Cosmetic Eye Surgery

Upper Eyelid Blepharoplasty

Sagging, heavy, puffy, or tired-looking eyes can be rejuvenated with customized surgical treatment.

As you age, the skin and muscles of your eyelids may sag and droop. Your upper eyelids may become more puffy or heavy as the normal fat around your eye begins to show under the skin.

An upper eyelid blepharoplasty is a surgery to remove excess skin on the upper eyelid area with removal or contouring of the fat. If the excess skin obstructs vision, blepharoplasty can improve peripheral vision issues and provide a more youthful and rested appearance.

During upper eyelid blepharoplasty, your surgeon makes an incision in your eyelid crease, removes the extra skin, and removes or re-contours the upper eyelid fat (if needed). Small sutures are used to close the incision line.

Patients often refer to this procedure as an “eyelid lift” or “eyelid tuck”. Know that the eyelid itself may not be lifted during this type of surgery, but the heaviness of the upper eyelids is usually improved. The peripheral vision to the side and above your central vision is often improved as well.

Before & After

Before Blepharoplasty
After Blepharoplasty

Lower Eyelid Blepharoplasty

Puffy lower eyelids can be dramatically improved with a lower eyelid blepharoplasty. This procedure permanently removes puffy lower eyelid fat, better known as “eye bags”.

Puffiness of the lower eyelids is most commonly from fat in the eye socket that bulges forward. The ”dark circles” below the bulge is an area of hollowness caused by the natural attachments of the skin to the underlying bone. The lower eyelid skin is the thinnest in the body, which means it is most prone to wrinkling.

Fat in the lower lid can be removed or re-positioned through an incision hidden on the inside of the lower eyelid (transconjunctival blepharoplasty). Laser resurfacing can be performed at the same time if desired, to smooth and tighten the lower eyelid skin.

Typically this is the only treatment that is needed to improve the lower eyelid appearance.  However, if hollowness of the orbital rim remains after surgery, Botulinum and facial fillers work nicely to treat this area.

Ptosis (Droopy Eyelid) Repair

Droopy, sleepy, or closed looking eyes is often due to ptosis (drooping of the eyelid).  Customized treatment can improve vision and create a rested, alert appearance.

Ptosis is the medical term for drooping of the upper eyelid.  When the edge of the upper eyelid falls, it may block the upper field of your vision. The ptosis may be mild – in which the lid partially covers the pupil, or severe – in which the lid completely covers the pupil.

Symptoms of ptosis include:

  • Difficulty keeping your eyes open
  • Eyestrain
  • Eyebrow aching from the increased effort needed to raise your eyelids
  • Fatigue, especially when reading

In severe cases, it may be necessary to tilt your head back or lift the eyelid with a finger in order to see out from under the drooping eyelid(s).

The most common treatment for ptosis involves making an incision in the eyelid crease and tightening the main muscle that opens the eye (levator muscle). The main goal of ptosis surgery is to open the upper eyelid wider to improve the field of vision. It is important to note that when operating on an abnormal muscle, completely normal eyelid position and function after surgery may not be possible to achieve.

Dr. Bearden and Dr. Langelier try very hard to get the eyelid position and curvature just right, but there are many variables that determine the final position of your eyelid. Symmetry within 1mm is typically considered a success. There is always a possibility that the lid will be higher or lower than desired, or the curve and shape of the lid turn out different. Touch up surgery to improve lid position may be necessary. While perfect symmetry between the two eyelids can never be guaranteed, the vast majority of patients see a great improvement in their lid position and are happy with their results.

Learn more about Droopy Eyelids (Ptosis)

Before & After

before ptosis treatment
after ptosis treatment
before ptosis treatment
after ptosis treatment

Brow Lift

Eyebrow ptosis or drooping eyebrows, can make the eyelids feel heavy, block peripheral vision, and/or create an angry or aged appearance. Age and heredity are the two main reasons why eyebrows become droopy. Some patients have drooping of the brows due to a neurologic problem (such as Bells Palsy) or trauma (injury to the brow or forehead).

The natural brow position in men is generally on the brow bone with a flatter (less arched) contour. In women, the natural brow position is generally just above the brow bone with the arc approximately at the lateral limbus (outer edge of the colored part of the eye). Everyone’s natural appearance is different and a customized approach that considers your unique facial characteristics can help you obtain your best results.

Did you know your surgeon can lift your eyebrows during your blepharoplasty surgery?  Dr. Bearden is an expert on the internal browpexy technique for a minimally invasive brow lift.

Cancer Reconstruction

Skin cancer on or around the eyelids is very common. Skin cancers often appear as a painless bump, a scab that won’t heal, or an area of missing eyelashes. Our surgeons are experts in the detection, treatment, and reconstruction of eyelid skin cancer.  Our goal is to help you maintain your vision, keep your eyes comfortable, and maintain a natural appearance after your reconstruction.

Learn more about eyelid skin cancer

In-turned Eyelid (Entropion)

Entropion, or an In-turned Eyelid, is a condition when the eyelid rolls inward toward the eye. This causes the eyelashes of the eyelid to rub on the surface of the eye. Common symptoms of entropion include eye irritation, pain, redness, tearing, and mucous build up. The most common cause of entropion is aging, but some injuries and medical conditions can cause entropion as well. Entropion is commonly treated with an in office procedure or eyelid surgery to correct the position of the eyelid.

Learn more about In-turned Eyelid

Out-turned Eyelid (Ectropion)

Ectropion, or an Out-turned Eyelid, is a condition where the eyelid rolls outward or pulls downward.  This is most commonly caused by aging, but can also be due to trauma, previous surgery, paralysis or nerve damage. 

The eyelids normally protect the eyeball from air and debris. However, when the eyelid is pulled outward or downward, the eye is exposed to the air and becomes dry. Other symptoms of ectropion include:

  • Eye redness
  • Irritation
  • Pain
  • Mucous discharge
  • Tearing or watering eyes
  • Blurry vision.

Treatment for mild cases of ectropion include the use of eyedrops or lubricants to keep the eye moist.  In more severe or bothersome cases, surgical treatment is needed to improve the comfort of the eye.

Learn more about Out-turned Eyelid (Ectropion)

Thyroid Eye Disease

Thyroid eye disease is an autoimmune disorder that can cause abnormal thyroid hormone levels as well as changes to the eye socket and eyelids.  Common signs and symptoms of thyroid eye disease include:

  • Bulging of the eyes
  • Swelling of the eyelids
  • Redness or irritation of the eyes
  • Pressure sensation in the eye socket
  • Double vision

When thyroid eye disease is severe, it can result in damage to the surface of the eye or permanent vision loss from damage to the optic nerve (the nerve that sends visually messages from the eye to the brain).

thyroid eye disease

Treatment of thyroid eye disease depends on the phase and severity of the disease. Patients with mild disease may only need artificial tear drops to lubricate the surface of the eye. Patients with active or severe thyroid eye disease may require treatment with steroids, radiation or decompression surgery to reduce the bulging of the eye or to relieve pressure on the optic nerve. Patients who experience double vision may find relief from special glasses or eye muscle surgery.  Your oculofacial surgeon can assess your particular condition and determine a treatment plan that is right for you.

Learn more about Thyroid Eye Disease