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Eyelid plastic surgeon John B. Harris, MD, performs blepharoplasty under local anesthesia in Ponte Vedra Beach, FL

No single facial feature has as much impact on how the world views your image of youthfulness as your eyes. And no other cosmetic procedure has been more overdone and responsible for adversely changing an appearance than upper eyelid surgery. Dr. Harris’s approach to the surgical rejuvenation of your eyes considers the many subtle changes that have occurred over time. A surgeon who approaches the eyes’ rejuvenation with the same single operative procedure would be as ill-prepared for success as a portrait artist with a single oil color on their palette. 

The cause of aged eyes is a combination of many factors and should be addressed in multiple small measures. Simply removing skin and fat from the upper eyelids will not return youth but rather irreversibly change the eyes’ appearance and ultimately lead to a hollow operated-on look later in life. Many times what appears to be excess eyelid skin is managed with a simple elevation of the lateral portion of the eyebrow and subtle refilling of the forehead and eyelid area with fat grafting. This procedure completely eliminates the need for an upper eyelid incision. At the most, a small element of upper eyelid skin is removed to create a uniform crease above the lash line. Dr. Harris has always felt “less is more” with eyelid skin removal. One can always remove any small excess under local anesthesia to fine-tune – one cannot put it back if too much is removed. 

Lower eyelids are managed with the combination procedures, sometimes removing a small amount of fat through an incision inside the eyelid eliminating any visible scarring. Frequently Dr. Harris will recommend a peel (TCA) of the lower eyelids to help tighten the skin and diminish the fine wrinkles of the lower eyelid.   

Many upper eyelid patients have surgery on Wednesday and are back to work on the following Tuesday. At this point, all sutures are removed, and makeup or flesh-colored tape may be applied to the lateral visible incision line. The incision lines eventually blend in well with the lateral eye expression creases.

Thanks to Dr. Harris, I can see like a normal person again. I didn’t realize how bad my peripheral vision was!
P. A.

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