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Dear Ms. Beverly Moreno,
Thank you very much for your inquiry regarding cosmetic eyelid surgery of the upper and/or lower eyes, formally known as a blepharoplasty.
I have 20 years of experience performing blepharoplasty surgery. In my career, I have performed over 800 cosmetic eyelid procedures, which is significantly higher than the national average.
I completed a residency and fellowship at Stanford University Medical Center and remained as a clinical professor for seven years. I have a practice in Las Vegas, Nevada and in Laguna Beach, California, known as the Center of Excellence in Facial Plastic & Reconstructive Surgery. I am quadruple board certified including the American Board of Facial Plastic & Reconstructive Surgery, the American Board of Cosmetic Surgery in Facial Plastic Surgery and the American Board of Otolaryngology-Head & Neck Surgery.
Sometimes forehead or brow lift surgery is indicated at the same time as upper eyelid surgery to optimize the result. I have authored a published peer-reviewed manuscript on choosing the optimal forehead lift procedure given one’s anatomical issues (Koch RJ, Troell RJ, Goode RL: Contemporary management of the aging brow and forehead. Laryngoscope. 107(6): 710-715, 1997).
With regard to the lower eyelid, sometimes a mid-facelift or volume replacement to the indentation underneath the eyelid, known as the tear trough, may be indicated. A dermal filler (Restylane, Juvaderm, Radiesse) or placing one’s own fat (fat grafting) are available treatment options to fill areas of facial volume deficiency, especially in the tear trough.
The lower eyelid is addressed either through an incision inside the eye to hide the incision, usually when there is fat herniation with no to minimal excess skin, known as a tranconjunctival approach. The other option is an incision immediately below the lower eyelid lashes, usually for excess skin or to strengthen a weak lower eyelid, known as a subciliary approach. Laser skin resurfacing can also rejuvenate the skin in this area.
Surgery on the outer corner of the eye, lateral canthus, is indicated to strengthen a weak or redundant lower eyelid, known as a canthopexy. The lateral canthopexy may need to be performed simultaneously with the cosmetic lower eyelid procedure (blepharoplasty).
I have before and after blepharoplasty patient photographs at www.drtroell.com for you to review. I look forward to meeting you in my office. Thank you again.
Sincerely & Respectfully,
Robert J Troell, MD, FACS
