Rejuvenation of the Eyes: General Considerations
Read testimonials from blepharoplasty patients..
Eye Rejuvenation FAQs
Your eyes are the first thing others see when they look at your face. An immediate impression is formed about your age,
level of energy, and how tired you are. The eyes are also the first part of the face to show the signs of aging.
It is also important to note that when people look at our eyes, they are not just seeing the upper eyelids or lower
eyelids, they are seeing the entire region around our eyes. This includes the skin, the hollows and dark circles beneath the eyes,
and the sagging eyebrows.
Therefore when developing a treatment plan for real rejuvenation
of the eyes
, the changes that have occurred to the midface (upper cheek), eyebrows, skin, and volume have to also be taken into account.
Aging of the eyes starts in the mid 30's. One of the first signs of aging is loss of volume in the lower eyelid region.
This results in hollows (tear trough deformity) and dark circles that leave the eyes looking tired and drawn. With time other changes
occur. Puffiness or bags along the lower eyelid region, accumulation of excess skin along the upper eyelids, decent of the eyebrows,
loss of volume of the midface and upper cheeks, and the appearance of fine lines and wrinkles around the eyes are the other changes
that result from aging.
Following a comprehensive assessment of the aging-related changes around the eyes, a much more sophisticated treatment
plan can be prepared.
Commonly the plan involves a variety of non-surgical and conservative surgical modalities that when put together, truly
rejuvenate the eyes with minimal risk and downtime. This leaves the eyes looking revitalized and rejuvenated without changing the shape
of the eyes or their function.
Non Surgical Eye Rejuvenation
With age a layer of fat around our eyes begins to diminish, which leave our eyes looking hollow, sunken, and bony.
This process starts as early as mid 30ís and continues to worsen with age. In these cases, removing fat would make the eyes look
even more sunken and hollow. Therefore, fillers such as Restylane can be used to fill the tear troughs of the lower lids as well
as the hollows along the upper eyelid region. This is an in-office procedure and typically takes 10 minutes and is virtually painless.
Until recently, this component of facial aging was overlooked. We are now realizing what a major contribution volume makes to looking
younger, healthier and more energetic. The results can be dramatic. They leave the eyes looking significantly more refreshed and less
tired-appearing. Often this can be combined with Botox, which be used to lift the eyebrows and significantly reduce the appearance of
wrinkles in the crows fee and along the lower eyelid region. Learn more about the non-surgical
eyelid rejuvenation San Diego
Micro Fat Transfer
When the volume loss is more substantial and includes the cheeks and upper face, fat transfer is a preferable treatment.
When done well by an experienced facial fat transplant surgeon, the face returns to its more youthful contour and shape. The results
can be very dramatic yet natural appearing and subtle. The major advantage is that the results are permanent. The procedure is done in
the office setting under local anesthesia. Recovery takes 1-2 weeks in most cases. Learn more about the
non-surgical eyelid rejuvenation
Upper Eyelid Surgery Blepharoplasty
This is a procedure that is performed to remove the extra skin that sags and drapes over the upper eyelid. It creates
a lighter, more contoured upper lid. While Men and Women enjoy looking years younger and benefit from this procedure equally, the
techniques are different for each sex. A skilled and experienced eyelid surgery surgeon will create a natural rejuvenation while maintaining eyelid
In addition to the rejuvenation benefits, our female patients commonly note how much nicer it is putting eye shadow on
their new smooth upper lids.
Men, commonly note how much younger and rested their eyes appear. For men, looking younger and more energetic has major
implications professionally. This is the most common reason our male patients choose to have this procedure.
Upper eyelid Blepharoplasty is most commonly performed under local anesthesia in the office. The eyelid crease is first
carefully marked then the amount of excess skin is marked and an ellipse of extra skin is then carefully removed. Occasionally, fat or
muscle is removed to decrease the fullness. The incision lies in the natural crease, therefore it is imperceptible even as early as 1
week after the procedure. Stitches are removed within 1 week. The actual downtime consist of very mild swelling and redness and typically
resolves after 3-4 days. Bruising is very rare. The entire procedure typically takes 30 minutes.
The results are very dramatic.
Lower Lid Blepharoplasty
This blepharoplasty procedure is performed on patients with fat pockets (bags) under the eyes. In patient's with bulging fat but not
very much sagging skin, the blepharoplasty procedure is preformed without any external incisions (transconjunctival lower eyelid blepharoplasty).
This is ideal for patients who have very little extra skin but significant amount of extra fat ( eyelid fat pads or bags). On the other
hand, patients with extra lower eyelid skin with/without bags, are candidates for skin-muscle flap
- Eyelid surgery. In this procedure, an incision is made just below the eyelashes and the fat is
removed along with a small amount of skin and muscle. This tightens the skin in addition to decompressing the bags. Others who do not
have excess fat pads but simply have loose lower lid skin, are candidates for lower lid skin-only blepharoplasty ( eyelid surgery ). This safe and simple
blepharoplasty procedure and significantly tighten the lower lid skin and re-establish the smooth lower lid contour.
Eye Brow/Forehead Lift - San Diego
The eyebrows should be positioned above the bony rim. Whether because of genetics, volume loss, or gravity, in certain
cases, they begin to descend below the rim. When this occurs the eyes take on a crowded, tired, angry or sad expression. These expressions
may not reflect how you actually feel. The treatment is a procedure called the forehead lift or browlift. Based on variety
of factors including gender, position of hairline, and the shape of the brow, a different approach is used depending on the case. The basic
approaches are the endoscopic browlift, the coronal, the pretricheal, and the mini lateral brow lift.
The main difference among the various options for forehead lifting consists of the placement of the incision.
The original technique is the coronal incision, which is made slightly behind the natural hairline. An alternative is the
pre-trichial incision. This is similar to the coronal incision except that the mid-portion of the incision is made directly at the hairline.
This incision generally heals favorably and has the advantage of lowering the hairline. The disadvantage could be noticeable scarring. An
option is to place the incision within the mid-forehead creases. This is primarily used in men with deep pre-existing forehead lines. A
more recent approach is endoscopic forehead lift surgery. Several small one-half-inch to one-inch incisions are placed just behind the
hairline. Although this technique may require more surgery time, it is less invasive and results in a smaller chance of temporary scalp
A Mini Lateral Brow Lift, is a modification of a full brow lift. A very small incision is placed in the hairline in the
temple region and the corners of the brow are pulled up. This gives women the pleasant arched shape.
Depending on the type of browlift procedure being performed, it takes between one to two hours to perform. It is most
commonly performed under local anesthesia, IV sedation (twilight anesthesia).
Not infrequently, a brow lift is combined with blepharoplasty (an eyelid tuck) or face lift to provide a harmonious
Eyelid Surgery Patient Testimonials
Gold Standard Hands Down
I will absolutely never trust my face to anyone other than Dr. Karam. Hands down. I began seeing Dr. Karam last year, at which time he performed surgery on my upper eyelids, as well as a fat transfer under my eyes and into my cheek area in order to freshen and rejeuvenate. The results are truly astounding. Before I had this done, at age 40 most people guessed my age at late 30s. After Dr. Karams work - I am consistently guessed to be in my very early 30s. The work is so natural & fresh, that even when I share what I have had done - friends cant detect a thing....regardless of how long they stare! As a result - I sent both my parents to him for facelifts, fat trans, upper eyelids....they are THRILLED with the results, and both look a good 10-12 years younger. No joke. I am fortunate to be able to see any surgeon of my choosing - and Dr. Karam is the absolute Gold Standard to whom other physicians should aspire. I am so stoked to have found him!! Who says you have to grow old gracefully? ;-)
read more eye surgery testimonials
read browlift patient testimonials
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If you are ready to schedule an appointment with facial plastic surgeon Dr. Karam for eyelid surgery San Diego or rejuvenation or blepharoplasty
San Diego California call us at 858-259-3223 today.
Dr. Karam is the co-author of the chapter titled, Lower Eyelid Blepharoplasty