Aging around the eye area is one of the first and often most significant signs of facial aging. The areas around the eye that change are the brow and both upper and lower eyelids. All the above sag due to not only loose skin but redundant (extra) skin as well. Most patients have a clear idea of these issues when it comes to the upper eyelid. They can clearly see skin hanging down onto their lashes and loss of the youthful supratarsal crease or fold that previously existed between the brows and the eyelashes.
Correction of the aging upper eyelid, known as upper blepharoplasty, is one of the simplest and most successful of all facial plastic surgery procedures. While it does cause some temporary bruising and swelling, the removal of a strip of the extra eyelid skin helps create an immediate change. The upper eyelid is tightened and the supratarsal fold is immediately restored.
One of the potential concerns that some patients may have about the procedure is the risk of visible or poor scarring. The good news is that is one issue which is a rare problem. The scarring is so good in this area, and the scar is always hidden when you are awake (with the eye open, the upper eyelid crease rolls back inward), that this is really a non-issue most of the time.
There are several reasons for the almost always good scarring which occurs on the upper eyelid. First, the upper eyelid has the thinnest skin on the entire body. The thinner the skin (with less dermis), the less tissue there is to produce scarring. Scar formation comes from the skin’s dermis which is paper-thin. Quite frankly, the excellent eyelid scars we see is as much the result of its thin skin as it is surgical technique. Secondly, the scar line is sufficiently above the lashline of the upper eyelid that it is completely covered when one’s eyes are open. To find an upper eyelid scar, you would have to ask the patient to close their eyes and then look carefully up close. Lastly, most poor scarring comes from wounds that are closed under significant tension. As the eyelids spent a significant part of their time being open, the incision closure or scar line is not under much stretch or tension.
In my Indianapolis plastic surgery practice, I have observed that the upper blepharoplasty is a very effective and simple procedure to go through. Most patients report virtually no pain, no matter how it looks to the viewer. Scarring is a very rare issue with blepharoplasty or eyelid surgery.
Dr. Barry Eppley
Indianapolis , Indiana