A high-quality blepharoplasty can offer far more than just elevating the eyes. It can eliminate under-eye bags and dark circles, firm up wrinkled lids and remove excessive skin, creating the impression of more space above; enhance facial rejuvenation; and even improve vision that has been affected by sagging skin or ptosis, the medical term for a droopy eyelid – all within less than an hour and without leaving obvious signs of cosmetic surgery.
Typically an outpatient operation, an eye lift only requires local anesthesia for upper eyelids, or either IV sedation or general anesthesia for lower eyelids. Nevertheless, the recovery period can extend for weeks, and its side effects comprise dry eyes and irritation.
If you desire a youthful look around the eyes without incisions, great news: There are also choices for a non-surgical eye lift. Injectables, such as Botox and fillers, can be strategically placed around the eyes to temporarily uplift them. However, it largely depends on your specific concerns and goals; for a more severe sag, for instance, a brow lift might be necessary.
For a surgical eye lift, though, precisely what differentiates a well-executed job from an outcome that raises eyebrows? In the big picture: “The patient should appear revitalized without being stretched or having exaggerated features,” says Dr. Bruce Moskowitz, a board-certified oculoplastic surgeon in New York City.
On a more detailed level, the subtle distinguishing indicators of a skillfully performed blepharoplasty can be just as straightforward to identify – if you know what to look for. If you’re contemplating an eye lift, pay close attention to the following characteristics when browsing through a potential surgeon’s before-and-after gallery.
1. Symmetry
Whether your natural eyes are symmetrically formed initially or you’re pursuing a blepharoplasty in the hope of attaining a better equilibrium, you should not leave the operating room with asymmetrical traits.
“I handle a significant number of revised botched eyelid surgeries, and the most frequent complication is asymmetry, where the two eyes look highly distinct,” says Dr. Robert Schwartz, a board-certified cosmetic oculoplastic surgeon in New York City. The overall aim should be “a symmetrical, natural contour” where the eyes match in size and shape while remaining in harmony with the rest of the face.
2. A concealed, fine scar
Another advantage of eyelid lifts, both upper and lower: there should be no visible scarring. In an upper blepharoplasty, a thin incision is made along the natural crease of the lid. “In daily interactions, with your eyes open, it’s not noticeable because it’s hidden within that crease,” explains Dr. Jessica Lattman, a board-certified oculoplastic surgeon in New York City. “If you were to close your eyes and look closely, the scar would be visible for the first few months, but then it truly heals into just that same tiny fine line.”
Generally, the thinner the skin on the body, the more rapidly and completely the scarring will fade – and the skin of the upper eyelid and around the entire eye area is exceptionally thin.
In a lower blepharoplasty procedure, there are two distinct paths for incision, and your surgeon will determine which to adopt, depending on the issues you aim to address. One option (technically termed a transconjunctival blepharoplasty) is to make the incision on the inside of the lower eyelid – the pink, fleshy part you can observe if you pull down and peek inside. With this approach, “there is no scar on the skin, no stitches, nothing at all,” Dr. Lattman says, elaborating that it works best “for young individuals who only have problems with bulging.”
The second technique (the subciliary approach) can handle a bit more, including loose eyelid skin and muscle. In this case, the incision is made just beneath the lower eyelashes. “It’s a slightly longer healing [time] because you do have stitches under the eyelid, [which] come out after approximately a week,” Dr. Lattman explains. Still, when done well, “within a couple of weeks, that scar should be undetectable,” she states.
3. Unaltered eye shape
“A patient’s eye shape should remain the same, unless there is a reason for it to change,” Dr. Schwartz remarks. Even in cases where there is a cause to modify the shape – a downward-slanting outer corner, for example – “it’s typically not favorable to change someone’s appearance, and altering the shape of the eye can do precisely that.”
So if you’re viewing a set of before and after photos and the actual shape of the eye appears significantly different in the latter image, that’s a warning sign.
If you are seeking blepharoplasty specifically to assist in correcting any downward slant (which could be genetic or age-related), you’ll want to have an in-depth conversation with your surgeon to guarantee the best aesthetic outcome. Your doctor may even request pictures of your younger self to evaluate your original eye shape and replicate it during the surgical process.
Related: The Ultimate Guide to Larger, Brighter Looking Eyes – From Makeup to Medical Treatments
4. An overall natural appearance
The results should not seem artificial or copied from another person. “I’m going to attempt to take the eye the patient [already] has and make it look as good as possible,” Dr. Lattman says. “I’m not going to try to create a different eye.” Anything that appears pulled, tense, or otherwise abnormal does not represent a first-class eye lift. “Natural-looking results that make the patient seem refreshed, relaxed, [and] youthful” are the ultimate objective, says Dr. Phillip Langsdon, a board-certified plastic surgeon in Germantown, Tennessee.
One final piece of advice: “Photos can be deceptive,” Dr. Langsdon cautions. In addition to conducting your research and having an in-person consultation, when examining before and after images, be sure to “look for similar lighting in the photographs for accurate comparison,” he says.
