Blepharoplasty surgery (eyelid tuck) is performed to cosmetically and functionally rejuvenate the eyelids and associated structures. By rejuvenating the eyelids, patients look more alert, awake and refreshed.
As we age, the skin and muscle associated with eyelids become loose and baggy. This produces a sad and saggy look that makes us look old and tired. In addition, tissues that separate the cushioning fat around the eyeball become weak and fat protrudes into the eyelids forming bags under the lower eyelids and making the upper lids appear thick.
The excess tissue can also obstruct vision and by having cosmetic eyelid surgery, patients don’t only look better, but oftentimes see better as well. Aging changes of the eyelids can begin in the third decade and it is not uncommon to perform cosmetic eyelid surgery on patients in their 30’s and 40’s. Many people watch what they eat, they exercise and they pay attention to their appearance. Although they feel young, a complaint from many patients is when they look in the mirror they see a person that looks much older than they feel. Their friends are asking them if they are tired and they have lost that happy, refreshed look. Droopy and baggy eyelids simply make patients look older and tired.
When you pinch you excess eyelid skin and it stays pinched, it is time for blepharoplasty.
Eyelid Lift Educational Videos
In the videos below Dr. Niamtu discusses the essentials of safe blepharoplasty with natural results. Since a patient may only have this operation once in their life, investing some time and watching this video can be valuable to understand the procedures, dispel myths and make the correct decision when choosing a blepharoplasty surgeon.
Blepharoplasty Patient Photos
The patients below show improvement of eyelid aging after cosmetic blepharoplasty by Dr. Niamtu
The before and after photos below show selected patients with cosmetic eyelid surgery.
Some Blepharoplasty Patient Comments
HEREDITY AND EYELID SURGERY
Festoons are “boggy tissue” under the lower lids and and can sit on the upper cheek. Technically this is a process known as lymphedema where lymphatic fluid backs up in the tissues. Older treatments required surgical excision of the festoons, thus leaving a scar. CO2 laser technology has provided a 10 minute treatment (with about 7-8 days of recovery) that can dramatically improve this condition. The patients below were treated by Dr.Niamtu with CO2 laser resurfacing.
How is Eyelid Surgery Performed?
Blepharoplasty surgery is performed in our fully accredited office surgery center with light IV anesthesia. If desired, the surgery can usually be performed with local anesthesia as well. This surgery takes about 15 minutes per eyelid and the recovery time is usually about a week. During this time, the patient must refrain from any heavy activity and lifting. The eyes may swell or bruise for several days after surgery. Most patients that have eyelid surgery on Thursday or Friday can recover over the weekend and get out of the house by Monday or Tuesday with sunglasses to cover the surgery.
Dr. Niamtu uses the newest technologies of laser and radiowave surgery for eyelid surgery. This produces less bleeding and tissue damage which means faster recovery, less bruising, faster healing and less post operative pain.
Dr. Niamtu also uses the transconjunctival approach for lower eyelid surgery. This method allows the incision to be made inside the lower eyelid so there is no visible surgical scar. This approach is also less likely to cause a pulling down of the lower eyelid that is frequently seen with external incision techniques.
Older style external incisions (on the outside of the lower eyelid) can cause retraction of the lower eyelids and an unsightly pull down of the lower eyelid. This also causes exposure of the sclera (the white of the eye) and these changes are telltale signs of improper surgical technique. This can also result from excessive skin removal on the lower eyelid.
To avoid problems associated with lower eyelid malposition and excessive scleral show, Dr. Niamtu frequently treats the excess lower eyelid skin with laser resurfacing. This allows dramatic skin tightening without cutting away skin. No incisions are required. When performing laser resurfacing of the eyelid skin the patient will be red for a week and then pink for another several weeks. Makeup can be used to cover the pinkness until it resolves. For minor to moderate lower eyelid wrinkling, chemical skin peel can be performed and heals in about a week. The results are not quite as dramatic as the laser treatment, but the recovery is faster.
Types of Eyelid Surgery
Festoons are the baggy pouches that some patients develop on the lower eyelids and cheeks. Dr. Niamtu treats many and out of state patients for festoon improvement. He has numerous lasers to take away festoons and years of aging.
Fat that normally cushions the eyeball protrudes and causes bags of the lower eyelids. This can be a heredity condition and occur early in life.
For patients that do not desire laser or chemical peel skin tightening, Dr. Niamtu utilizes a conservative procedure called a “skin pinch”. This small procedure is done with a mini incision hidden under the eyelashes and can tighten the wrinkles without adversely affecting the normal eyelid position.
When considering cosmetic eyelid surgery it is important to inform your surgeon of any abnormalities of your eyes, vision, or general eye health. You should also schedule your surgery when you can relax for a week. Eyelid surgery is very safe but complications can occur when patients over exert themselves. When using laser and radiowave techniques like Dr. Niamtu does, patients often feel great shortly after surgery and can have a tendency to over due activities such as sports, gardening, exercise, etc. It is truly important to refrain from strenuous activities that require bending or lifting for a week after surgery to avoid complications. In addition, any drugs that increase bleeding such as aspirin, some vitamins and herbs and some over the counter medications need to be discontinued 2 weeks before surgery. The standard of care is to have minor blood work performed before eyelid surgery to make sure the patent’s clotting system is functioning properly.
The position of the forehead and eyebrows also effects upper facial aging. Endoscopic and mini open brow lifting are newer procedures that are used to address this problem. Brow position should always be considered before undergoing Blepharoplasty. If you consult a cosmetic surgeon for eyelid surgery and they do not mention brow position in the first minute, you should probably see another surgeon!
Dr. Niamtu has performed thousands of cosmetic eyelid procedures and it is one of his favorite procedures. Hundreds of Dr. Niamtu’s before and after pictures can be seen by viewing the before and after galleries.
...Feel and look like a celebrity...
5 out of 5 stars
Dr. Niamtu performed the best Blepharoplasty on my lower eyelids just two and a half months ago. I am so please with the results and I feel lifted both mentally and physically. As an African American woman, we often assume that we don't need cosmetic surgery but in my case, the natural milestones faced in later life had taken a toll on my appearance and dampened my feeling of well-being. Dr. Niamtu conquered all this with prompt, friendly and courteous service and his superior facial art works. During my initial consultation, the high level skill of Dr. Niamtu was apparent as he easily diagnosed and recommended treatment which included blepharoplasty, botox and smile line filers. The beauty of my two best female friends and colleagues (one Philippine and the other African American) are enhanced by Dr. Niamtu's skill as the both were his patience. They shared their immaculate satisfaction with Dr. Niamtu and all the staff. I must say that they all make you feel and look like a celebrity every time.
- Wanda Y
Very, very pleased
5 out of 5 stars
Dr Joe. Many thanks for the before after photos. As both of my daughters remarked, when I sent than photos before I saw than in person, that I was still me, but without all that excess 'baggage' I don't know what they were expecting, and for that matter, neither did I, but I am very, very pleased. Seeing the smiles on their faces 1 month post-op told me all that I needed to know. The care and attention given by you and your staff put me totally at ease, and for that I am most grateful.
5 out of 5 stars
Dr. Joe,Amazing results! I had been wearing glasses to hide my bags for years. After having them removed I feel more confident. Now I’m wearing contact lenses and eye makeup for the first time. 🙂 I don’t look tired anymore.You and your staff were wonderful. I couldn’t have asked for a better doctor.
Insurance Coverage and Eyelid Surgery
Dr. Niamtu does not participate with insurance plans. He performs purely cosmetic eyelid surgery with attention to sculpting skin, muscle, fat and wrinkles. There can be a big difference between cosmetic eyelid surgery and insurance-covered procedures that simply remove some excess tissue to improve vision.
More information about Eyelid Surgery from Dr. Niamtu's library of articles
Dr. Niamtu shows some great cosmetic surgery eyelid results.
These are two videos that are short vignettes of radiowave assisted cosmetic blepharoplasty. This is one of my topics that I am presenting at the Cosmetic Surgery Forum in Las Vegas next week. Radiowave surgery (like laser incision) is a practically bloodless means of performing blepharoplasty and no bleeding means faster healing with less pain and bruising. These are actual live surgery videos and viewer discression is advised.
For more information about blepharoplasty or cosmetic facial surgery visit www.lovethatface.com
Joe Niamtu, III DMD
Cosmetic Facial Surgery
The eyes are called the “seat of the soul” and are one of our most attractive features in youth. Studies have shown that when we first view a person, we make hundreds of subconscious impressions based upon the persons features and invariability, the first thing we look at are the person’s eyes.
As we age, we experience changes with the skin, bone, muscle and fat of the eyelid regions. On of the main changes that happens is the development of “fat bags” especially on the lower eyelids.
The eye is naturally surrounded by a generous layer of fat to protect and cushion the eyeball. As we age, the tissues that normally keep the fat in place begin to weaken and the fat protrudes and becomes apparent. In addition, the skin of the eyelids becomes very wrinkled.
Cosmetic blepharoplasty is a procedure that reduces the protruding fat and rejuvenates the aging skin. Dr. Niamtu performs blepharoplasty with lasers which prevent bleeding and enable faster and less painful recovery with minimal bruising. He also employs a surgical approach that keeps the laser incision scar inside the lower eyelid so it is not visible. This video shows a patient with very large lower eyelid (and upper) bags being treated by Dr. Niamtu with the CO2 laser. This case represents extreme fat protrusion and the patient has much less fat to be reduced.
This video show actual surgical footage and may not be suitable for all viewers.
This video contains actual surgical footage and may be graphic for some viewers.
Dr. Niamtu performs lower and upper blepharoplasty on a patient with large fat depositions in the eyelids.
Dr. Niamtu demonstrates a alternative surgical approach to lower eyelid blepharoplasty. This incision is rarely used by Dr. Niamtu but does have certain indications where it is preferable.
TV commercials where Dr. Niamtu talks about making patients look 10 years younger by rejuvenating the upper eyelids and getting rid of under eye bags
The video below show condensed scenes of Dr. Niamtu performing a blepharoplasty with the Lumenis Encore CO2 laser. This is graphic surgical video and may not be suitable for viewing by some people. Notice that throughout all steps of the surgery there is no bleeding! Bleeding causes longer recovery, with increased pain and bruising. By having a bloodless procedure, the patients recover faster with less pain and bruising.
Non Surgical Lower Eyelid & Cheek (Midface) Treatment
Some patients have aging situations that can be treated without surgery. Masquerading lower lid fat bags by filling the depression with injectable filler and simultaneously plumping the cheek is a small 10 minute procedure that can make a huge difference in looking younger. The recovery is minimal and your friends wonder if you are getting more sleep! This video shows actual injection so viewer discretion is recommended.
Dr. Niamtu explains the details of proper eyelid diagnosis and treatment and discusses common mistakes made by surgeons and patients. If you are planning to have cosmetic eyelid surgery, invest several minutes of your time to view this video. It may save you a lot of frustration in the future.
Eyelid surgery can be seriously complicated by common medications that many patients take on a regular basis. Although these medications may seem harmless, they can affect the ability of blood to clot which can lead to complications in any surgery, but especially in eyelid facelift surgery. The following list show common medications that can increase bleeding. Before any surgery always tell your surgeon what medications you are taking.
click image to view pdf
Dr. Niamtu has published a 1,000 page comprehensive textbook on cosmetic facial surgery which includes a large chapter on his cosmetic eyelid techniques. Few surgeons receive the honor to publish such a text with a major medical publisher like Elsevier .
Dr. Niamtu has published numerous scientific publications on cosmetic blepharoplasty including the following;
- Dr. Niamtu J.
Lower Blepharoplasty Techniques
Surge Magazine American Academy of Cosmetic Surgery
- Dr. Niamtu J.
Upper Blepharoplasty Techniques
Surge Magazine American Academy of Cosmetic Surgery
- Dr. Niamtu, J
In:Cosmetic facial surgery. Editor: Dr. Niamtu, St. Louis, 2011, Mosby Elsevier.
- Dr. Niamtu, J
Contemporary blepharoplasty: less is more
Expert Rev. Dermatol. 2010;5(4):489-90.
- Dr. Niamtu J.
Blepharoplasty incisional modalities: 4.0 Radiosurgery vs. CO2 Laser
In Pearls and Pitfalls in Cosmetic Oculoplastic Surgery. Hartstein ME, Holds JB, Massry GG, (eds.) Springer :NY, 2009, 81-83
- Dr. Niamtu, J
Surgical Treatment Options for Lower Eyelid Aging
Cosmet Dermatol 2008;21:652-657
- Dr. Niamtu, J
Radiowave surgery versus CO2 laser for upper blepharoplasty incision: which modality produces the most aesthetic incision?
Dermatol Surg 2008;34:912-921
Dr. Niamtu lectures frequently on cosmetic eyelid surgery and is a regular speaker at the prestigious Cosmetic Eyelid and Brow Course at St. Louis University, Department of Oculoplastic Surgery. He is shown in the anatomy lab with cosmetic eyelid icon and guru, Dr. Alan Putterman.
Dr. Alan Putterman and Dr. Niamtu teaching eyelid and browlift surgery at St. Louis University.
Faculty at St. Louis Blepharoplasty & Facelift Course
Dr. Niamtu to Lecture at St. Louis Oculoplastic Eyelid and Facelift Course 2013
Dr. Niamtu had the honor of being on of the few non ophthalmologists to speak at the annual meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgeons in Chicago in 2010.
Dr. Niamtu on faculty at St. Louis Oculoplastic Course February 2010
St. Louis July 2010
Dr. Niamtu continues to be invited as guest faculty for the St. Louis Oculoplastic and Cosmetic Blepharoplsty course and Facelift Course.
Dr. Niamtu is a regular lecturer at the Cosmetic Eyelid & Brow course at St. Louis University for the Department of Oculoplastic Surgery. Click on above to enlarge.
The above brochure is from a multispecialty cosmetic facial surgery course at the University of St. Louis in July of 2006 where Dr. Niamtu lectured on eyelid and brow surgery. Click on the image to enlarge.
The above brochure is from a multispecialty cosmetic facial surgery course at the University of St. Louis in February of 2007 where Dr. Niamtu has been a regular lecturer on eyelid and brow lift techniques. Click on the image to enlarge.