Dr. Coleman’s comments:
There are certain identifiable changes that take place with women’s eyes as they get older.
The lower lid muscles get weaker and are pulled downward by the descent of the malar fat pads just below them. The barrier that normally holds the fat around their eyeballs gets weaker and the fat begins to herniate out in front of the eyeball crating a baggy appearance. The lateral canthal tendon that holds the outer corners of their eyes stretches out and the eyes slowly assume a round appearance, instead of the almond shape of youth.
The upper eyelids also get baggy from the same herniation above the eyeballs. The skin gets looser and begins to fold over itself. The eyebrows also descend and can aggravate the redundant skin even more.
The goals of surgery here are to reverse these changes. Redundant skin and fat can be aggressively removed from the upper eyelids. The muscle that surround the eyes and controls some of their function can be removed from above to reduce crow’s feet and can be tightened from below to resuspend the lower lids and get rid of the saggy appearance.
We have been more conservative in fat removal to avoid the “hollow” look that can appear years later. My one caution is that the swelling which comes and goes from morning to night will not be corrected by surgery. This swelling is caused by the flow of fluids in the tissues, which explains why it changes during the day.
In these photos you won’t see drastic changes; just subtle improvements that get even better with time.