When is it time for an eyelid lift?

Eyelid lifts are my most popular cosmetic surgery. But how do you know when it’s the right time? In general, people want to manage their aging process gracefully, meaning that they want to look better but don’t want anybody to really be able to tell. The key for surgical solutions is often timing. You want to make sure it’s the right time for surgery, but you don’t want things to have gone SO far that the change will be obvious to other people.

Today we’re going to review the aging process as it affects your eyes and things to consider as you decide whether it’s time for an eyelid lift.

Let’s review the anatomy of your eyelids and how it is affected by aging. The outer layer is made of skin. This skin is the thinnest skin of your entire body and it’s extremely susceptible to stretching out and wrinkling. Under the skin lies the orbicularis oculi muscle (don’t worry, there won’t be a quiz later). It’s the muscle that makes you close your eyes when you squeeze them shut. Under that is a layer of thin connective tissue called the orbital septum. Behind the septum is fat. The fat is meant to be there and it serves as a cushion for your eyeball.

As we age, the orbital septum thins out which allows the fat to bulge forward. No amount of weight loss is going to make the bulge go away because it’s an issue of support. Think about the orbital septum like you would a pair of Spanx®. Spanx® make you look good because they squeeze what you have into a smaller shape under your clothes. The same amount of tissue is there, it’s just better supported. Which gets to our first consideration of when it’s time for an eyelid lift.

    1. You have excessive bulging of your upper or lower eyelids. Once the orbital septum starts to thin out, the fat is going to bulge and there’s nothing you can do about it. It also stretches out the overlying skin.


      Two weeks post

      Check out these before and afters of a younger patient who had an eyelid lift for tremendous bulging of her upper eyelids. She also had another consideration for an eyelid lift.

    2. You’re starting to get deep wrinkles on your forehead. Your forehead muscle (the frontalis for you anatomy lovers) is responsible for pulling up your eyebrows. Frequently people with deep forehead wrinkles have them because they’re constantly pulling up their eyebrows because they have extra weight sitting on their eyelids.

      This is the same patient as above. You can tell she’s lifting up her eyebrows because it helps her to see!

    3. Your eyes (and forehead) feel and look tired at the end of the day. You’ve been pulling all that weight up and out of the way all day so you can see. No wonder your face feels exhausted! It’s ok to be tired, but you don’t have to look tired!
    4. You’re having issues with your makeup. Many patients who need an eyelid lift avoid wearing mascara because it rubs off on your eyelid skin during the day, giving you a second line on your lids.


      This patient was thrilled to be able to wear mascara again!

      1. You look in your rearview mirror, and you see your mother’s eyes looking back at you. You can love your mother, but you don’t need to love looking like her…

      Upper eyelid lifts can be done in my office and you could be home in time for lunch. Many patients are back at work in a matter of days. If you’re wondering if it’s the right time for you to have an eyelid lift, reach out to us through the form to the right!

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