Anatomy is the Key to Precision Eyelid Surgery
Eyelid surgery is one of my favorite procedures. Outcomes are usually excellent, and problems are few. We see many types of patients in our practice and need to tailor each surgery to their individual anatomy and preferences. Although there are racial differences one can see single or double lids in any racial group. These photos from my book Surgical Anatomy of the Face show some common variations with a single lid, outer double lid, inner double lid, and typical Caucasian lid from top to bottom.
The underlying anatomy which creates these differences are basically how the muscle that lifts the lids and its tendon (levator muscle and its aponeurosis) attach to the skin.
When we operate on a patient with a single lid, we basically create a double lid by using sutures to attach the underling aponeurosis to the skin. I have been fortunate in my teachers. I teach in Asia frequently and have been able to learn from experts such as Sufan Wu in China, Choladhis Sinrachtanant in Thailand, Gordon Soo in Hong Kong and many more.
There are basically 3 types of eye surgery.
- One can do a suture technique without cutting the skin. This is simple but it isn’t permanent, so I rarely do it.
- In an older patient with excess skin, we do a blepharoplasty just as we would in any aging patient but use a sewing technique to ensure the fold is created at the desired level. Blepharoplasty (BLEF-uh-roe-plas-tee) is a type of surgery that repairs droopy eyelids and may involve removing excess skin, muscle and fat.
- In younger patients who want a double lid but don’t need skin excised we do a short incision
Eyelid surgery is a highly technical and provides excellent results. If you are considering eye surgery learn more about it here.
Check out our before and after pictures.