There’s a lot to balance when performing an eyelift. Woodbury, NY oculoplastic surgeon David Schlessinger, MD says surgeons must consider brow position, the amount of excess skin, ptosis, drooping of the upper eyelid, excess fat and lower eyelid laxity when performing an eyelift, also known as a blepharoplasty. “A well-done eyelid lift is one in which the normal anatomy is restored,” explains Dr. Schlesinger.
Boca Raton, FL oculoplastic surgeon Steven Fagien, MD notes that not only could a bad eyelift look aesthetically unappealing, it could also have more serious consequences to the health of the eyes and vision. With so much at stake, it’s important to find an expert that has a track record of performing good eyelifts. These are the signs to look for.
Featured Experts
- David Schlessinger, MD is a board-certified oculoplastic surgeon in Woodbury, NY
- Steven Fagien, MD is a board-certified oculoplastic surgeon in Boca Raton, FL
- Kimberly J. Lee, MD is a board-certified facial plastic surgeon in Beverly Hills, CA
- Edward S. Kwak, MD is a board-certified facial plastic surgeon in New York
- Christopher Zoumalan, MD a board-certified oculoplastic surgeon in Beverly Hills, CA
Top Signs of a Good Eyelift
Eyelids are in a natural rested position
According to Dr. Schlessinger, a well-done eyelift lift should leave your eyelid in a natural, resting position. “There shouldn’t be over-resection of skin which can lead to a tight unnatural look,” he explains. Over-resecting the skin can also lead to a condition known as lagophthalmos, “where the eyelid is so tight it can’t close properly and leads to dry eye.”
He adds that it could result in pain and even vision loss. Beverly Hills, CA facial plastic surgeon Kimberly J. Lee, MD warns that these kinds of complications could affect eyelid function and quality of life.
There is fat leftover
Since youthful eyelids are full and supple, a good eyelid lift preserves fat, says Dr. Schlessinger. “Removing too much fat can leave a hollow look. Although the eyelids may look cleaner, they can look older with the deep recess of the upper or lower eyelid,” he explains. According to Dr. Schlessinger, in some cases, fat can be transposed or grafted to avoid that excessive hollowness.
The eyebrows are positioned correctly
Your eyebrows are a hugely important part of your face, so it’s essential that your eyelift doesn’t alter the look of your natural brows. “In general, women’s eyebrows should be C-shaped with the tail slightly higher than the middle portion. Men’s eyebrows are more T-shaped with inner and outer portions at the same height,” says Dr. Schlessinger.
There’s a Natural Eyelid Crease Height
New York facial plastic surgeon Edward S. Kwak, MD notes the “supratarsal platform,” aka the eyelid crease, is pivotal in unlocking a great surgical result. “Often, candidates for an eyelift have redundant upper lid skin resulting in the skin covering the supratarsal platform,” or eyelid crease, he says. When severe, Dr. Kwak says the lid crease can extend to or go beyond the eyelashes, which can create a smaller appearance to the eyes. “A good surgical outcome will address this skin redundancy to establish a natural crease height.”
The two eyes are balanced
Beverly Hills, CA oculoplastic surgeon Christopher Zoumalan, MD points out that following an eyelift, you want the eyes to be balanced. He says it’s common for eyelids to have asymmetry pre-procedure, but this should be addressed during the eyelift.
There are no signs of surgery
According to Dr. Fagien, a notable sign of a good eyelift is having no visible signs of surgery. Following the procedure, the patient should simply look “like a younger or better version of themselves.” A bad eyelift has “unacceptable signs of surgery” such as “significant visible scarring, alteration of the natural and youthful shape of the eyelid or surface contours that are asymmetric or unnatural,” says Dr. Fagien.
Dr. Schlessinger explains that a well-done eyelift “should look as if no surgery was done at all, except when you compare them to their before photographs.” Hiding as many incision scars as possible is essential to a good eyelift, says Dr. Zoumalan.
The skin on the eyelid looks healthy and youthful
In a well-performed eyelift, the eyelid skin must be addressed, says Dr. Schlessinger. While excess skin can be surgically removed, this won’t improve creepy or sun-damaged skin, he explained. He recommends a Co2 laser or chemical peels during the procedure to “help restore a youthful glow.”
The Eyelids Don’t Look Puffy or Hollow
Dr. Kwak delves deeper into the importance of natural eyelid contours. “Centrally, the upper lid has a medial fat pad which can start to herniate over time, which can create a puffy appearance to the eyelid along the nasal side of the upper lid,” Dr. Kwak explains. “Also with time, the eyelid can lose volume just adjacent to this fat pat which can create a hollowed appearance to the eye.”
These two regions can result in significant contour issues which can create an aged appearance to the eye. “To address the medial fat pad herniation, the redundant fat needs to be properly excised to achieve a natural contour centrally,” Dr. Kwak says. “For the hallowed upper lid, a fat transfer may be necessary to address this volume deficiency. A good outcome will have a seamless contour as it transitions from the nasal side to the outer side of the eyelid above the supratarsal platform (crease).”
The lower eyelid has a smooth appearance
According to Dr. Lee, “Successful eyelid lift surgery results in a natural-appearing result that makes you look 10-15 years younger without the dull, tired look.” The lower eyelid should have a smooth, youthful appearance, says Dr. Schlessinger.
The outer corner of the eyelid has natural placement
The placement of the outer corner of the eyelid is an important indicator of a good eyelift. “The outer corner of the eyelid should either be at the same level or higher than the middle corner,” says Dr. Schlessinger.
According to Dr. Zoumalan, good eyelifts impose minimal change to the shape of the eyelid post-surgery.
The lower eyelid isn’t retracted
“One of the worst complications of cosmetic lower blepharoplasty is retraction of the lower eyelid,” says Dr. Schlessinger. “If too much skin is removed or if the canthus isn’t properly tightened (canthoplasty), then the outer corner of the lower eyelid can turn down and expose too much of the eyeball.” This complication can lead to a change in appearance, dry eye and tearing.
The eyelid skin matches the surrounding skin
To ensure that your eyelift looks natural, it’s essential that your eyelid skin blends in with the skin around it. “The skin should look tighter and smooth, yet match the surrounding skin so as not to stand out as different,” says Dr. Schlessinger.
Any Ptosis Is Addressed
Dr. Kwak says upper eyelid ptosis is common with an aging upper eyelid. “Like the overlying skin, the muscles responsible for opening the eyelid can loosen and stretch with the aging process, which can lead to a sleepy appearance to the eyelid,” explains the surgeon. “If only the skin or upper lid contours are addressed and there is an underlying ptosis, the eyelid surgery can actually make the patient look more tired or sleepy.”