Age Issues

Cosmetic Surgery Magazine article, posted 2005

"Blepharoplasty", the medical term for eyelid surgery, can be used to correct several facial problems. Two of the most common, according to plastic surgeon Dr. Stephen Brown, are the drooping eyelid, and the so-called "tired" look.

The drooping eyelid can occur when the skin of the upper lid loses its elasticity. This causes the appearance of bags hanging down over the eyes, often affecting vision. Dr. Brown recently treated an 88-year-old woman who was having difficulty reading the newspaper in the morning – after surgery she was able to do this.

Eyelid Surgery

The other common function of eyelid surgery is to fix the "tired look." Dr. Brown often has patients come to a consultation and report their friends or family have told them they "look tired," when they do not necessarily feel so. "This can be due to heaviness of the upper lids, puffiness of the lower lids, or both," reports Dr. Brown.

Interestingly, this condition does not appear to be age-related, with surgery performed on patients as young as 17. "Many people inherit heavy upper lids, or more commonly heavy lower lids, from their parents and grandparents," explains Dr. Brown. "They maybe young or they may be old."

As with all surgery, the variety of ages of those interested in blepharoplasty means the surgeon needs to take care of evaluating the patient’s readiness for surgery. General health conditions are an important issue for elderly patients, since healing can often be more difficult with older skin. "However," Dr. Brown explains, "Age doesn’t have everything to do with it." The best way for a prospective patient to know what to expect from this procedure, is to look at before and after eyelid surgery photos.


"A lot of healing has to do with the individual’s state. This is also true in terms of emotional readiness. It’s a known fact that any kind of stress or doubt about the operation can affect healing," reports Dr. Brown. With younger patients it is especially important to make sure they are emotionally mature, and prepared for the surgery.

While the surgeon is careful in selecting prepared patients, the patient must also be careful in selecting the appropriate surgeon. "Some people pay more attention to buying a household appliance than choosing a surgeon," notes Dr. Brown.

"The other common function of eyelid surgery is to fix the ‘tired look’."

For lower blepharoplasty especially, the technique depends on the individual surgeon — whether they choose to make an internal or external incision. Dr. Brown chooses the external approach, making the incision along the fold of the lower eyelid, which gives direct access to the fat needing to be removed. He explains, "Ninety-eight percent of the scar is in the fold, so it can’t really be seen."

However, many surgeons do choose to operate on the inside of the eyelid, making the scar completely invisible. Therefore, a patient must be careful to choose a plastic surgeon using the approach they desire.

Eyelid surgery can rejuvenate facial features — correcting a "tired" expression or lifting bags from the eyes. While our eyes do change as we age, eyelid surgery is not necessarily a treatment only after age has taken its toll. Like most surgery, blepharoplasty cannot be rushed into; but it can be an appropriate and desirable option for any age group.