The patient is a 68 year old woman who noted that her eyes appeared to be closed when she gazed into the mirror and she thought there was extra skin in her upper eyelid and folded skin and fullness in her lower eyelid. The patient had upper eyelid surgery to remove the extra skin and fat. She had lower eyelid surgery with the external approach to remove folded skin and fat bags. Her swelling resolved quickly. She was walking outside the next day after her procedure and by the fifth day most of the swelling was gone and she could easily be in public. She was very gratified by her cosmetic result and felt that she looked a lot younger.
There are two ways to approach the excess skin and fat of the lower eyelids. The external approach involves making a hidden incision right at the skin edge and removing excess fat from the outside. The extra skin folding is smoothed out and excess skin removed. The other way to remove excess fat and smooth lower eyelid skin is to remove the fat from inside the lid and use the laser to smooth skin wrinkles. A thorough consult with a plastic surgeon can help patients figure out which is the best technique and can give the best results.
