Procedures offered include: upper eyelid surgery, lower eyelid surgery, droopy eyelid repair, forehead/browlift, and nonsurgical eye rejuvenation.

Upper Eyelid Surgery (Upper Blepharoplasty)

Upper eyelid surgery seeks to rejuvenate the appearance of the eyes by addressing the excess skin and bulging fat that leads to a tired, aged appearance. When this procedure is done properly, the eyes appear more alert, rested, and youthful. This procedure is often combined with lower eyelid surgery. During upper blepharoplasty, fine incisions are made in an upper eyelid skin crease and remove excess loose skin is excised. Protruding fat is also addressed by either removal or repositioning to improve the eyelid contour. The eyelid skin is closed with a fine suture. The procedure is generally very well tolerated.

Lower Eyelid Surgery (Lower Blepharoplasty)

Lower eyelid surgery seeks to remove lower eyelid bags and tighten lower eyelid skin. The lower eyelid bags are usually caused by fat malposition under the eye that leads to tired-looking eyes. In this procedure, an incision is made on the inside surface of the eyelid and the protruding fat tissue under the eye is repositioned or excised to provide a more youthful, awake appearing contour. The skin of the lower eyelid can then be tightened with either a pinch excision or resurfacing with microneedling or fractionated CO2 laser. When combined with the upper lid procedure, this can lead to a great improvement in the patient’s tired or aged appearance.

Dark circles under the eyes? – These can be caused by more than just being tired. This patient had a lower eyelid bag surgery or ‘blepharoplasty’ to help remove the dark circles and bulging tissue from under her eyes. During this surgery, an incision is made on the inside of the eyelid and both the lower eyelid and cheek fat are restructured to help restore a more pleasing contour. This problem is influenced by both genetics and age. The fat cushioning the eye pushes or ‘pseudoherniates’ forward causing the ‘bag’ appearance on the lower eyelid. This fat and the ligaments supporting the cheek which have stretched and fallen are adjusted during surgery to restore a more youthful appearance. The result is that the patient’s eyes look more awake, restored and fantastic! – The anatomic points above are adapted from a recent paper I helped author: Sand JP, Zhu BZ, Desai SC. “Surgical Anatomy of the Eyelids.” Facial Plast Surg Clin North Am. 2016 May;24(2):89-95. – – – #plasticsurgery #spokane #coeurdalene #blepharoplasty

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Droopy Eyelid Repair (Ptosis Repair)

As the eyelid ages, the muscles which hold the eye open can stretch, leading to decreased natural eyelid opening and a sleepy appearance. Dr. Sand can perform a repair to help increase eyelid opening and improve the droopy upper eyelid appearance. This effect can be simulated with a topical medication and may be a part of your consultation with Dr. Sand.

Forehead/Browlift

Over time the forehead and brow are affected by persistent muscle activity, gravity, and sunlight that cause the skin to wrinkle and loosen. This leads to a ‘heaviness’ to the brow that contributes to an aged and tired look. A forehead or browlift is one option to reverse the effects of time in this area. This procedure involves making small incisions behind the hairline and with endoscopic assistance lifting these tissues to place them into a more youthful position. Some of the muscles that cause vertical brow wrinkles may be weakened to provide a smoother appearance to the central brow. This procedure is often combined with upper and lower eyelid procedures to provide complete eye rejuvenation. Dr. Sand can discuss the expected results with these procedures during your consultation.

Nonsurgical Eye Rejuvenation

Many patients have tired appearing eyes but are not interested in surgery to correct these concerns. With the advent of Botox® and dermal fillers like Restylane® there are many options to help reduce wrinkles, fill in hollows, or redistribute volume to provide an alert, awake, youthful appearance to the eye region. These types of treatments offer quick results with minimal to no downtime. Dr. Sand can discuss these options with you during your consultation.

Eye Surgery

A: The cost of the eyelid procedure depends on the type that is performed and whether it is combined with any other procedures. A facility fee or anesthesia fee may be needed. After your consultation with Dr. Sand, you’ll receive a quote for the cost of the procedure.

A: The type of anesthesia used depends on the procedure performed. Upper eyelid surgery can be performed under local anesthesia, however lower eyelid surgery or a browlift generally requires sedation to perform. A full discussion regarding the options for anesthesia will be discussed during your consultation with Dr. Sand.