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EYELID REJUVENATION

Additional Offices

Examples of some of Dr. Scaccia's surgical results.
All photos are untouched and shown with patient's permission.

Eyelid Rejuvenation

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Seven week postoperative view of a lady who underwent upper eyelid blepharoplasty to both rejuvenate her upper eyelids and to also functionally improve her vision. The upper eyelid surgery was covered by her insurance company since in addition to also aesthetically improving her appearance it was medically necessary as her upper eyelid skin was so lax and redundant it was blocking her vision in the upward and outward direction. After the surgery, she was very pleased with her improved and more youthful appearance and also her ability to see in all directions and the heaviness of her eyelids had been removed.

 

Eyelid Rejuvenation

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47-year-old lady who presented with a combination of both aesthetic and functional complaints. Her functional complaints include heavy eyelids that progressively worsened during the day which also contributed to poor vision as it limited her visual fields and looking up and out because of the excessive hooding of her lower eyebrows and excessive upper eyelid skin that was blocking her vision. Because of this reason, her entire surgery was completely covered by insurance.

She was also unhappy about her appearance which she perceived as older and tired because of the low-lying eyebrows and fullness of her upper eyelids. She underwent a coronal browlift and upper lid blepharoplasty at the same time. Again, both were covered by the benefits of her insurance.  Postoperatively, she claims she experienced no pain or discomfort. There was a slight amount of numbness as to be expected around the incision and in the forehead which will dissipate within a month.  Her scar is well hidden deep within her hairline which should be undetectable even by her hairdresser with time. As can be seen, her eyebrows were lifted up to a more youthful and aesthetically pleasing position but not overdone which would look unnatural. Her eyelid creases are symmetrical and youthful but again not overdone. She claims her vision is much better. Her headaches are gone. The heaviness in her forehead and upper eyelids is gone. She feels as if she has more energy. As an added benefit, although this was an upper third of the face forehead eyelid lift, it did rejuvenate her cheeks even as far down as her jowls, although to get complete improvement in those areas a facelift would be necessary. She was offered to have her bulging lower eyelids to be fixed at the same time, however she decided to wait until a later period for this. She also noticed that the browlift not only raised her eyebrows and eyelids to a more acceptable position but at the same time I was able to weaken and/or remove the muscles that actually control the creases between her eyebrows and her forehead creases. They are much softened and this is almost what could be considered a permanent Botox effect as she may never need Botox again as these muscles are now partially removed or ablated that control the movement in that area. Her eyebrows and forehead, however, still maintain natural movement.

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Eyelid Rejuvenation

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Six week postoperative view of a middle aged man who underwent upper and lower eyelid rejuvenation with Botox injections to the forehead four weeks after the surgery was completed. As can be seen in the postoperative picture, the excessive skin in his upper lids that was hanging and hooded and causing obstruction of his vision is now corrected and a more youthful but yet natural and still masculine appearance has resulted. 

It should be noted that because of the excessive upper eyelid skin, he was experiencing problems with his vision, especially with visual fields upon looking up and outward. This was verified by an ophthalmologist and as such his upper eyelid was covered totally by insurance. The lower eyelids were done without an external incision via a transconjunctival approach so that the bulging fat pads which were even more noticeable on his right side than left were removed. There is still evidence of a small amount of wrinkling in his skin. This can be addressed at a later date with possibly Juvéderm injections, however he is quite happy with the improvement as it is and having a small amount of wrinkles and loose skin in the lower eyelid is actually advantageous in maintaining a natural and masculine look. In addition, Botox was placed throughout his forehead and glabella region. You can see a dramatic improvement in his forehead lines, and a weakening of his vertical mid eyebrow crease. It was recommended that Juvéderm be placed into this crease to lessen the depth of it, however he opted not to because he was happy with his overall appearance as it stood.

 

 

Eyelid Rejuvenation

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Early four week postoperative views of a man who underwent bilateral upper lid blepharoplasty and right lower lid transconjunctival blepharoplasty. The patient had years ago undergone a surgical procedure on his left lower eyelid that involved repairing an orbital floor fracture from trauma that resulted in him subsequently losing fat in his lower eyelid. For this reason, no fat needed to be removed from the left lower eyelid, however the patient was a candidate for fat removal only in his right lower lid. This was done with a no exterior incision approach, approaching the fat transconjunctivaly on the inner part of the eyelid. As the swelling resolves, the right lower eyelid will continue to smooth out and improve in appearance. The removal of excessive skin and fat and muscle in the upper eyelid is obvious in his postoperative more wide eyed open view. In addition because of his severe upper eyelid skin laxity and redundancy, medical insurance covered the removal and correction of his upper eyelid skin as it was causing visual impairments. He is already reporting improvement in his vision and significantly less discomfort in his previously described fullness and heaviness of his upper eyelid skin.

 

 

Eyelid Rejuvenation

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Middle aged lady who presented with both functional and aesthetic visual complaints. She has felt that over the last few years her upper eyelids have gotten heavy and not only does she not like the appearance but she felt the heaviness of her lids had caused her to feel tired, especially when driving at night and reading. She was seen by an ophthalmologist who verified that her visual fields superiorly were being obstructed by the excessive skin and weight of her upper eyelid skin. Because of these findings and her complaints, her upper lid blepharoplasty was covered by insurance. It was also noted on exam that part of the fullness in the outer part of the upper eyelids was due to a prolapsed lacrimal gland. It is a very rare condition that affects only a very small percentage of presenting blepharoplasty patients. She was seen postoperatively two-and-a-half months with still some residual swelling and redness from the surgery.  She, however, notes that she is extremely happy with the appearance of her eyelids now and her eyelid fatigue has gone away 100%. The procedure involved removing excessive upper eyelid skin, muscle and also tucking the prolapsed lacrimal gland underneath her orbital bone. This was all done under local anesthesia. Her tearing was not affected even though the lacrimal gland is responsible for producing tears. For this reason, the gland is not resected but carefully sutured in a more superior position. It should also be noted as seen on the lateral views, the two lesions present on her cheek were removed with the radio surgical unit leaving hardly any evidence of the previous lesion or a scar. The radio surgical unit removal of lesions is a very effective way to remove benign skin lesions without requiring sutures or a knife which can sometimes cause small dents and unsightly scars on the skin.

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Eyelid Rejuvenation

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Ten week postoperative result for patient who underwent forehead/brow lift and upper eyelid rejuvenation. Both procedures fully covered by patient's insurance since here vision was affected by heavy eyelids and brows. Patient now sees and feels much better. Note improvement in forehead wrinkles, frown lines, eyebrow position, and eyelid hooding.

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Eyelid Rejuvenation

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Four-year postoperative result of a patient who underwent upper lid blepharoplasty only. As can be seen in the postoperative picture, the patient's significant amount of eyelid skin redundancy and hooding had been corrected and has held up well over the years. Her vision is also significantly improved, especially when looking upward and laterally since the excess skin blocking her vision has now been removed. Her eyelid crease is normal and her eyelids look brighter and more youthful.

Eyelid Rejuvenation

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Three-month post-operative view of a patient who exhibits in the pre-operative photos on the left significant hooding of the upper eyelids secondary to excessive upper eyelid skin and low positioned eyebrows. In addition, he was concerned about the tired, aged look of his lower eyelids secondary to excess and wrinkled skin and fat deposits. His excessive upper eyelid skin was so prominent that it was the cause of a visual field loss and, thus, was considered a functional problem that allowed for insurance reimbursement. Post-operatively, the patient's vision improved after removal of the excessive skin. A direct browlift was done which involved an incision directly above his eyebrow hairs that healed well and is barely visible. Excessive skin and fat were taken from both his upper and lower eyelids again with virtually undetectable scars which now allows for a more youthful and open appearance to his eyes.

Eyelid Rejuvenation

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3 week post-op review, of one of our own nurses, of lower lid trans conjunctival blepharoplasty done under local anesthesia, as per patient choice.  No visible scars result from this technique, which resulted in flattening and smoothing of eyelid region after removal of fatty lower lid pouches.

Eyelid Rejuvenation

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Two month post-op frontal view of brow lift and upper lid blepharoplasty. Note correction of frown lines and forehead wrinkles. Eyebrows placed in a higher but natural position. Excessive skin also removed from upper lids. Her eyelid hooding was such that her vision was significantly affected and allowed for insurance reimbursement. All scars are virtually undetectable and hidden in either the hairline or eyelid crease.

Eyelid, Facelift and Chin Implantation

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Four month postop result of cheek and neck lift, chin augmentation, and upper and lower eyelid tightening. All incisional scars well hidden in natural skin creases. The patient now appears more youthful and balanced. Note that fat bulge under the chin is now removed with better neck contour. Additional refinements are possible, if the patient desires, with attention to skin care utilizing either chemical peels, laser abrasions and/or Gentlewave LED Photomodulation.

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Eyelid Rejuvenation

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Upper and lower eyelid enhancement with conservative forehead/brow lift.
Result gives more youthful and rested appearance along with vision improvement by removing hanging obstructing lids.

Eyelid Rejuvenation

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Six week post-operative result of upper eyelid sculpturing done only. Eyebrows were in adequate position preoperatively and did not require surgical correction. Since the patient's vision, when looking up, was impaired by her heavy lids, repair of her eyelids was deemed medically necessary and was covered by her insurance.

Eyelid Rejuvenation/Brow Lift

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Dramatic improvement in upper lid hooding and eyebrow position. Lower eyelids also tightened. Hooding was severe enough to cause visual obstruction allowing for partial medical insurance coverage.

Upper Eyelid Rejuvenation

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Upper eyelids tightened only. Conservative skin, muscle and fat removal
to give refreshed, youthful and open eye appearance.

Facelift, Lower Eyelid Rejuvenation and Botox

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Three month post-op result of facelift, lower eyelid rejuvenation and Botox to forehead. Notice practically invisible scars around eyes and ears. Neck, jaw line and cheeks significantly tighter and more youthful. Patient will be returning soon for CO2 laser treatment to help further improve skin texture and wrinkles especially evident around her mouth.

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Eyebrow and Eyelid Rejuvenation

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Eyebrow & eyelid hooding eliminated. Bags under eyes also removed.

Upper Eyelid, Midface Lift and Botox

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Rejuvenation of entire upper and lower eyelid region along with midface lift to restore cheek and smile line area. Three-quarter view demonstrates early four-day post-op result while sutures still in with minimal swelling. Note smooth forehead from botox injection.

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Asian Nose and Eyelid Enhancement

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Early post-op result of patient who desired crease formation in
upper eyelid along with added structure to bridge and tip of nose. Nostrils which have been brought down, can be appreciated on frontal and three-quarter view.

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Tip is more triangular, projected and narrowed on
''worm's-eye view" with sutures still in place at seven days post-op.