Cosmetic Blepharoplasty & Eyelid lift Surgery

The eyes are typically the first feature to show signs of aging. Eyelid skin is very thin and becomes loose, wrinkles and sags earlier than other areas of the face. Cosmetic eyelid surgery is the ultimate solution for tired looking eyes. An upper blepharoplasty removes excess upper eyelid skin in a very natural way with minimal downtime.  Lower eyelid surgery is designed to tighten skin and also remove eye bags. After deciding that it’s the right time to pursue eyelid surgery the most important decision is choosing the right surgeon.

Dr. Kolstad is a Board Certified Facial Plastic Surgeon.  He does not perform breast or body plastic surgery. By focusing all of his expertise on rejuvenation of the face and neck Dr. Kolstad can design an eyelid surgery that is best for your unique features.

Tired-looking eyes can be the result of too much skin, excess fat, retained fluid or bulging muscles. Dr. Kolstad can help you identify what is the cause of your concerns and design a surgery specific to you. Dr. Kolstad’s most important goal for every surgery is a natural appearing result.  If it doesn’t look natural, it doesn’t look good.

A blepharoplasty rejuvenates your eyes through the gentle and precise removal of excess eyelid skin and occasionally eyelid fat. Repositioning heavy brow skin may also be necessary to achieve the optimal improvement in upper eyelid surgery.  Lower eyelid surgery is typically improved by adding volume to the tear trough and cheeks by facial fat grafting.

A blepharoplasty is best performed by a surgeon with an artistic vision and skillful hands.

There are many tell tale signs of a poorly done eyelid surgery. Surgeons that remove too much skin and fat can leave patients with hollow eyes, devoid of wrinkles, and lacking a natural appearance. An eyelid that is pulled too tight can create a rounded, unnatural corner. Dr. Kolstad is a face specialist.  He does not use the one-surgery-for-every-face approach found in many plastic surgery practices. He has many different surgeries to address upper and lower eyelid aging.  Dr. Kolstad will help you decide which technique is best for your eyes.  

He believes in a customized approach that is specific to the way that your eyelids will harmonize with your face.

Dr. Kolstad learned his techniqued from one of the best blepharoplasty surgeons in the world. He spent an entire year in New York working exclusively with one of the world’s premier Facial Plastic Surgeons.

During your consultation Dr. Kolstad will help guide your through different options to improve the appearance around your eyes.  Many patients seeking eyelid surgery are surprised to learn that they are better candidates for less invasive treatments like injectable fillers, Botox, chemical peels, or facial fat transfer.

Cosmetic blepharoplasty is a very safe and common procedure. Upper eyelid lifts requires less surgery and have less downtime compared to lower blepharoplasties. Eyelid surgery can be performed in the office using local anesthesia or in a surgery center with sedation. The incisions are placed into natural creases around the eyes and heal well.

What Is The Best Type Of Eyelid Surgery For Me?

Ideal Eyelid Appearance

Every face is unique. Dr. Kolstad’s expertise in Facial Plastic Surgery allows him to design a procedure that is best for you.

* Individual Results May Vary

San Diego Blepharoplasty Frequently Asked Questions

incisions-used-for-an-upper-eyelid-lift-blepharoplasty

The incisions used for an upper eyelid lift (blepharoplasty) are depicted in the images.

A) The incision is placed into the natural eyelid crease and extends outward into one of the crows feet.

B) When the eye is open the incision will be hidden by the eyelid crease.

Upper eyelid surgery is designed to remove the loose, excess skin that accumulates as we age. The incision lays within the natural eyelid crease and is hidden when the eyelid is open. The incision extends outwards into one of the crow’s feet to remove the lateral hooding.

Every surgeon has different techniques and goals for upper eyelid surgery. Dr. Kolstad believes that fat excision during an upper blepharoplasty will lead to hollowing in the majority of eyelids. He achieves a natural appearing result by focusing on skin removal and leaving much of the orbital fat behind. Dr. Kolstad also prefers to leave much of the blinking muscles (orbicularis oculi) intact to minimize the risk of dry eyes after surgery.

To achieve the best and most natural upper eyelid appearance a combination of brow lift and blepharoplasty are typically performed.  The differences between brow lifting and blepharoplasty are best demonstrated in the office.  During your consultation Dr. Kolstad will demonstrate the effect of brow position on your facial appearance.  He will be able to simulate the results of a brow lift, upper blepharoplasty or both using a mirror and a Q-tip.  By accurately demonstrating the results of each procedure patients are able to make a more informed decision if they need a blepharoplasty, a brow lift or both to achieve their desired outcomes.

For patients with a low eyebrow, prominent lateral hooding

1) Endoscopic forehead and brow lift: this surgery is designed to minimize scarring by placing the incisions in the hairline. There are a total of 4 incisions required, two in the temples and two very small incisions in the frontal hairline. When browlift san diego 3 copyhealed the incisions are hidden by the surrounding hair.

Endoscopic brow lifts place the incisions far from the surgical site and require cameras, monitors and technology to aid the surgeon. This procedure is designed for someone that requires lifting of the entire eyebrow and forehead. The surgery typically takes about 1.5 hours and requires sedation anesthesia. Downtime is about 7-10 days.

Men with temporal or frontal recession typically do not have enough hair for coverage and are not great candidates for this approach.

* Individual Results May Vary

2) Forehead shortening (trichophytic brow lift): Dr. Kolstad offers this unique approach to accomplish two goals with one surgery. Using a special beveled incision just behind the hairline the eyebrows can be lifted and the forehead shortened at the same time. brow lift san diego 421 copyIdeal candidates for this surgery have relatively long foreheads want to shorten then distance between the hairline and eyebrows.

A limitation of the endoscopic browlift is that everything, including the hairline, is lifted upwards and backwards. Dr. Kolstad believes that the forehead shortening brow lift creates a more youthful appearance for most people with average to long foreheads. This type of surgery has a longer recovery than the endoscopic lift. The shortcomings of the trichophytic brow lift are numbness lasting several months or longer behind the incision and the potential for a less hidden incision.

* Individual Results May Vary

3) Minibrow / temple lift: this procedure is designed for someone with lateral hooding and fullness of the outer part of the eyelid. A temple lift raises the lateral (outer) eyebrow without raising the inner corner. Dr. Kolstad’s Advanced Eyelid Lift combines a minibrow and upper blepharoplasty and is his most popular upper eyelid rejuvenation technique. Two incisions are placed into the temporal hairline and are camouflaged by the surrounding hair.

4) Direct browlift: men with temporal or frontal hair loss are not acceptable candidates for endoscopic, forehead direct brow incision copyshortening or minibrow lifts. All three of the procedures use thick hairlines to camouflage the incisions. Men with hair loss and deep forehead creases are ideal candidates for direct brow lifts. Dr. Kolstad removes 1-2 cm of skin above the eyebrows to raise them to a more youthful location. The resulting scar appears like a normal wrinkle in the forehead.

* Individual Results May Vary

For most men Dr. Kolstad advises against brow lifting surgery. Hollywood has countless examples of men that had eyebrows lifted much too high. Over-elevating a man’s brow does not make the person look any younger. They just look different. Dr. Kolstad’s philosophy is to never raise men’s eyebrows unless absolutely necessary.

5) Coronal browlift: this historical type of surgery may have contemporary indications, but Dr. Kolstad does not know of any. For most patients there are more modern and more effective techniques to lift the eyebrows and forehead.

incision-used-for-a-lower-eyelid-lift-blepharoplasty

The incision used for a lower eyelid lift (blepharoplasty) is depicted in the image.

A) The incision is placed just under the eyelashes and extends into one of the crows feet laterally. The scar is camouflaged by the eyelashes and difficult to find in most cases.

Dr. Kolstad has several different techniques to get your lower eyelids looking their best.  Aging in the lower eyelids is typically due to three things, bulging fat, hollowing and loose skin.  Dr. Kolstad uses four different procedures that he tailors to meet the signs of aging in your eyes.

  1. ‘Scarless’ blepharoplasty: this procedure is designed for youthful eyelids that have fat bulging creating a tired, puffy appearance.
    Fat bags prominent at an early age are frequently hereditary and can make the eyes look much older then a persons actual age.  Dr. Kolstad employs a transconjunctival (inside the eyelid) incision to access the fat. There are no skin
    incisions and no external scarring.
  1. Skin tightening lower blepharoplasty: this surgery removes excess skin from the lower eyelids.  Not everyone has prominent lower eyelid fat bulging through the lower eyelid.  For patients looking to tighten skin without removing fat Dr. Kolstad utilizes the skin pinch blepharoplasty technique.  This procedure is safe to perform in the office using local anesthesia.
  1. Combined lower blepharoplasty: by far the most common type of lower eyelid surgery combines the gentle excision of lower eyelid fat with skin tightening. Dr. Kolstad addresses the fat bags through the transconjunctival approach and tightens the skin on the surface.  This modern blepharoplasty technique is less invasive and less likely to cause ectropion or eyelid malpositions after surgery.
  1. Fat grafting blepharoplasty: Some eyelids age by hollowing. Dr. Kolstad’s preferred technique for rejuvenation of hollowing is to borrow fat from the lower body and transfer fat grafts to the cheeks, midface and orbital area. Fat grafting blepharoplasty is the most technically challenging type of eyelid surgery Dr. Kolstad performs.

No surprised faces here.  This unacceptable outcome is completely avoidable when using the right technique.  When surgeon’s lift the brow too high or remove too much fat and skin the results do not make the eyes look any younger, just different.

Dr. Kolstad’s expertise as a Facial Plastic Surgeon allows him to achieve long-lasting results without making his patients look “done.”

Many of our patients express concerns about looking plastic after eyelid surgery. There are limitless examples of unnatural, operated results. When surgeons pull too tight, a rounded eyelid can result in an “operated” look.

It is very important to choose a plastic surgeon that specializes in operating on the face and is comfortable with the challenging anatomy and procedures.

Dr. Kolstad – Double Board Certified Facial Plastic Surgeon

PDFBlepharoplasty Before and After Surgery Instructions

Blepharoplasty is an out patient procedure meaning you will be able to go home after surgery. The eyes will have swelling and will be a little blurry so you will not be able to drive yourself home. If sedation is used it is recommended to have someone stay with you for the day of surgery.
Upper eyelid and skin pinch lower blepharoplasty are most commonly performed in the office using local anesthesia.  Direct brow lifts and some advanced brow lifts can be performed in the office.

The type of surgery you need is the most important criteria for determining where the surgery will take place.  Fat excising lower eyelid surgery and most brow lifts are safer to perform in a surgery center.

Patient safety is paramount and Dr. Kolstad does not take chances with your health.  If it is safer to perform a procedure under general anesthesia then it is always the best to have the surgery done in a surgery center.

Blepharoplasty is an out patient procedure meaning you will be able to go home after surgery. The eyes will have swelling and will be a little blurry so you will not be able to drive yourself home. If sedation is used it is recommended to have someone stay with you for the day of surgery.
Upper eyelids heal faster than lower eyelids after surgery. Most people take a week off of work to heal from blepharoplasty. For patients that do not want anyone to know they had surgery it is advisable to take two weeks to recover. At this point the majority of the swelling has resolved and any residual bruising can be camouflaged with make-up.
Many of our patients do not complain of significant discomfort, with the majority using only Tylenol as needed. Prescription pain medicine is made available to you and we recommend that you have it available in case it is needed.

Every incision on the skin >1mm will result in a visible scar. Eyelid incisions and scars tend to heal better than every other incision on the face. Eyelid skin is the thinnest skin on the body and heals better than incisions used for rhinoplasty, facelifts, chin implants, lip lifts and almost every other plastic surgery. For most people the blepharoplasty scar is simply a line that is hard to recognize at conversational distance.

Want to learn more about how to prevent scars after blepharoplasty?

PREPARING FOR THE PROCEDURE: BLEPHAROPLASTY

HOW TO REDUCE SCARRING AFTER LOWER BLEPHAROPLASTY / EYELID SURGERY

HOW TO ICE AFTER BLEPHAROPLASTY / EYELID SURGERY

HOW TO CLEAN INCISIONS AFTER BLEPHAROPLASTY / EYELID SURGERY

HOW TO REDUCE SCARRING AFTER UPPER BLEPHAROPLASTY / EYELID SURGERY

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