Background: Blepharoplasty or eyelid tucks/lifts for men is an increasingly requested facial improvement and is the second most frequently performed male plastic surgery, exceeded only by liposuction body contouring. Periorbital rejuvenation provides a very visible enhancement to a man’s appearance as it removes sagging upper eyelids and puffiness underneath the eyes. For those men that suffer from visual field obstruction from excessive skin and heaviness of the upper eyelids, upper blepharoplasty can provide functional benefit as well.
How eyelid lifts are performed on a man is not significantly different from that on a woman but there are some subtle but important differences. Most importantly, a man’s look must not become feminized. This means that a more conservative change is needed. Too much eyelid skin removal in a man will result in an unnatural appearance and will change their looks. It is quite acceptable for a man to retain a little extra skin and have a few wrinkles on the eyelids after surgery. The eyelids don’t have to be perfectly smooth and wrinkle-free. Also, if a browlift is being consider with the blepharoplasties it is important that the brows are not lifted too high and have a feminine arch created in them. A man’s brow is horizontal and naturally more low on the brow bone.
Case Study: This is a 56 year-old male who finally felt that his eyes looked tired and old. His upper eyelids were heavy although he had no specific complaints of vision obstruction. His lower eyelids had large protruding bags with wrinkled light brown pigmented skin over them. He had no chronic tearing or dryness with his eyes.
An upper blepharoplasty was performed by removing a large amount of skin and a small amount of orbicularis muscle. During his lower blepharoplasty, large protruding fat pockets were found and removed. About 5mms of lower eyelid skin was removed and the lower eyelid incisions were closed using an orbicularus muscle suspension technique. Total operative time was 90 minutes done under general anesthetic as an outpatient.
After a 10 day recovery period, most of his swelling and bruising has subsided. Other than some temporary eye irritation and tightness, he reported no significant pain. He looked much less tired while retaining a natural and completely recognizeable appearance. He did not look like he had recent surgery.
Men should not fear blepharoplasty surgery as it can make a real difference in their appearance. The key to a natural result is that the man’s features should be preserved during eyelid tucks as well as to not over-correct or remove too much skin. As men age, their eyelids will differ from those of their youth and blepharoplasty for men should appreciate this subtle difference.
Case Highlights:
1) Blepharoplasty in men can make a real difference in the appearance of the eyes by removing upper eyelid skin hooding and lower eyelid bags, creating a less tired appearance.
2) Male eyelid tucks should be done considering that men desire less dramatic changes and do not need to have an eyelid appearance that is completely smooth, lest it look overdone.
3) Browlifting in men should be considered carefully and, if done, should keep the eyebrows even and not arched in their elevation.
Dr. Barry Eppley
Indianapolis, Indiana