Especially for the patient over thirty, it is critical that a correct diagnosis is made.

Diagnosis: Is Surgery Needed?

If the eyes feel heavy or look heavy, the first thing you have to do is make sure the structures around them are not contributing to this appearance.

Upper Eyelid

Specifically, on the upper eyelid, you have to make sure the brows are in the correct position. The brow goes up, about sixty percent of the time, you do not need upper lid surgery, or only minimal surgery is required.

Lower Eyelid

If the lower lid has a bulge in it, you first have to make sure the mid face is not collapsed. If the midface is up, about seventy percent of the time, you do not need lower lid surgery, and in fact it would be a mistake as it would make the eye more hollow.

The Procedure

However, sometimes you do need to take a little skin out of the upper lid, and fat out of the lower lid to get the optimal result. The upper lid requires usully just a small incision and the with the lower lid, just removing a small amount of fat to get the ring in the lower eye removed. This is done through the inside of the lid, so there is no scar on the lid, and no risk of eyelid pull down.

A typical patient, with her eyes in a good position, we know that the extra skin is just from eyelid skin which we can remove. Her lower eyelids mainly have wrinkles on them, so we can treat that with laser therapy, and a small incision inside to get rid of the little bulge.

The Result

Our final result shows the area where the eye shadow goes re-exposed, and the lower lid smooth with no ring anymore, and no tell tale signs that the laser therapy was done.  All that is left is a natural appearance.