Upper and Lower Blepharoplasty – Blepharoplasty Revision
Beverly Hills Plastic Surgeon Dr. Renato Calabria has a new philosophy and approach to eyelid surgery.
Eyelid surgery has changed dramatically in the last few years. For the upper eyelid the trend is definitely “less is more”. This for on obvious reason: any changes of the eye shape are very recognizable and easy to detect. Dr. Calabria can point out innumerable example in the celebrities arena, where an over aggressive eyelid surgery is a dead give-away.
It is a fact that by performing an aggressive upper blepharoplasty in the effort to excised all the redundant skin the shape of the eye changes and from a natural almond shape becomes round: a classic” done” look.
Dr. Calabria’s philosophy is to keep the eyes looking as natural as possible; in fact most of the time is performs an endoscopic eyelid before any type of upper eyelid surgery to correct the redundant skin which almost invariably improves in a more natural way.
Dr. Calabria’s upper blepharoplasty is different then the traditional blepharoplasty: the skin excision is minimal, almost no fat is taken out and the muscle is not violated. All these maneuvers don’t hallow to violate the anatomy of the area and they will delivery an absolutely natural result.
Most of the time the eyelid rejuvenation is completed by an endoscopic brow lift to further improve the results.
Beverly Hills Plastic Surgeon Dr. Calabria performs also many eyelid revisions secondary to an overaggressive approach, both upper and lower. With his techniques, he restores the natural anatomy of the peri ocular area and he is able to reestablish a more youthful look which was previously compromised
The double Pexy Lower Blepharoplasty: A True eyelift.
The signs of aging of the lower eyelid include:
- Laxity of the cantal ligament
- Descent of the orbicularis oculi muscle
- Herniation of the fat pads
- Loose and excess skin
- Texture changes of the skin.
In rejuvenating this area all the factors have to be addressed and corrected. The double pexy blepharoplasty is a combination procedure that addresses all the structural components of the aging lower eyelid, maximizing the cosmetic results and minimizing complications.
The approach is through a standard lower blepharoplasty incision. A skin flap is elevated of the length identical to the projected skin excision. (2-3 mm). This accomplishes two goals: preserves the preseptal portion of the orbicularis for function and the pretarsal part of the muscle for support. Then a skin muscle flap is elevated. The herniated fad pads are exposed through the septum orbitalis, re draped over the orbital rim and sutured in place. In selected cases (deep nasojugular hollow, skeletonized look or redoes), a thin layer of alloderm is added for support and also sutured it in place. No fat is removed.
A lateral retinaculum cantopexy is done through either an upper or lower blepharoplasty incision to correct cantal laxity. The excess skin is excised preserving all the orbicularis muscle. Then a small (1cm) orbicularis muscle flap is developed at the lateral edge of the skin muscle flap and it is suspended to the periosteum of the lateral orbital rim, just slightly inferior to the cantopexy. The skin is then approximated with interrupted fast absorbable sutures. This double pexy provides more support then a standard procedure, therefore minimizing any potential complications, (especially if it’s combined with any midface type of suspension) and allows redraping the skin muscle flap in a more youthful position.
With this procedure all the structural components of the aging eyelid are addressed at the same time, restoring them to the original, more youthful position, where the aging lower eyelid is treated more like an aging face, with the same volume redistribution and preservation principles.
For more information on Blepharoplasty or to speak with Dr. Calabria, please feel free to contact us.
To view before and after pictures of this procedure, go to our photo gallery.
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