Introduction to Blepharoplasty (Eyelid Surgery)
Blepharoplasty in Philadelphia helps patients achieve bright, youthful eyes devoid of bags. Your eyes are the first features of your face to show signs of aging and will be beautifully rejuvenated by Dr. Ho with minimally invasive eyelid surgery.
Before and After Blepharoplasty (Eyelid Lift Surgery)
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Before and After Upper and Lower Eyelid Surgery
What is Blepharoplasty?
Blepharoplasty is the technical term for eyelid surgery and focuses on improving the appearance of the eyelids. Upper and lower blepharoplasty address the upper and lower eyelids, respectively.
The eyes are the first features of the face to demonstrate signs of aging. Over time, the forces of gravity induce downward descent of the skin and soft tissues, resulting in dermatochalasis (excess skin in the eyelids) and a “baggy eyes” appearance.
Aging eyelids may also suffer puffiness due to fat herniation (the protrusion of orbital fat through the weakened orbital septum layer). The descent of the midface soft tissues including the cheeks may further accentuate the aging changes in the lower eyelids.
Other anatomic features that can contribute to the tired appearance of aging eyelids include brow ptosis, crow’s feet, ectropion (sagging or outward sagging of the eyelid) and under eye hollowing.
Blepharoplasty is designed to remove excess skin and fat to restore a youthful appearance to the eyes. This surgery requires the expertise of a surgeon who specializes in plastic surgery of the face and understands eyelid anatomy well.
Dr. Ho specializes in blepharoplasty and performs each eyelid surgery according to the anatomic issues and surgical goals of the individual patient.
Dr. Ho’s Approach to Blepharoplasty
As a facial plastic and reconstructive surgeon, Dr. Ho specializes exclusively in aesthetic and reconstructive procedures of the face including the eyelids.
She possesses well-rounded training in a variety of blepharoplasty techniques from one of the top facial plastic surgery fellowship programs in the country. Dr. Ho operates on eyelid surgery patients hailing from Philadelphia and Wayne and from all over Pennsylvania, New Jersey, and New York.
Dr. Ho dedicates the needed time and effort with every patient to determine the best surgical plan that meets their goals and expectations.
Dr. Ho pursues a conservative approach to blepharoplasty and avoids removing excessive skin or fat that may put a patient at risk of overcorrection with a hollowed-out result. Her surgical technique focuses on creating a natural, more youthful-appearing result that is tailored to the individual patient’s anatomy.
Dr. Ho performs meticulous closure of the eyelid incisions for minimal scarring and can design her approach to lower blepharoplasty such that an external lower eyelid scar is avoided all together.
Furthermore, Dr. Ho often performs fat transfer and/or laser skin resurfacing in conjunction with lower eyelid surgery to restore volume to the under eye and cheek regions and improve eyelid skin tone and texture to further enhance a patient’s rejuvenated appearance.
Her goal is to create a more youthful and more awake, unoperated look for every blepharoplasty patient.
Patient Testimonials Blepharoplasty (Eyelid Lift Surgery)
Brow Lift and Eyelid Surgery: Patient Testimonial
We are truly grateful for this patient’s beautiful brow lift, upper eyelid surgery, lower eyelid surgery, and facial fat transfer surgical results and even more humbled by her kind testimonial. Empowering patients with beautiful, natural results.
Patient Testimonial: Eyelid Surgery
In this patient testimonial, our wonderful patient describes her surgical experience with Dr. Ho. We are thrilled with her upper eyelid surgery results.
What are the Ideal Eyelids?
Dr. Ho believes that while every face is unique, the ideal eyelids carry a more awake, refreshed appearance and harmonious with the rest of the face. The ideal eye aperture is 10 to 12 mm vertically from upper eyelid to lower eyelid and about 30 mm, or length of the distance between the eyelids, in width.
The ideal lower eyelid rests 1 mm above the inferior border of the iris of the eye, whereas the ideal upper eyelid spans a vertical distance of 8 to 10 mm from the upper eyelid crease to its inferior edge, which rests at the superior border of the iris.
Eyebrow position is an additional important consideration in eyelid assessment. The ideal eyebrow rests just above the supraorbital rim (upper bony of the eye socket) and arches at the level of the lateral border of the iris in females and rests at the supraorbital rim with less arching in males.
The medial end of each eyebrow should line up vertically with the lateral aspect of the nostril on the same side, whereas the lateral end should approach an oblique line that passes tangentially from the nostril to the lateral corner of the eye on the same side.
Dr. Ho uses several of these anatomic principles as a foundation for her surgical technique as well as her aesthetic intuition in eyelid rejuvenation.
What is Double Convexity or Double Bubble Deformity?
Over time with aging, the soft tissues of the midface region descend due to the forces of gravity, resulting in an increased demarcation and convexity occurring at the lower eyelid-cheek junction.
The additional process of fat herniation (protrusion of orbital fat through a weakened septum layer) creates a second convexity in the lower eyelid. The double convexity deformity may be minimized with non-surgical treatment options such as filler injection or may ultimately require surgery for definitive improvement. Dr. Ho is experienced in the management of the aging eyes and midface and will discuss with each patient the best treatment options to address their aesthetic concerns and goals.
Behind the Scenes of Eyelid Surgery
Extended Lower Eyelid Surgery Video
What is Tear Trough Deformity?
Tear trough deformity refers to a concavity or hollowed-out appearance in the lower eyelid region. Patients with tear trough deformity may present with concerns of dark circles or tired look in their lower eyelids.
Several anatomic factors associated with this issue include descent of the cheek soft tissue, loss of facial volume, underdevelopment of the lower eyelid-cheek complex, and a defect in the orbital muscle.
With aging, the combination of soft tissue atrophy and orbital fat herniation may accentuate the tear trough deformity. This condition may present in both younger and older patients and can be treated with a variety of non-surgical and surgical treatment options.
Eyelid surgery may be used to treat some of these issues. Dr. Ho is experienced in the management of tear trough deformity and dedicates ample time and effort with every patient to determine the best non-surgical or surgical plan that meets their goals and expectations.
BEFORE & AFTER PHOTOS
Upper Eyelid Lift
The upper eyelid lift, also called upper blepharoplasty, is used to address sagging skin and loose muscle and fat tissue in the upper eyelids.
When upper eyelid surgery is performed to tighten the drooping skin that obscures a patient’s vision, it is considered a functional procedure and may be covered by medical insurance. When upper blepharoplasty is executed specifically to create a younger appearance for the eyes, it is considered a cosmetic procedure.
This procedure can be performed on one or both sets of upper eyelids (unilateral or bilateral). It may be pursued under local anesthesia in the office setting or under sedation or general anesthesia at a surgery center.
When the lower eyelids are also being rejuvenated at the same time, the upper eyelid lift is performed first. The incision for an upper eyelid lift is very fine and heals well and is made in the natural crease at the top of the eyelid. Through this incision, excess tissue is removed.
Dr. Ho’s Approach to Upper Eyelid Surgery
Dr. Ho takes her time with meticulous attention to detail when she marks out the upper eyelid incisions prior to surgery, as the preparation process is the most essential aspect of the surgery.
The incisions are typically marked within the natural eyelid creases in an elliptical fashion to capture the needed excess skin to be removed. In female patients, the incisions are extended laterally by the lateral brows.
Dr. Ho pursues a conservative approach to upper eyelid lift and often does not remove underlying muscle or fat to avoid an overdone or hollow-appearing result. She also takes into consideration the fat pad volume in the upper eyelids, as some patients with volume loss may require additional fat transfer rather than fat removal for additional rejuvenation.
Dr. Ho performs meticulous suture closure of the skin to ensure the incisions heal well and become minimal scars. The sutures are typically removed at 5-7 days out from surgery.
Lower Eyelid Lift
Lower eyelid surgery, also known as under eye bag surgery or lower blepharoplasty, is an ideal option when patients are looking to resolve a constantly tired appearance. A lower eyelid lift restores a smooth and youthful appearance to the lower eyelids.
This procedure involves removing and/or repositioning excess lower-eyelid fat and tightening drooping lower eyelid skin. Adjusting the fatty tissue in the lower eyelids resolves the puffy appearance.
When it comes to associated incisions with the procedure, there are two main approaches to lower eyelid surgery. The right option for you will be decided during your consultation.
The transcutaneous, or subciliary, approach is recognized as the traditional method and involves an incision made right below the lower lash line. With this approach, redundant skin is pinched and then excised. This option is ideal for removal of excess skin and fat. The external scar is typically minimal.
The transconjunctival approach incorporates an incision on the inside of the lower eyelid so there is no apparent scar. It is best for situations where only excess fat must be addressed and does not involve removal of skin.
Once all adjustments have been made, fine sutures are used to close the incisions, completing the lower blepharoplasty procedure.
Dr. Ho’s Approach To Lower Eyelid Surgery
Dr. Ho pursues a trifecta approach to lower eyelid surgery that yields beautiful, natural results for every surgical patient.
She most commonly creates incisions on the inner side of the lower eyelids via a transconjunctival approach that avoids external scars and distorts the lower eyelids. Through these incisions, she first removes protruding fat that causes the puffy eyelid appearance from each of the three fat pads in each eyelid.
Dr. Ho next restores the volume in the lower eyelids through facial fat transfer. She harvests fat through liposuction of the abdomen or thigh and then injects fat to the tear trough areas as well as rest of the midface including the cheeks to restore facial volume. Dr. Ho has a thorough understanding that with lower eyelid surgery, the rest of the midface also shows signs of aging and needs to be globally addressed as well to achieve the best and most youthful results.
Finally, Dr. Ho performs CO2 laser resurfacing of the lower eyelids and rest of the face to tighten the skin and optimize eyelid rejuvenation without removing eyelid skin.
Double Eyelid Lift
Double eyelid surgery, or Asian blepharoplasty, is a variation of cosmetic eyelid surgery offered by Dr. Tina Ho to create creases in the upper eyelids.
A patient who lacks upper eyelid folds may be an ideal candidate for this procedure. For a double eyelid lift, excess skin and fat may be removed during this procedure for additional rejuvenation.
This surgery requires the expertise of a surgeon who specializes in facial plastic surgery and understands Asian eyelid anatomy well. Dr. Ho’s expertise in blepharoplasty, with a focus on double eyelid surgery, is what makes her among the best options Philadelphia residents can rely on. Click here to learn more about Asian blepharoplasty.
Dr. Ho’s Approach to Asian Blepharoplasty
Dr. Ho typically performs this surgery under sedation such that the patient is comfortable and asleep during the first portion of the procedure and then awakened when it comes time to place the crease sutures to ensure appropriate crease formation while the patient is awake and opening and closing their eyes.
She creates fine horizontal incision lines in the upper eyelids that usually heal well and become faint scars. She removes minimal eyelid skin unless the patient has excess skin due to aging. Dr. Ho then performs careful dissection with the removal of a strip of muscle until she reaches the levator aponeurosis plane. Dr. Ho next places crease sutures through the skin and levator aponeurosis layers to create eyelid creases. These sutures are usually removed 7-10 days after surgery.
“My surgical technique focuses on creating a natural, more youthful and more awake, unoperated look for every blepharoplasty patient.”
– Dr. Tina Ho
What should patients expect after Blepharoplasty?
Each blepharoplasty procedure is different and catered to the individual patient. Therefore, the types of incisions utilized, as well as extent of swelling, bruising, and tenderness that occur after surgery, will vary by patient.
Every blepharoplasty patient will follow up with Dr. Ho one week after surgery for suture removal. Each patient will then follow-up again at weeks to months out at regular intervals for re-evaluation.
The downtime for blepharoplasty is usually minimal; most patients can return to normal daily activities, apart from heavy lifting, straining, and strenuous activity, the day after surgery.
Patients should expect immediate bruising and swelling after surgery that can be managed well with icing and head elevation and typically resolve by two weeks out from surgery.
Patients who undergo additional fat transfer may experience more lingering swelling that may take up to one month to resolve. Post-operative pain is usually mild and managed well with prescribed pain medication.
Improvement in the appearance of the eyelids is typically observed immediately or after most of the bruising and swelling has subsided. Eyelid skin heals quickly, and blepharoplasty incisions usually heal well with minimal scarring.
Dr. Ho seeks regular follow-up with her patients to ensure that every patient heals well and is satisfied with their surgical outcome.
What are other surgical procedures that are routinely performed with Blepharoplasty?
It is common for other procedures to be performed at the same time as blepharoplasty surgery, depending on the patient’s anatomic issues and surgical goals. They include but are not limited to the following: facelift, neck lift, browlift, fat transfer, and laser skin resurfacing.
Dr. Ho is experienced in a wide range of aging face procedures and will thoroughly evaluate each blepharoplasty candidate and discuss with them whether they would benefit from additional procedures at the time of their surgery.
The cost of a blepharoplasty procedure is dependent on a number of factors. The techniques utilized play a role, as does the type of anesthesia administered. Additionally, the price of eyelid surgery is impacted by the overall time required to perform the surgery.
When it is being performed for functional reasons, part of the eye lift procedure’s cost may be covered by health insurance. With all of that said, pricing typically starts around $3,000.
Dr. Ho performed an upper eyelid surgery and a lower face lift on my wife. The left eyelid was torn by a dog bite – it was gruesome. Dr. Ho came out in the middle of the night, 8 months pregnant to repair my wife’s torn eye. Her eyes look gorgeous. This prompted my wife’s decision for a lower face lift. WOW. My wife has the jaw and neck line of a super model. The jaw and neck line she never had. Stunning work by Dr. Ho!! Ask for pics and see for yourself!
– Timothy Carlin
Dr. Ho recently performed my upper eyelid surgery on December 3, 2020.I was looking “tired” at 54 y/o and she had suggested the upper blepharoplasty procedure.Dr. Ho took her time and care to ensure I would be comfortable with the procedure and post surgery experience.She answered all of my questions honestly and carefully. She even provided a shopping list of items I could purchase to ensure my recovery and post recovery process went smoothly.She called and checked on me a few hours after the surgery and a couple of days later.It was important to Dr. Ho that I felt cared for and supported throughout the process.I am beyond thrilled with my results! The down time to heal was very minimal (two weeks). We are already discussing lower eyelid surgery for 2021.Thank you Dr. Ho for helping this middle aged woman feel like a better version of herself!
– Noreen L.
Initially, I had blepharoplasty (eyelid) surgery with Dr. Ho. She was great, talked me through the procedure, excellent post follow up. A week into my recovery, a dog bite to the eye – terrible! Because it was at night, I went to the ER and waited for hours. I was so upset! I called Dr. Ho and she came – 8 months pregnant – in the middle of the night. She worked on my eye for hours to repair the torn eyelid. The bite was terrible, but Dr. Ho went above and beyond. Her post op follow up was weekly. My eyes look amazing. The eye that was injured is healed and thanks to Dr. Ho, you can’t even tell. Dr. Ho is a highly skilled surgeon, first and foremost. She is meticulous, provides honest feedback, and cares tremendously about her patients. I’m lucky to have her as my surgeon. I’m a raving fan for life!
I do not have enough words to express my joy with Dr Ho and her artistry! A couple of months ago, at the recommendation of a dear friend, I met with Dr Ho to discuss options for my eyes in particular. For the past five years or so, I had developed permanent dark circles and bags under my eyes (despite more than adequate amounts of sleep) and my eyelids were starting to look very hooded. Dr Ho was incredibly thorough during our consultation, clearly and plainly explaining her suggestions. Her demeanor is friendly and absolutely genuine. Furthermore, she is conservative with her approach so she will not try to “sell” you on something you don’t need….just keeping her eye on making you look your natural best! After my consultation, I decided to proceed with her recommendation of an eyebrow lift, upper/lower blepharoplasty (eyelids), facial fat transfer and laser resurfacing. My surgery went beautifully. Now is the best time to mention that Dr Ho’s bedside manner has the perfect balance of calm, nurture and confidence. Not once did I feel frightened or concerned in her capable hands. Additionally, she made herself available during the post-op period (still does) for any questions, concerns, etc., always responding in a timely manner!
Just a little over two months after surgery and I am already completely healed. Honestly, I was in great shape one month in but now you cannot even tell that I had anything done! All people notice is that “something” is different, I look “refreshed” and….the best one…..you look ten years younger! What is your secret??? My secret is Dr Tina Ho and I don’t mind telling everyone because if you are looking to refresh your look, this is a name you definitely need to know!
Dr. Ho is a highly skilled, fellowship-trained double board-certified facial plastic surgeon who will help guide you through the entire process of blepharoplasty in Philadelphia. She will be happy to address any questions and concerns you have along the way.
Your Blepharoplasty (Eyelid Surgery) will be performed by Dr. Tina Ho at an office or surgery center setting in Philadelphia or the Main Line.