There are three types:
Skin only - Only the excess upper eyelid skin is removed, usually done under local anaesthesia and takes about 1 hour. Seen in people over 50 years old.
Comprehensive - Treats excess skin and simultaneously addresses deeper tissues such as fat, muscle and connective tissue. Excess skin is one aspect of eyelid ageing but the other aspects such a as excess fat, increased muscle activity and bulk, loose connective tissue, weak tendons and droopy eyebrows are equally important and all need to be addressed for the best results. This can take up to 90 minutes.
Ptosis (droopy eyelid) correction - In this condition, the muscle that opens the upper eyelid becomes overstretched and loses its ability to open the upper eyelid. This is similar to an overstretched rubber band that has lost its elasticity. Surgical tightening of this loose muscle restores the function of this muscle and fixes a droopy eyelid. Since a droopy upper eyelid co exists with multiple ageing changes of the upper eyelid, both these operations can be combined to restore the function and aesthetic of the most important part of your face. This combined operation can take upto two hours.
Ageing changes in your upper eyelids are noticeable in your late 30s or 40s. The 10 most common ageing changes in the upper eyelid are:
The eyebrows are just like any other structure in the face and are affected by ageing in one of three ways:
A very high arched eyebrow is caused by the pull of an overactive forehead or frontalis muscle in response to a droopy eyelid. The treatment is to correct the droopy eyelid.
If the eyebrows are low and droopy then a brow lift done at the time of eyelid surgery is effective. A brow lift can be done either endoscopically, or by an external or internal approach.
If your only problem is excess skin and every other supporting structure of the eyelid is in excellent condition, then a skin-only Blepharoplasty is appropriate. Unfortunately, this only occurs in a small group of patients who are young, when the remaining eyelid tissues are capable of maintaining robust and strong support to the eyelid.
The surgery removes excess thin and crepey skin from the lower eyelid, removes the eyebags and redistributes bulging fat. It also tightens the supporting ligaments that have weakened with age.