Balanced Blepharoplasty

Eyelid surgery or blepharoplasty is our most commonly performed procedure.  A well done operation can immeasurably enhance appearance in general and simultaneously make the entire face appear more youthful. Dr. Larrabee performed the reconstructive as well as cosmetic eyelid procedures at Virginia Mason Clinic and did special training in these procedures at the Moorfield’s Eye Hospital in London UK.  Like many procedures in facial plastic surgery, good craft must be married to a good aesthetic sense and the procedure tailored to each patient’s facial contour. 

Upper lid surgery alone can be performed under local anesthesia on most patients. Youthful lids are full and not hollow. It is important in male patients not to feminize their eyelids by removing too much eyelid skin or fat. Some patients who come in for this surgery have primarily a low brow. The surgeon must make the correct diagnosis and perform a forehead lift as well as eyelid surgery if indicated.  Other patients have “ptosis” which means their actual lid margin is lower and the muscle/tendon that lift the lid needs to be repaired. Other patients have eyelid folds that are asymmetric or too low. Many Asian patients, in particular, want to create or elevate their lid folds.

Because of our Seattle location and Dr. Larrabee’s work in Asia, we have considerable experience performing Asian eyelid operations.  Our goals are not to “westernize” the patient’s eyes but to give them the more open look they desire and place the fold in a natural position that harmonizes with the rest of their face.  Lengthy experience with many types of blepharoplasty allows the surgeon to select the right procedure for each patient.

Lower lid operations can be complex and have evolved over time. We do most fat removal from inside the lids (transconjunctival) and are conservative so we don’t get a hollow look. In some cases, rather than remove fat, it is transposed into hollow cheek areas below the lids (e.g. tear trough deformities). In many situations, laser resurfacing or chemical peels can be used to smooth and tighten the skin of the lower lid. This can decrease the times actual skin excision is necessary.  The specific lower lid procedure recommended will depend on many factors, including the lid support, skin type, and muscle laxity.  A good examination will permit us to make the best recommendations.

Upper and lower blepharoplasty surgery provides an excellent rejuvenation with few complications. It is usually the first procedure patients seek out.  Here are a few patients who had blepharoplasty with or without other procedures.

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