EYELIDS Note: All procedures shown were performed by Dr. Churukian and no photos were altered to enhance the results. UPPER EYELIDS Before After 6 months It is common for the upper lid skin to gradually droop. Removing the extra skin can make the eye appear more youthful while avoiding the “startled” look. Pinch test - female Pinch test - male How do we decide how much skin to remove? We don’t want to pull the eyelashes up, or pull the brow down. So we do a simple “pinch test.” It is always best to stay on the safe side. Marked and ready for procedure Mid-surgery The incision is placed in a natural crease. Here you can see halfway through the procedure, the right eye is finished and the incision follows her natural crease. Before (L) & 6 months after (R) Why do we choose to place an incision in the natural crease of the eyelid? Mostly because we can get the best results and better symmetry with this placement. A bonus is that the incision is usually not noticeable after healing. 3 days after procedure We use a stitch here that lies under the skin so it doesn’t leave “railroad” marks. This stitch is usually removed between 3 and 7 days. Here you see a patient ready to have her stitches removed. Small tapes (steri-strips) will remain for a few more days. Before After (12 years later) This is the same patient as above who returned after twelve years. We both felt that the result was still good. Without surgery the skin would have eventually pushed down on her eyelashes. Before 4 Months Later Here our patient is a little older and the skin has already dropped down to the eyelashes. This can limit upward vision and is an example of “lash ptosis.” After surgery it is also easier to apply makeup to the upper lid. Before After 6 months This is a more pronounced example of “lash ptosis.” The upward vision is obviously limited. There’s also a feeling of heaviness that is relieved when the excess skin is removed. Before After 6 months In this patient, a brow lift was recommended. This is typically performed endoscopically under general anesthesia. She preferred instead the relatively simpler procedure of trimming the upper lids. This gave a more subtle but still helpful result. Before After 8 Months In this younger individual there is more upper lid showing on her left. There is clearly more fullnes of her right upper lid but also a subtle lower right brow. Again we opted to deepen the right upper lid rather than lift that brown. The perception became one of greater symmetry. Also, makeup can be applied to both upper eyelids making them really stand out. Before After 6 Months Here we see that again only one upper lid has dropped. This degree of asymmetry is unusual and means we only remove the excess skin on her left to better match the two upper lids. Before After 7 Months Maximum definition was desired by this patient to show more upper lid and give a more dramatic look. Makeup completes the process and enhances the surgical results. Before After 6 Months Are we ever too old for upper eyelid surgery? Fortunately, this is a relatively safe office procedure where a little bit can go a long way. One of my very first upper eyelid patients was my 85 year old aunt. She just wanted to read more easily. She was still active well into her late 90s. LOWER EYELIDS Before After 8 Months Looking up tends to define and accentuate the location of the lower eyelid fat. The lower eyelid bulging fat bags tend to make us look tired. Removing the fat, along with proper makeup, can give a greatly refreshed look. This procedure is done from the inside of the lid. This avoids an external incision and maintains the lower lid position. Before After 2.5 Years In this patient, there was a combination of bulging fat followed by a depression. Since we don’t want to create a hollow eye, the extra fat was transposed (or moved) downward to fill the depression. This was still done from inside the lower eyelid. Before After If we need more fat for the rest of the face we can take it from another area of the body. Then we can use it to fill the depression under the lower lid fat bulge, under the cheekbone, and elsewhere as needed. Before & after Here is an example of removing the lower lid fat bulges and transferring fat from elsewhere to her face. She also had a tuck along her jawline. These were done together in the office with pills and local anesthesia. This is an early three week result with minimal bruising but still general swelling. Before After 20 Years The tendency to have lower lid fat bags is a familial trait but does tend to worsen with age. Fortunately, it is usually only necessary to correct it once. After 20 years, there are still no fat bulges returning, and no hollows. The aim is to age gracefully - which she certainly has! Home | Face & Neck | Nose | Ears | Eyelids | Fat Grafting | Microlipo-Neck | Microlipo-Body | Skin Resurfacing | Testimonials | Give Back | About Dr Churukian | About the Clinic | Patient Info | Contact