Our eyes have a huge impact on our external appearance; they can make us look and feel young and joyful, or tired and old. We’d like our physical reflections to represent the youthful vision of ourselves that we have in our minds, as well as express the vibrant manner we still feel.
Unfortunately, the eyes are often the first to show signs of ageing, due to the very thin and delicate skin that surrounds it. Years of neglected skin care, sun exposure, and rough make-up application can contribute to the eventual wrinkling and sagging skin around the eye area, though most of it is largely due to the natural ageing process. In fact, the simple act of blinking our eyes causes minuscule stretching of the elastic fibers in the skin around the eyes, as well as the fibers in the levator muscle, which is responsible for raising the eyelid.
New York-based Oculofacial plastic surgeon, Dr. Amiya Prasad is an eye “superspecialist” and a Fellow of the prestigious American Society of Oculofacial Plastic and Reconstructive Surgery. With over 16 years of experience in practicing eye surgery (or what is known as blepharoplasty), Dr. Prasad can help you recapture your youth and feel more confident about your appearance, while addressing the problem signs of aging safely and effectively.
Board-certified plastic surgeon Dr. Prasad routinely performs eyelid surgery, as well as unique procedures not offered by many cosmetic surgeons, including: asian eyelid surgery, exotic eyelifts, eyelash transplant and non-invasive eyelifts. Concerns and complications related to aging, prior surgery, trauma or hormones (wrinkles, scars, or a deformity of the eye area) can be corrected with eyelid surgery.
Can I get upper and lower eyelid surgery done at the same time?
Cosmetic upper and lower eyelid surgery or blepharoplasty is a very popular procedure throughout the world the goal of these procedures is to improve the aesthetics of the eyes by addressing excess and sagging upper eyelid skin often associated with genetics and aging as well as the appearance of puffy under eye bags other issues which can be addressed in the eye area include upper and lower eyelid hollowing wrinkles and dark circles which may be addressed non-surgically.
I’m Dr. Amiya Prasad I’m a board-certified cosmetic surgeon and fellowship trained oculofacial plastic and reconstructive surgeon I’ve been in practice in Manhattan and Long Island for over 20 years as an oculoplastic surgeon specializing in aesthetic procedures I perform a wide range of cosmetic eyelid procedures I also treat complications of eyelid surgery originally performed by other doctors I have throughout my career developed several techniques in eyelid surgery to allow for minimal incisions save for anesthesia and quicker recovery it’s important to understand some basic principles in a younger person the skin quality tissue volume and bone structure gives the upper eyelids a youthful appearance the supporting structures can change due to genetics aging and medical issues the upper eyelid area can have fat pockets prolapse forward hollowing and excess skin referred to as dermatochalasis. Under eye bags which are caused by lower eyelid fat prolapse is often associated with genetics and if many young people under eye bags that are also often seen with facial aging it’s common to see both sagging skin in the upper eyelids as well as under eye bags at the same time another issue affecting the upper eyelids which is commonly associated with aging is upper eyelid ptosis ptosis means that the upper eyelid position is lower than it should be and this position is unrelated to the physical weight of the upper eyelid skin ptosis has to do with the muscle that raises the eyelid called the levator muscle like the word elevator without the letter e the condition needs to be identified before any cosmetic procedure so the muscle which lifts the eyelid is addressed at the time the surgery is performed to get the best outcome for many people the appearance of excess skin on the upper eyelids puffiness in the upper eyelids and hooded eyes can be very frustrating many of our patients note how it’s difficult to apply makeup to the upper eyelids being perceived as older or lacking in energy is also a common complaint expressed by patients during consultation in fact the appearance of looking tired even when well-rested is one of the most common reasons for inquiring about eyelid procedures these conditions affecting both the upper and lower eyelids often occur concurrently so wanting to have both upper and lower eyelids procedures done at the same time as a frequent request there are specific procedures used to address hooded upper eyelids and puffy under eyes depending on the underlying causes and the degree of severity for example the appearance of hooded upper eyelids may be improved non surgically I’ll be it temporarily with the procedure called Botox brow lifts if the upper eyelid fullness is caused by eyebrow position only if the eyebrow position has descended more significantly while surgical brow lifting options may be considered as well if there is excess or sagging skin over the eyes the more definitive and long-term solution is an upper eyelid blepharoplasty an upper eyelid blepharoplasty is a procedure for restoring the upper eyelids shape and contour creating a more rested and refreshed appearance excess upper eyelid skin is carefully measured a design is drawn to address the excess skin and additional tissue below the skin is artistically contoured so the eyes look refreshed and natural afterwards gentle handling of this delicate tissue with meticulous care allows for minimal bruising and swelling after surgery resulting in quicker recovery as far as under eye bags are concerned there are usually two approaches which are considered these are the transcutaneous approach or the transconjunctival approach the transcutaneous approach involves making an incision right below the eyelashes to get to the fat pockets it typically leaves an external scar and an approach that can be potentially lead to complications due to compromise of lower eyelid support structures in addition unnecessary skin removal can contribute to problems such as lower eyelid ectropion and lower eyelid retraction for most of my patients regardless of age and ethnicity I prefer the transconjunctival approach this procedure is considered technically more complex but in my hands has proven to be safe with minimal risk of complications patients find this approach particularly advantageous as I’m able to maintain the natural shape of the eyes and avoid the rounded look which is seen all too commonly after eyelid surgery preserving the shape of the eyes allows me to provide my patients with the feeling of confidence about retaining their character while looking more refreshed specialized procedures for upper eyelid ptosis or drooping upper eyelids due to a weakened levator muscle can be performed at the same time when addressing the excess upper eyelid skin as well as under eye bags specialized surgery like ptosis correction is done almost exclusively by oculoplastic or oculofacial plastic surgeons like myself this is not usually done by general plastic surgeons or cosmetic surgeons I routinely perform upper and lower eyelid surgery with any of the advanced or additional procedures and necessary all at the same time all procedures are performed using local anesthesia with light intravenous sedation which means easier recovery and less downtime in comparison to eyelid surgery performed under general anesthesia the upper eyelids heal extremely well and the area where sutures are placed blends very well with the adjacent skin even when the eyes are closed upper and lower eyelid surgery when performed together usually takes less than two hours to perform minimal bruising and swelling are typical after upper or lower eyelid surgery and my patients routinely go back to work in one week upper and lower eyelid surgery can be performed at the same time with minimal risk and quick recovery I recommend meeting with qualified and experienced oculofacial plastic and reconstructive surgeons who specialize in cosmetic eyelid surgery so you can learn about your options I hope you found this information helpful thank you for your question
In order to determine whether you are a candidate for blepharoplasty, consider the following points:
If you can relate to these points, then you are most likely a good candidate for a blepharoplasty. Keep in mind, however, that in addition to these points, a patient who wants to undergo blepharoplasty, like with any other type of surgery, must be in good health with no existing serious medical conditions.
They must hopefully also be willing to make the necessary changes to their lifestyle (quitting smoking or excessive sunbathing, exercising more, eating right, etc.) in order to get the most out of the results of their surgery.
When considering if you are a candidate for blepharoplasty surgery, you need to be clear about why you feel the need to change your appearance. Remember: No one should ever convince you to get cosmetic surgery. Ultimately, the decision to have blepharoplasty surgery is a highly personal choice and will depend on your own cosmetic goals.
Hi my name is Kelly and most of you may know me as Dr. Prasad receptionist but today I am his patient when I first started working here I believed in plastic surgery but I didn’t think that at the time I needed it after seeing Dr. Prasad patients I realized that I could actually be one of them it’s I know I’m 22 so for some people you’re like really eyelid surgery but it’s not about age and it’s not about what you look like it was something that I knew would make me happy
Kelly is young so there’s not a lot of aging changes so what we want to do is retain a natural appearance to her eyes and so and it first identify the crease this space right here is where you apply eyeshadow and so that will be the definition nature gives us a crease so that it is as you get older gets less defined but when you’re young is pretty well defined and some basically follow what’s already there as the starting point.
I knew that Dr. Prasad was the right doctor to fix that for me he is excellent at what he does he’s a master of his art and just like any artist could draw a picture Dr. Prasad can fix your eyelids
Now the art of eyelid surgery is deciding how much to do as well as how much not to do so when I’m looking at her I’m asking her to open her eyes and I like to do my drawings with the patient’s standing up because we’re vertical and when you’re laying down everything kind of shifts up and back so with her students getting up I can confirm that the crease is in a nice place based on what I saw with her eyes closed and now I look at her and see how much extra skin there is and skin is not the enemy it doesn’t going to remove all the skin what we want to do is to look young and natural so if we take off too much skin it can actually make you look older okay so what I’m doing now is measuring a certain amount of skin that I’d like to reduce and at the same time not take too much and this is where the art is because technically she has enough elasticity in their skin to be able to remove a lot more so we almost have permission to take away a lot but really we don’t because then she will look like she had surgery so what we want to do is to make her eyes look more open and nor natural and this is where experience and artistry are very very important essentially anybody can take away skin but taking you right about a skin away and doing in a way that looks nice and natural that’s judgment that is I feel intrinsic what I like to do is create enough space on the outer aspect of the eye so that you can really apply eyeshadow and it will look very nice at the same time we don’t want any scars that go outside of the natural shape of the eye if you go to any restaurant to look around the city or Long Island you’ll see a lot of people walking around with an incision line out here because the doctor when they did the surgery drew it in a way so that the scar went outside so again she’s young we don’t want her to look like she’s had surgery so with this design here it flows and tapers and it looks it matches his wife of her face it’s mental do the same thing on this side it’s important to realize when you look at eyes that know very few people have a hundred percent symmetric eyes and you realize that when you’re doing the drawing that the subtle or subtle asymmetries and wood Kelly her left brows a little bit higher than her right brow and bone structure has an effect on how these areas are manifested because the soft tissue where the skin drapes over the bones so compensating and trying to maximize the symmetry is also important but again we are naturally a little bit asymmetric so there’s a lot of heaviness on the outer aspect here there’s not much over here so it’s almost graduated we’re going to take a little bit more as we go out so that what everything is done you’ll actually have more of an eyelid do that Calvin yes nice so that’s that’s what we can expect okay all right so we get to work now
I am four days post-surgery it seems unbelievable to me I was literally fascinated with my results I’m back at work after four days which most people were even shocked about I got a call the next day from the nurse and she said when are you gonna be back I said Tuesday she said really I said yes and I knew would be possible because honestly I was stunned by the fact that I didn’t look like I had surgery um I went to wool bombs last night and nobody even looked at me like I was crazy which most people would think they would I am back at work feeling fine and I am ecstatic over my results they really look good really is it for one week I can’t believe it yeah yeah I feel like I’d literally I don’t look like I had surgery someone wouldn’t say hey did you have plastic surgery but I look different to myself and I’m so happy about that because it I have knowledge which I didn’t have before my sister couldn’t believe it she said she can’t wait to do my makeup which is exciting for her but I just wanted everyone to know that I feel great and I’m excited this is my month and a half post-op video I did my upper eyelids because I had a lot of extra skin and oh people are always saying you look tired or when I smiled I literally didn’t have an eyelid I would wear makeup and you couldn’t tell so I made the decision to do this and I’m so excited to be here talking to you guys about this because it has made such a difference for me the funny thing is that people will see me and nobody knows the difference my friends haven’t noticed family members that didn’t see me after the surgery haven’t noticed and it’s just like I like that in a way because he didn’t change my look he just enhanced it so I am so excited I’ve been wearing makeup every day basically because now when I do you could see the eye shadow my eyelashes are up my mascara looks wonderful and that’s just like something little that comes along with it and I don’t look as tired I feel like I look awake and enhance I don’t look different but I definitely look better and that is why I’m so thankful to Dr. Prasad for this if the upper eyelid surgery I had done gave me that natural crease that most people don’t have to have surgery to do but I was a person that did the skin that hung over prevented me from having an eyelid basically before the surgery one of the nurses said to me when you smile you know you don’t have that look that most people have so now I’ve gained that natural crease just from doing the surgery I’m actually an aspiring actor so for me that’s your looks is what sells you you need that in that business and I feel like Dr. Prasad gave me an opportunity to enhance my look and I’m very excited about that because you want to look your best it’s important you’re on camera people are looking at you that’s what they’re judging you by the first step you walk in the door so he gave me an opportunity to give them something a little better to look at I look a week I look alive I look like I’m ready to be there and like I slept last night which is important it’s something that everybody wants but especially someone whose look is something that you know is imperative in their career.
If you have decided that blepharoplasty surgery is right for you, schedule a consultation with Dr. Prasad, super specialist in eye and eyelid surgery.
Motivated by the desire to perform more effective eye surgeries, Dr. Prasad developed a technique for blepharoplasty surgery that he calls the SmartLift™ Eyelift. This particular technique is designed to make use of a minimal incision method, alongside Dr. Prasad’s LITE™ Anesthesia sedation method, in order to achieve maximal, natural-looking results with minimal risk. Because of this approach, the downtime after the procedure is significantly shorter than that of blepharoplasty surgery performed under general anesthesia.
General anesthesia is known to have more attendant risks than local anesthesia. There is a tendency for the patient to suffer from nausea after the procedure, and recovery is known to take much longer. And while, having a patient under general anesthesia may be more convenient for the surgeon, it may represent a greater burden to the patient, thus the SmartLift™ Eyelift approach is certainly a safer option.
Dr. Prasad has also developed a system that helps him categorize a patient’s eyelids based on gender, age, ethnic background and skin condition. Because eye surgery is such a delicate procedure and because no eye is the same, each approach much be customized to suit the individual. While this system is undoubtedly helpful, it is ultimately the personalized artistic touch of Dr. Prasad that makes all the difference in the beauty of your results.
Upper eyelid blepharoplasty surgery is performed on excess, loose, saggy skin on the upper eyelids. This excess skin, as experienced by runners, tends to cause irritation especially when sweat drips into the area. Some women also note that putting on make-up is frustrating, as the excess skin tends to cause creases in their foundation or eyeshadow.
The goal of upper eyelid blepharoplasty is to restore the lid’s natural line, and this is achieved by making a small incision in the crease of the upper eyelid. The scar usually heals quite well and is difficult to see, even when your eyes are closed.
Lower eyelid blepharoplasty (under eye bag surgery) is used to eliminate puffiness and heavy bags under the eyes that is caused by displaced orbital fat (fat that surrounds and cushions the eye inside the orbit). Lower eyelid blepharoplasty can be done in two ways: the more traditional transcutaneous approach (through the skin), and the transconjunctival approach (inside the eyelid). But generally, both techniques involve the removal and sculpting of excess fat and skin.
“Awesome Eyelift! – I had been getting very tired eyes daily even though I wasn’t tired. My upper lids were covered by drooping skin and I had fat deposits on my lowers. My plastic surgery was only 4 weeks ago and I am thrilled with the job Dr. Prasad did. It was easy, painless and very quick recovery. If you are considering this, you want Dr. Prasad, excellent results !!” —Patient JC