In the past, many surgeons performed the same eyelid operation on every patient: removing skin, fat, and sometimes muscle from the upper and lower eyelids. Fortunately, eyelid surgeons today know that genetics and sun exposure can also contribute to how your eyelids age. For that reason, Dr. Killingsworth and his plastic surgery team will customize your blepharoplasty in Atlanta to address your specific needs.



This means we may suggest surgery on all four eyelids or just the upper or lower eyelids, depending on your condition. Aesthetic eyelid surgery itself can correct many eye problems, and various techniques can be used on one eyelid or another. However, in some cases, combining additional treatments may be necessary to achieve the most aesthetically-pleasing outcome. Aging can cause excess fat around the lower eyes to protrude, resulting in under-eye bags and dark shadows. A lower lid blepharoplasty will tighten the fat and membrane holding the orbital septum and / or remove the excess fat. The appearance of the lower eyelid can also be significantly affected by the loss of soft tissue volume (mostly fat) of the inner cheek – near the nose and just under the lower eyelid; this flatness tends to give an elongated, washed-out appearance.



For decades, a lower lid blepharoplasty always included the removal of fat, but since people lose volume as they age, the techniques used today preserve volume for patients who have lost fat by moving (not removing) the fat pads. In patients with a loss of volume in the lower eyelid that causes a hollow appearance or a deep “tear trough”, lower eyelid blepharoplasty is designed to restore the slight youthful convexity by adding volume. Common techniques include moving part of the fat pad into the tear trough (fat transposition) or moving upper cheek fat into the horizontal hollow of the lower eyelid.



Often, an upper eyelid blepharoplasty consists of a conservative removal of excess skin to recreate the upper eyelid crease. In some cases, a small amount of fat and muscle may also be removed. Lost volume is a major factor in aging and continues after eyelid surgery, so instead of removing upper eyelid fat, our blepharoplasty surgeons will sometimes tighten the membrane that holds the fat in place. This repositions the fat so that it no longer protrudes. If your brow has become much lower, and your eyebrows are sagging from age, instead of only removing tissue from the upper eyelids, your upper eyelid blepharoplasty may be combined with a brow lift at the same time to achieve the best results. For some people, smoothing out crow’s feet can be accomplished with BOTOX®. Although BOTOX® treatment is temporary, it can accentuate the results of your eyelid surgery.



As you can see, there are many options available to correct the cosmetic problems that have changed your eyes. During your consultation for blepharoplasty, you will be provided information on any and all of the cosmetic procedures available that would be the most beneficial to your circumstances. For most patients, eyelid surgery is performed as an outpatient procedure using a local anesthetic and intravenous (IV) sedation, but general anesthesia may also be an option. Blepharoplasty usually takes thirty to ninety minutes to perform. If you are having both upper and lower blepharoplasty performed, your surgery will usually take longer.