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In some racial groups, such as Asians, blepharoplasty can also create a double upper eyelid fold and restore the fat distribution in the eyelids to correct the sleepy, tired look.

Aging around the eyes is often more pronounced than the rest of the face and as such, blepharoplasty is often performed as an independent procedure or in combination with a facelift.

Blepharoplasty surgery usually involves removal or redistribution of the bulging fat and importantly, resetting or tightening the septum (curtain) that holds back the fat pads to where it was in youth. This technique of resetting the septum is important to prevent removal of too much fat. Removal of too much fat gives a ‘hollowed-out’ look to the eyes and ages a person markedly.

The final part of the operation is to then remove the excess skin once the underlying structures (fat, septum, muscle) have been restored. This allows for tension-free closure and incisions hidden in the eyelid fold (upper eyelid) and eyelash line (lower eyelid). Commonly the lower eyelid will also be supported with an internal suture (canthopexy) that counters gravity pulling down the eyelid during the healing process.

Younger patients undergo blepharoplasty where they have annoying bulging fat pads under their eyes despite how much sleep and rest they may have had. In these cases, where the skin is of good elasticity, the operation is performed from internally behind the lower eyelid eyelashes thus avoiding an external incision.

For more information regarding this procedure, please refer to our blepharoplasty functional or cosmetic? blog post.