Blepharoplasty, or cosmetic eyelid surgery, joined mainstream plastic surgery over seventy years ago but was then practiced with only minor refinement over the ensuing decades.
Thirty years ago, a new and less invasive approach to the lower lid initiated rapid evolution in eyelid surgery technique only to be overtaken near the end of the last century by any number of highly invasive "advances" that some oculoplastic surgeons now view as overly enthusiastic.
While aggressive surgery on and around the eyelids will indeed provide a noticeable if not dramatic change, this is seldom for the better and may leave the eyes and lids looking harsh, windswept, sunken, and, paradoxically, less youthful.
By trading one eyelid deformity for another, such overworked eye and face lifts can often transform a person's appearance into something it never was.
While ever-evolving, today's best cosmetic blepharoplasty procedures are built around a newfound respect for the perils of disturbing orbital fat and the eyelid's complex system of support. Baggy upper and puffy lower lids can now be addressed surgically with less tissue disruption, scarring, and loss of function, while eyelid hollowness can be softened by orbital fat grafting.
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