Dr. Coleman's Comments:

Blepharoplasties are a favorite subject of mine, so there is a lot to read here. It's popularity has risen tremendously in the past few years.

Prior to 1980, a blepharoplasty consisted of simple removal of extra skin and fat from the eyelids. As we have had a chance to see the results after 10 to 15 years, we have changed our approach. As we have strived to find better ways to do facelifts and alternatives to facelifts, we have found that much of the problems can be addressed with advanced techniques combined with surgery on the eyes. It is no longer uncommon to do muscle tightening, lift cheek fat pads, remove frown lines, lift the corners of the eyes, and even elevate the corners of the mouth through this incision. Many of us have stopped removing fat from the lower eyelids; instead, repositioning the fat under the creases of the lower eyelids to rejuvenate the appearance here. In fact, there are times when we actually strategically place fat grafts in some areas. Even though some surgery can be done through the inside of the eyelid (subconjunctival approach) I have returned to doing an incision just beneath the eyelashes. In my hands, I can redrape the skin and muscle better, and I can remove some of the excessive skin this way. In the past we thought we could avoid this incision by use of laser resurfacing. However this procedure has been rapidly losing popularity because of the complications and the prolonged recovery. You will note that these incisions are invisible. With careful technique, I have avoided the complication of eyelid weakness by preserving some of the muscle at the lashline.

You will see that many patients have eyelid surgery combined with forehead lifts. This is because we have learned that a lot of the problem with the heavy appearance of the upper lids is due to gradual descent of the brows instead. It is an ever evolving art and more changes are coming; so hold on to your seats.

You will see in the pictures of my patients, the results are not drastic as you examine the eyes closely. However as you look at their overall appearance, they definitely look much more refreshed and alive.

Patient Photos

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8715 Village Drive, Ste. 504, San Antonio, TX 78217

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