The Bad News: Things Eyelid Surgery May Not Improve

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There are certainly many things that an eyelid surgery can improve - The Good News: Things Eyelid Surgery Will Improve, however, as with any operation, there are limitations to what eyelid surgery will be able to improve. To better ensure satisfaction with your eyelid surgery, it is just as important to be aware of the problems that it will not correct as those it does.

Dark Circles

Dark circles under your eyes may be caused by shadows or skin discoloration. If your dark circles are due to shadows caused by bulging fat, eyelid surgery will help. If they are due to discoloration, eyelid surgery alone will not help.

To determine if your dark circles are due to discoloration or shadows, study your eyelids in the mirror. Using your index and long fingers, stretch the skin of your lower eyelid upward and outward. If the dark circles disappear, then they were due to the shadow cast by fat bulges of your lower eyelids and may improve following lower eyelid surgery. If the dark circles remain, they are due to skin discoloration and will not improve following eyelid surgery. Chemical peels or laser resurfacing can sometimes improve discoloration.

Malar Bags

Malar bags are areas of puffiness on the cheeks, just below the eyelids. They are often confused with puffy eyelids because the two are so close. To determine whether your puffiness is due to eyelid fat or malar bags, close one eye. Gently press on your eyeball through your closed lid. Eyelid fat will bulge in response to pressure, but malar bags will not change.

Although close in proximity, they are worlds apart with regard to treatment. Eyelid fat is improved through eyelid surgery. Malar bags are not. Many treatments have been used for malar bags, but none have achieved consistent or reliable results. Malar bags are due to swelling, and swelling is something that surgery (with few exceptions) does not generally improve.

Tear Troughs

Tear troughs are the creases that some women have from the inner corner of the eye to the cheek. Eyelid surgery does not directly affect tear troughs, although removing protrusive eyelid fat above them often makes the tear troughs less obvious by comparison: if one lowers a hill, the valley does not appear as deep. Tear troughs can be addressed through fillers.

Crow's Feet

Crow's feet, the tiny wrinkles that appear at the outer corner of eyes, will not be improved through eyelid surgery. These wrinkles can be treated with nonsurgical options.

Pseudo Excess Skin

Things would be simple if all of the excess skin you see in your upper eyelids were just that: excess skin. Too often, it is not. In most cases, the eyebrows have dropped, contributing to the problem of excess skin of the upper lids.

To determine how much of your upper lid problem is due to your descended brows, use your fingers to pull your brow up to the bone above your eyeball. When you do, you will note a definite improvement in your upper lids. The amount of improvement you see with this maneuver is termed pseudo excess, as it is due to low brows, not excess skin of the upper lids.

As you lift your forehead skin, you will continue to note some excess eyelid skin, although it will appear less abundant than it did when you were not supporting your forehead. The excess skin you see is from your eyelid and will be improved through eyelid surgery.

This exercise is worth repeating because it demonstrates that the excess upper eyelid skin that you perceive is not truly all excess. Anywhere from 10 to 90 percent is due to excess eyelid skin and the rest is due to droopy eyebrows. This percentage differs for everyone. Your surgeon should determine your ~~ ratio of excess to pseudo excess skin prior to surgery to help you understand the variable improvement you can expect from eyelid surgery, forehead lift, or both. In short, if you have both a droopy forehead and excess eyelid skin, eyelid surgery alone will improve only the portion that is due to true excess, and brow lift surgery will only improve the portion that is due to droopy brows.