Blepharoplasty is a procedure to correct excess eyelid skin and to treat prominent fat pads. Excess skin weighing down the upper lids, and fat pads in the lower lids, can produce a tired look. This procedure can be performed on both upper and lower lids.
Brow descent can occur over time and contribute to the upper lid skin excess. For this reason, brow position should be evaluated in all cases where upper lid blepharoplasty is considered. In the past, long incisions were required to correct brow descent, but modern techniques allow brow elevation with only a few small incisions. Sometimes minor procedures may be done through the upper lids to elevate the brow.
Cheek descent can contribute to a tired look by increasing the vertical dimension of the lower lid and worsening the nasolabial fold (crease from the nose to the corner of the mouth). This area is often called the mid-face, and it is not improved by conventional face lifting procedures. Cheek descent may be improved with fat grafts or suspension with sutures. The cheek lift is called a meloplasty.
Upper lid procedures may take an hour under local anesthesia. Brow lifts, cheek lifts or lower lid procedures are performed under general anesthesia and take around two hours to perform.