Excess upper eyelid skin can also make placing mascara difficult. It can cause one to overly raise their eyebrows, which in turn can cause lines across the forehead. A blepharoplasty can improve all of these issues and that is why it has been one of the most popular plastic surgery procedures for many decades.
"The beauty of a woman must be seen from in her eyes, because that is the doorway to her heart, the place where love resides."
The most frequently requested facial surgery is an upper eyelift, also known as an upper blepharoplasty. Since so much of our beauty comes from the eyes, a blepharoplasty is one of the most powerful means to make appropriate men and women look substantially better. Just as important is that much of our personality is conveyed through our eyes. Blepharoplasty does not just make people look prettier, but it helps them convey a much more youthful and vital energy.
An excess of upper eyelid skin can affect patients both cosmetically and functionally. At its most basic level, extra eyelid skin can make people look older. It can become difficult to apply mascara. The hooding will make the eyes look more tired and less attractive. Many people subconsciously raise their eyebrows to elevate eyelid skin hanging on to their eyelashes, and this can lead to prominent horizontal forehead lines.
And there can be functional problems. Skin that overhangs the eyelashes can interfere with vision. Since it takes effort to hold the eyes open when there is extra skin, some people will find it too fatiguing to read at night.
The good news is that an upper blepharoplasty is extremely effective at solving these problems. It can be done under local or general anesthesia with relatively insignificant discomfort and a short recovery period.
Upper eyelid lift surgery is frequently done as a solitary procedure, but it is often combined with other facial surgery. This is a problem that affects men and women equally.
There is a temptation by some patients and surgeons to remove as much skin and fat from the upper eyelids as possible, but this can lead to "the surgical look," with hollowed out eyes and lids that are not in balance with the remainder of the face. Dr. Teitelbaum brings a high level of aesthetic sensibilities and technical expertise to his eyelid surgery.
What is perhaps most wonderful about upper eyelid lifts is that the scars are typically inconspicuous and the result does not look at all "surgical." People just look better.
While the predominant problem of the upper eyelids is excess skin with only occasionally a small excess of fat, the lower eyelids are just the opposite. Here there is only occasionally excess skin, but the problem usually is just excess fat in the lower lid that causes bulging.
Since the problem is just fat bulging from the inside, it is usually treated with what is called a transconjunctival blepharoplasty, which involves removal of fat from a hidden scar inside of the eyelid. This does not need stitches, has no external scar, and heals inconspicuously.
When there is excess eyelid skin, then a pinch of skin can be removed with a tiny incision just below the lower lashes.
In the past, surgeons frequently took too much fat from the lower eyelids, creating a bit of a skeletonized look with the roundness of the lower eye too visible. Dr. Teitelbaum seeks to make the area flat, but still full. Humans lose fat around the eye with age, and it is very important not to remove any more fat than absolutely necessary to restore a beautiful and youthful shape to the lower eyelids.
Few things give rise to the negative stereotypes of plastic surgery as much as does an eyelift. The eyes are the most beautiful and expressive part of the human face and are the focus of the most attention. The lids frame the eyes and convey much about the person's age, happiness, and fatigue. So it is exceedingly important that a blepharoplasty be done carefully and tastefully.
It is all too easy to remove too much skin doing a blepharoplasty, it is important for the eyes to close all the way so that there is not a problem with dry eyes at night. So removing too much upper eyelid skin is not just a cosmetic issue, but it can be a functional one as well. There is a myth that removing too much upper eyelid skin causes the "deer staring into headlights" look, but in reality that is caused by a brow being pulled high and not by removal of too much upper eyelid skin.
However removal of too much lower eyelid skin can create an unnatural appearing eye. In fact, removal of the tiniest amount of lower lid skin can change the eye's shape. The reason skin is removed from the lower eyelids is to smooth and tighten loose or redundant lower eyelid skin. The incision is placed along the edge of the lower eyelashes. But the lid itself is very delicate, and even the smallest removal of skin can sometimes pull down on the lower eyelid. When this happens, there can be excessive show of the lower outer white portion of the eye. The area where the upper and lower eyelids join can start to round out rather than being sharp and crisp. This creates an eyelid that is not just less attractive but unnatural as well. Few non-plastic surgeons would specifically identify this when it happens, but most all people would nonetheless have a sense that there is something not natural in the appearance of the eyelids.
A big culprit in causing eyes to not look natural is removing too much fat from the upper or lower eyelid. In some people fat bulges in these areas with age. It is important to smooth these out. Sometimes that means removal of a small amount of fat, and at other times it means the addition of fat in the depressed areas adjacent to the bulges. Historically plastic surgeons would remove all the fat they could, but this results in an overly hollowed out look which looks like there was surgery.
When you peruse Dr. Teitelbaum's eyelift photos notice how he achieves a substantial improvement without creating off-putting suggestions of there having been any surgery.
While eyelid surgery is most frequently performed on its own, it is often done together with a facelift. There are many people who could benefit from a facelift but obviously prefer to focus only on their eyes. But when someone is having a facelift, it is important to take the eyes into consideration as they have such a profound effect on the appearance of the face. Facelift results are so significant that it is important to make sure that the eyelids are dovetailed with the rest of the face. And a simultaneous upper and/or lower blepharoplasty does not add to the length of recovery of a facelift, so these procedures compliment one another nicely.
If a facelift patient needs an eyelift but forgoes one, the result will look off but, interestingly, the opposite is not true. If someone does not want to have a facelift, then a significant, natural, and beautiful improvement can be made operating on the eyelids alone.
No surgical plan can be determined for the upper eyes without considering the role of the eyebrows. If you push up on your eyebrow with your hand, your upper eyelid skin will be smoothed. Push down on your brow and you will see excess upper lid skin. How do you determine if you also need a brow lift? In general, if you see the fold of skin that begins in your upper eyelid continue outside of your eye socket towards the crow's feet, that is something that frequently requires a brow lift. A brow that is low and inside of the rim of the eye socket also may need a brow lift, and so too is a brow that is too low and horizontal. An ideal brow form has the tail of the brow higher than the central brow in women. It is very feminizing and creates a lighter and friendlier expression. Low and horizontal eyebrows give the impression of seriousness and lacks the levity of higher and more arching eyebrows. There are indeed differences in the ideal appearance of eyebrows in men and women which must be considered.
While it is most common for someone to only need to have an upper blepharoplasty, there are situations in which patients only need to have a brow lift, even though they thought their problem was their eyelids.
The problematic situation is the patient who needs to have a brow lift in addition to an upper blepharoplasty, but who prefers not to have the brow lift. The brow lift is more costly and entails a longer recovery. So the decision to avoid the brow lift is understandable.
But in those situations patients must understand that there may still be a fold beyond the eye socket and some residual skin in the upper eyelid. If Dr. Teitelbaum would remove enough upper eyelid skin to remove any apparent excess in the setting of a low brow, then the distance between the lash and the brow would be too short. And were that patient to ever decide later to have a brow lift, then there may not be enough upper eyelid skin to allow a full closure of the upper eyes.
When a brow lift and an upper eyelift are done at the same time, it is important that the brow is lifted the right amount and that the right amount of skin is removed from the upper eyelid. On one hand there has to be enough done to achieve the ideal result, but on the other hand it is important not to do something that makes it hard for the patient to close their eyes. Dr. Teitelbaum has done these together many times and is adept at making these decisions. But there are some situations in which there is so much excess in each area that he will encourage patients to do the one that is the largest source of the problem, let that settle, and then come back to do a maximal improvement of the other once it is safe to accurately do so.
These issues are subtle, but extremely important in terms of giving patients the most beautiful and natural appearance to their faces. Dr. Teitelbaum clearly explains to each patient how the options of eyelift alone, brow lift alone, or a combination of the two would look on them.
As a serious photographer, Dr. Teitelbaum realizes a portrait can only be as good as the eyes. By understanding how to avoid shadows and make the eyes sparkle, he has gained a marvelous understanding of the characteristics of a beautiful eye, and that understanding translates into improved eyelid surgery.
Unlike many other features a plastic surgeon operates upon, the eyelids have important functions, and anything Dr. Teitelbaum does with the eyes first considers these functions. Visual field improvement and avoiding dry eyes are always his first priorities.
He achieves an improvement that is dramatic yet does not specifically draw attention to itself. Skin needs to be removed, fat may need to be removed, and wrinkles smoothed. It is all too common to see when the eyes are deprived of fat or the eyelids are deficient in skin.
Dr. Teitelbaum performs his eyelift surgeries so that his patients’ eyes can be front and center, neither being concealed by the eyelids nor looking “bug-eyed.” He is an expert at avoiding surgical telltales, and will create a look that is harmonious and balanced with your face.
Dr. Teitelbaum has performed eyelids with great interest since he was a resident. His father is an ophthalmologist and he benefited from a lifetime of learning and understanding about eyes.
He has since performed hundreds of eyelid surgeries of all sorts, on their own, with laser treatments, with brow lifts, and with facelifts.
His command of the anatomy of the eye, appreciation of the important function of the eyelids, and fine aesthetic sensibilities enable him to consistently produce beautiful eyelid results.
Dr. Teitelbaum was a member of the national plastic surgery task force that developed the Covid-19 protocols for plastic surgery offices. He is therefore well-versed in all of the recommendations and his office meets or exceeds all of them. By now you are familiar with all the obvious measures such as reminding patients and staff not to come to the office if they have any symptoms, taking temperatures, maintaining social distancing, having everyone wear masks, placing hand sanitizers everywhere, reducing the number of patients in the office at one time, testing all surgical patients, etc. One unique feature is that Dr. Teitelbaum’s operating room has "laminar flow" – a very advanced system that directs the flow of air from a large diffuser on the ceiling to exhausts near the floor, ensuring that the fresh air flows in one direction. This not only reduces the chance of COVID infections for the patients and staff, but it also reduces the risk of surgical infections.
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