
Cheek Implants come in many shaped and sizes. Depending on which shape is chosen, and where the implant is placed, varying effects may be obtained. Implants placed high up and towards the “apple” of the cheek can create a dramatic, or sometimes angular look, while implants placed toward the front of an aging cheek can “lift” and fill sunken cheeks, and frame the eye. Often, to achieve a truly youthful lower eyelid, a cheek implant is necessary, as the lower eyelid and upper cheek area age together and must be treated in concert. Generally, cheek implants are placed through a small incision inside your mouth.
Botox is a muscle-relaxing medication that is often used in the eye area to improve wrinkes and brow position. After more than a decade of widespread cosmetic use, Botox remains the single best means of treating crow’s feet and frown lines. Even in patients who undergo laser resurfacing or browlifting, Botox use in these areas is beneficial to prevent the early return of these wrinkles. Properly performed Botox can also elevate the tail of the brow into a pleasing, youthful position, creating a “chemical browlift” effect.
Injectable fillers, such as Restylane, Juvederm, Evolence, Radiesse, and Sculptra, improve facial lines, wrinkles, and folds by “filling them in” through a series if injections. They are often performed as a simple office visit, but may also be combined with surgery. The lips, smile lines (nasolabial folds), marionette lines (puppet lines), and cheeks are commonly filled areas. The tear trough, or depression between the side of the nose and lower eyelid area, is also often a great place to use injectible fillers. In people with little or no actual fat bags, filling the tear trough with dermal fillers can make an improvement that is actually more impressive than surgery.
Laser Resurfacing uses the energy from a highly focused beam of light to renew skin. Some kinds of laser energies target and destroy hair follicles, and are good for laser hair reduction. Others target and remove excess pigment in “age spots”, and still others can remove a precise amount of the outer layers of sun-damaged skin to treat facial lines, wrinkles, and dark spots simultaneously. It is this type of “resurfacing” laser that is often used in the eye area to treat wrinkles and dark circles, with or without a blepharoplasty procedure. While early resurfacing lasers, called CO2 lasers, healed very slowly and had a high rate of long term skin pigment change, more modern lasers hear quickly in the eyelid area – usually within 5 days – and rarely change the color of the skin.
If you would like to know more about combined blepharoplasty procedures contact our office and we can set up a consultation.