Frequently Asked Questions
Are you a candidate for cosmetic eyelid surgery (alsoo known as an eyelid lift or blepharoplasty?
• Do you look tired in the morning even after you take a nap?
There is more swelling in the eyelids especially after lying flat in bed all night. This dependent fluid dissipates as the day wears on. Due to aging, the eyelid skin sags and bulges beyond a certain critical point such that no amount of sleep will relieve the tired appearance.
• Are you in a competitive working environment where age, looks, and communication count?
A youthful, less tired appearance is extremely important in the working
environment today. Whether you work or stay at home with your family,
you will look, feel, and possibly perform better after cosmetic eyelid
surgery. Attractive people receive preferential treatment in our society. Less attractive people do not command as much attention. Baggy and sagging eyelids and depressed cheeks take focus away from your eyes.
• Do either of my parents or siblings have drooping eyelids and do I wish to have similar appearing lids at their particular age?
By simply viewing other members of the family, particularly one of your
parents whose eyelids resemble yours, you can predict with a fair degree
of certainty how you will look with age.
• Do you feel extra weight on your eyelids and when you manually lift the eyelid skin with your fingers is the “heaviness” temporarily relieved?
Excess skin above the eyelid crease that overhangs the eyelashes create
Heaviness similar to “fish weights” on the upper eyelids. Skin folds may
also rub against themselves may causes redness and itching. Most
commonly, a combination of such factors interfere with reading, watching television, and driving a car. Does manually lifting the upper eyelids with your fingers relieve the symptoms? When the eyelid tissues contribute significantly to such functional complaints, medical insurance may reimburse patients for upper lid surgery.
• Are there horizontal lines in the forehead?
A special muscle in the forehead (the frontalis muscle) elevates the
eyebrows and heavy upper eyelids so that vision is improved. You may
notice horizontal forehead lines and that your eyebrows are constantly
elevated in order to compensate for the weighted-down heavy upper
eyelid tissues. Ultimately, the eyelids become increasingly heavy over time and you may become fatigued after reading for only a brief period.
• Do you get tired after reading for as short as only a few minutes or as long as an hour due to heaviness of the your upper eyelids? Do you sometimes get headaches by the end of the day especially when reading?
A frontal (forehead) headache may occur by the end of the day by
constantly raising the eyebrows in order to elevate the heavy upper eyelids. Similarly, one’s leg would be sore if one stood on one leg all day. Headaches due to eye strain tend to occur at the end of the day or after a period of time due to eyestrain.
• Do you have problems seeing cars when driving especially out of the corner of one or both or your eyes?
Peripheral vision may be blocked by excess eyelid skin which directly obscures part of the field of vision. Simply, lifting the uppers eyelid(s) with your fingers will simulates the effects of upper eyelid surgery. You may experience difficulty passing cars when driving due to decreased peripheral vision.
• Do you have bags below the eyes?
Baggy lower eyelids are especially bothersome to both women and men.
These unsightly bulges are unacceptable and detract from your beautiful eyes. The lower eyelids and upper cheeks may be improved by Dr. Mauriello’s techniques that are part of his routine cosmetic or restorative lower eyelid surgery.
• Do your eyes appear smaller?
The space or opening between the upper and lower eyelid margins. This
space narrows vertically with age. It also narrows horizontally due to
loosening of the ligaments especially at the outer corners of the eyes.
These distances may be increased with surgery in order to open the eyes.
• Do coworkers ask if you are tired when you are not?
If your response is positive to any of the above questions, you may benefit from eyelid surgery and may benefit from reading further.
WILL THE SHAPE OF MY EYELIDS BE CHANGED?
The simple answer is “no.” Patients who undergo eyelid surgery performed by Dr. Mauriello are grateful for subtle changes that dramatically restore the upper face without changing the shape of the eyelids. Dr. Mauriello and his patients believe that cosmetic eyelid surgery should not create a plastic appearance. Rather in its purest form, surgery restores a youthful appearance.
WHAT ARE THE GOALS OF COSMETIC UPPER LID SURGERY?
The upper eyelid requires a defined, natural crease with a fold of skin that symmetrically overhangs that crease. Age-related loss of a well-defined upper eyelid crease occurs. The crease may be surgically reformed and sharpened to rejuvenate the eyelids without changing their natural appearance. Excess loose, aged skin that overhangs the upper eyelid crease is removed in a conservative fashion. Fat that bulges unevenly in the upper and lower lids may be surgically excised or flattened in order to create symmetry and achieve a refreshed look. After all, what physical structure such as a car or home does not need occasional maintenance and, eventually, structural support after 30 to 50 years? Dr. Mauriello reviews photographs of patients taken when young in order to restore their eyelids.
WHAT ARE THE GOALS OF COSMETIC LOWER LID SURGERY?
Dr. Mauriello has developed surgical techniques that remove excess skin and bags and also elevate the upper cheek fat pad. All the surgery is performed through a tiny skin incision in the corner of eye. An incision that goes across the entire lower eyelid is not required.
HOW LONG DOES COSMETIC EYELID SURGERY LAST?
Surgery generally lasts 10 to 15 years. Additional eyelid surgery years later have not been performed by Dr. Mauriello who has practiced for 21 years. If necessary, such surgery is less involved
SHOULD I UNDERGO A BROWLIFT
Dr. Mauriello believes that eyebrow lifts are rarely necessary for several reasons:
• The shape of the eyebrow may change
• Eyebrow elevation also affects the upper eyelid fold but since the results of the
eyebrow lift are not entirely predictable, both eyebrow and eyelid asymmetry may
result.
• Studies show that the risks of small incision endoscopic lifts are similar to those
of the old coronal ear to ear lifts including loss of scalp hairs, thick scars,
numbness and sometimes pain in the forehead that may extend into the hairline
• Eyelid surgery combined with eyebrow surgery is lengthy and the final results
unpredictable. It is difficult to assess the amount of the upper eyelid skin to
remove at the time of surgery because the final brow position often changes
after surgery.
• Eyelid surgery alone, in Dr. Mauriello’s experience, improves eyelid position
without moving the eyebrows with great consistency.
Dr. Mauriello sometimes recommends office Botox to temporarily simulate an eyebrow lift. No patient has returned for a brow lift, yet the patients return for additional Botox treatments in the eyebrows, corners of the eyes, and the lower face and lips.
WHY SHOULD I CONSIDER COSMETIC EYELID SURERY RATHER THAN A FACE LIFT?
The answer is simple: The first thing you notice when you look at a person’s face? Most people will answer, “the eyes.” The eyelids frame the eyes so that the underlying Beautiful eyes are appreciated with age as long as they are visible and not obscured by the sagging skin of the upper eyelids or asymmetric, baggy lower eyelids. Eyes brighten and are opened wider when drooping, excess skin is removed. Any distortion of the eyelids detracts from the observer’s view of the eyes.
The facelift in all its forms whether a full face lift or a min-lift should be performed at another time, either before or after the eyelid surgery in Dr. Mauriello’s opinion. The forces the pull the face may be inconsistent with the same healing process that is necessary around the eyelid.
WHAT ARE THE ROLES OF BOTOX AND RESTYLANE?
Office Botox® treatments maintain results in the upper face while Restylane® improves the wrinkles in the lower face. No matter what effort is taken to minimize aging, all rejuvenation efforts are satisfying and can dramatically improve the individual’s appearance.
WHO SHOULD PERFORM MY SURGERY?
Various types of surgeons perform cosmetic eyelid surgery or “cosmetic blepharoplasty.” Excellent eyelid surgeons may be found among other medical specialists including facial plastic surgeons, plastic surgeons, maxillo-facial surgeons, and so commonly dermatology. The best kept secret is that oculoplastic surgeons, board certified ophthalmologists, specialize in eyelid surgery. Some are more dedicated to other fields of interest including tear duct (lacrimal) and orbital surgery. There are approximately 400 such surgeons nationally. Because of their in-depth knowledge of the eye and the eyelids, ophthalmic plastic and reconstructive (oculoplastic) surgeons such as Dr. Mauriello offer their patients the highest level of specialization that are blended with technical skills and an artistic sense to create functioning and well proportioned anatomic eyelids. Dr. Joseph A. Mauriello joins a group of select surgeons nationally who dedicate their energies to cosmetic eyelid surgery. He has performed over 10,000 eyelid surgeries since 1983 (updated 9-04). Ask your surgeon for his(her) background and area of specialization. Always asks to view photographs of patients before and after surgery.
