Eyelid Surgery

The eyelid lift is one of the most effective and transformational facial surgeries available today. I often hear patients say that they look tired or that their upper eyelids feel heavy; this is usually a good indication that they are good candidates for an eyelid lift. This procedure can address both the upper and lower eyelids or one at a time for complete upper face rejuvenation.

I’m Dr. Andrew J. Miller, a board-certified facial plastic surgeon here at Associates in Plastic Surgery. My focus is exclusively on facial plastic and reconstructive surgery, although our practice offers body and nonsurgical procedures as well.

I completed my medical training at Baylor College of Medicine and had advanced training in head, neck, and facial plastic surgery at Tulane University. I continue to be board-certified by the American Board of Facial Plastic and Reconstructive Surgery. At my practice, I am always refining techniques for eyelid surgery, and I am confident we can deliver the results you want to see.

In this article, I’ll talk about the most commonly used techniques, the reasons why people get blepharoplasty, and what I do to make results look so natural.

To schedule a consultation with me, please fill out our online form or give one of our offices a call:

Before and After Photos

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Why Eyelid Surgery Is So Popular

The eyes are super central to the face; they determine facial balance and how we are perceived by others. In other words, the way the eyes look matters.

As we get older, several different changes are commonly seen in the eye regions, including:

The skin around the eyes is especially thin, so this area is one of the first to show significant signs of aging in the face. This is one reason why the eyelid lift is so popular; the procedure is effective and discreet for addressing signs of aging in the upper face. With an eyelid lift, I can help patients turn back the clock while still looking completely like their authentic selves.

Upper Eyelid Surgery (Upper Blepharoplasty)

First, we’ll talk about the upper eyelid surgery. This is a very popular procedure, and it can be performed as a standalone procedure or as part of a comprehensive ‘quad blepharoplasty.’

Common reasons patients choose upper eyelid surgery:

1. They look tired
2. They feel heaviness from excess skin resting on their lashes
3. They want a more refreshed, open appearance

In some cases, excess upper eyelid skin can even interfere with vision. In these cases, it’s possible that insurance might cover a portion of the procedure. With an upper eyelid lift, we can lift the skin and alleviate the heaviness that’s causing the vision obscuration.

Procedure

Upper eyelid surgery typically takes about 45 minutes. During the procedure, I:

One thing that can be overlooked by other surgeons is incision closure, which is very important. In my practice, I use a very fine nylon stitch to close incisions in the upper eyelid. I prefer this to dissolvable sutures, as dissolvable sutures can sometimes leave small bumps or irregularities in the skin even after the patient is completely healed. We absolutely do not want the patient to feel self-conscious about how their incision healed; they should feel completely confident with their results! My method allows the incision to heal into a very thin, very discreet line that fades significantly over time and blends with the natural eyelid crease so that patients look like themselves, just better.

Precision is so important during this procedure; the upper eyelid is measured in millimeters. We want to remove just the right amount of skin and make the most precise adjustments possible for a completely natural and balanced look that harmonizes with the other facial features.

Lower Eyelid Surgery (Lower Blepharoplasty)

Just like upper eyelid surgery, the lower eyelid surgery has its own complexities and considerations we take into account. Concerns in the lower eyelid often extend beyond just skin; sometimes, there is an excess or puffy fat bag that needs to be addressed.

When my patients talk about under-eye bags, they’re often referring to developments such as:

In order to perform a great lower eyelid surgery, we have to take all of these things into account and deliver precise and natural results.

Understanding Under-Eye Fat

One of the most important considerations when performing an under-eye lift is the under-eye fat. There is a fat pad underneath your eyes, and with age, that fat can push itself forward and become more prominent over time. This can make patients look like they are always tired and weary. To address this fat, we actually don’t want to remove it all—we don’t want to make the patient look gaunt or unhealthy. To maintain a youthful look, we simply want to shift that fat and reposition it. We can remove a conservative amount, but we will mostly be repositioning fat to fill hollow areas. We can even combine this procedure with fat grafting create even smoother transitions.

Surgical Approaches

There are two main approaches for lower eyelid surgery.

Transconjunctival Approach: This technique involves an incision inside the eyelid. It allows me to remove or reposition fat without making an external skin incision.

Advantages include:

Skin Incision (Subciliary) Approach: If a patient has significant excess skin, an external incision just below the lash line may be necessary. This allows for:

However, improper technique with this approach can increase the risk of lower lid retraction or visible scarring. This makes it especially important to choose a highly experienced surgeon with demonstrated experience with this technique.

How Long Do Results Last?

When talking about results, it is important to note that the eye area will continue to age over time, even after eyelid surgery. However, with my meticulous techniques, patients can enjoy very long-lasting results often for 10 years or longer. In any case, patients will look amazing for years to come and feel confident in their daily lives as they appear more refreshed and rejuvenated. Many of my patients report that they feel empowered to live their lives confidently as their appearance matches more closely with their vibrant selves.

Corresponding and Complementary Procedures

CO2 Laser Resurfacing

When patients want to address the quality and elasticity of their skin, I often recommend CO2 laser resurfacing around the eyes. This advanced technology can tighten the skin, improve skin texture, and reduce the appearance of fine lines.

CO2 laser resurfacing can be especially valuable for patients who do not want to remove any skin or patients who want to only have an incision inside their eyelid, as the procedure can potentially eliminate the need for that external incision.

Fat Grafting

I briefly mentioned fat grafting previously when we were reviewing the lower eyelid lift techniques. Fat grafting can not only be used to fill under-eye hollows, but it can also accentuate other areas of the face as well. To perform this procedure, I take fat from another area of the body where there is excess fat, such as the abdomen, thighs, or flanks. Then, after processing this fat, I inject it into the face and carefully selected areas. This can improve facial contours as well as smooth and fill wrinkles and hollows, making it an exceptional option for patients who would like to achieve a youthful glow.

Recovery

Recovery from eyelid surgery is generally well-tolerated.

Most patients feel comfortable returning to social activities within 10–14 days.

Discomfort is typically mild and managed with cold compresses and elevation.

Cost of Eyelid Surgery in New Jersey

The cost of your eyelid surgery will vary depending on the complexity of your case and whether upper, lower, or combined blepharoplasty is performed. After your consultation, your surgeon will provide a detailed cost estimate tailored to your personalized treatment plan. Associates in Plastic Surgery offers flexible financing options for qualified patients to make your procedure more accessible.

Schedule your consultation today to begin exploring your eyelid surgery options. If you have any questions, please call your closest Associates in Plastic Surgery office directly.

References

1. Rebowe RE, Runyan C. Blepharoplasty. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK482381/
2. Patel BC, Malhotra R. Upper Eyelid Blepharoplasty. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK537078/
3. Rostami S, de la Torre JI, Czyz CN. Lower Eyelid Blepharoplasty. PubMed. Published 2021. https://www.ncbi.nlm.nih.gov/books/NBK448181/