Eyelid Lifts

Turning Back the Hands of Time!

The effects of time

Over time, skin looses its soft texture and vibrant appearance due to the effects of the sun, diet, pollutants, gravity, heredity and poor skin care. The fine wrinkles that develop around the eyes and lips, drooping eyelids or bags under the eyes may give us "character", but they can also hide our real emotions. Instead of appearing energetic and enthusiastic, the wrinkles and bags make us look tired and lifeless, ready for a nap.

Skin changes

* Wrinkling

* Age Spots, blotches, or liver spots

* Laxness (bags under the eyes or sagging tissue)

* Dry, flaky skin

Skin structure

The skin is made up of two layers that have distinctive structures and properties - the epidermis or outer protective layer, and the dermis. The epidermis has remarkable regenerative capabilities and is continually replacing its outer dead cells as they are abraded from the surface. Damage to the epidermis results in dry, flaky skin, age spots and wrinkles. The dermis contains a high proportion of collagen fibers intermingled with fibers of elastin which gives the skin its mechanical strength. The junction between the epidermis and the dermis is uneven or ridged, and, along with the collagen and elastin fibers of the dermis, provides mechanical strength to the skin. Damage to the collagen and elastin fibers or straightening of the ridges results in loose or baggy skin.

Chronologic and photoaging

The processes that create changes to skin can be classified as intrinsic or chronologic (changes that occur over time but without the effects of exposure to light), and actinic aging or photoaging (changes due to the effects of exposure to light).

* Chronologic aging

In chronologic aging, there are some noticeable changes that occur in the epidermis; however the changes that occur in the dermis are striking. Chronologic aging of the skin results in slight atrophy of the skin or laxness; dryness; an increased tendency to bruise; slight wrinkling that temporarily disappears with stretching; a decreased ability to fight infections; and an increase in healing time after injury.

* Sun damage or photoaging

Photoaging is classified separately because of its importance in premature wrinkling and skin damage. Both short term acute sun damage (resulting in sunburn) and moderate exposure to the sun over a long period of time (sun tanning either in the sun or in a tanning booth), cause serious damage to your skin.

Sun light is made up of several kinds of energy rays or radiation, including ultraviolet light, visible light, and infrared light. While all three of these forms of sun light are thought to provide some contribution to photoaging, ultraviolet light is very damaging to the skin. Ultraviolet radiation can further be broken down into UVA and UVB rays. UVA and UVB both result in deep wrinkles (can not be erased by stretching), erythema (redness or inflammation), age spots, and skin cancer. UVB radiation also has a depressing effect on the skin's immune response (ability to fight off infection).

Skin resurfacing vs face lifts

Techniques used to treat wrinkles, like those that develop around the eyes (crow's feet) or lips, age spots and dryness involve skin resurfacing and are different than face or skin lifts which are used to treat loose, sagging skin such as bags under the eyes or sagging cheeks. Many people only require one of the techniques, while others may require both skin resurfacing and a lift.

* Skin resurfacing

Chemical peels, dermabrasion and CO2 laser skin resurfacing are used to treat wrinkles, age spots and dryness as well as other problems like acne scars, tattoo removal and port wine stains. These techniques focus on the removal of the epidermal skin tissue with limited effects on the deeper dermis. Use of these techniques results in the generation of a new layer of skin without the wrinkles, age spots and dryness.

Chemical peels use harsh chemicals to destroy the surface of the skin whereas dermabrasion uses abrasives (sandpaper like) to remove the upper layer of skin.

* The CO2 laser & skin resurfacing

Lasers are excellent tools for surgical treatment because of their precision and ability to be very selective in the tissues they treat. The CO2 laser has been used by ophthalmologists, neurosurgeons, dermatologists, plastic surgeons, general surgeons, oculoplastic surgeons and others for over 10 years. The development of the pulsed and rapid scanning CO2 lasers have allowed them to be used in skin resurfacing.

The CO2 laser works either by emitting a very short (in duration) but intense beam of light or by very rapid scanning of the beam over the treatment area. This instantaneous application of the beam, selectively vaporizes the damaged layer of tissue without hurting underlying skin. Taking less than one thousandth of a second, one pass of the CO2 laser can be controlled so that it only affects about half the thickness of a thin human hair.

Blepharoplasty (eyelid lift)

Blepharoplasty is plastic surgery of the eyelids to eliminate tired, puffy, drooping eyelids and bags under the eyes. Drooping eyebrows can also be corrected at the same time.

The CO2 laser is used for blepharoplasty because of its unique ability to seal off blood and lymphatic vessels and nerve endings as it separates tissues, minimizing bleeding, pain, and postoperative edema. In this common procedure, excess skin and fatty tissue are removed from around the eyes. With upper eyelids, the fine incisions made are usually hidden in the natural skin folds of the eyelid and are almost invisible during healing. With surgery of the lower eyelids, an incision is usually made on the inside of the eyelid so it is completely invisible during healing.

Outpatient surgery

Blepharoplasty and laser skin resurfacing are usually performed on an outpatient basis. In some cases, blepharoplasty and laser skin resurfacing are performed using a topical anesthetic cream, while at other times, a local anesthesia in used. Recovery after surgery depends on the patient's own healing characteristics and the procedure. After laser skin resurfacing, the patient washes 4 to 6 times a day and applies Vaseline® for 3-10 days after surgery. After this period the erythema (redness) that is present in the treated skin can be disguised with makeup. The erythema subsides in 4 to 8 weeks. The fine sutures used in blepharoplasty are removed in 3 to 6 days. There is some swelling and bruising that can be camouflaged with makeup after 7 to 10 days.

Hints on good skin care

* Avoid exposure to the sun and tanning beds.

* Use a sunscreen with at least an SPF 15.

* Over the counter "wrinkle" creams do not prevent or reverse wrinkles.

* Retin-A, Renova and Alpha-hydroxy acids are creams prescribed by physicians that can improve the quality of skin.

* Use a moisturizer such as petrolatum immediately after bathing.

* Commercial "fade" creams will not make age spots disappear.

Advantages of CO2 laser Skin resurfacing

* Better control and precision to "erase wrinkles"

* Can be used around the eyelids and lips, as well as the full face

* Reduced operating time

* Less swelling and bruising after surgery

* Reduced pain

* Results in the formation of new collagen fibers and tightening of skin


* Seals blood vessels, lymphatics and nerve endings, giving the surgeon better visibility and control

* Reduced swelling and pain after surgery

* Reduced operating time



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