The eyes are the first thing that we look at when we look at somebody. They tell us so much about the person both physically and psychologically. They are the windows to the soul; the eyes tell us with intuitive accuracy about the temperament, emotions, and trustworthiness of the person with whom we are communicating. They are indeed also our windows to see the world.
Unfortunately, they sometimes reveal more than we would like, especially our age. Furthermore, they may not open widely enough for us to fully see the world around us. So, the complex that makes up the window and window frame of the eyes is a very important functional, social, and cosmetic component of a person’s appearance.
It is not surprising therefore that a number of people look to smooth out the lines around and improve the appearance of their eyes, using both medical and surgical procedures.
The eyes are a very complex part of our anatomy. When a plastic surgeon reviews a patient considering eyelid surgery; the forehead, eyebrow, upper and lower lids, surrounding skin and sometimes even the cheeks need to be taken into account. A patient’s facial structure and even their personality are also important aspects to consider.
So, from a Plastic Surgeon’s point of view, the whole picture has to be taken into account, if the optimal result for any given individual is to be achieved. Consideration of how to proceed with rejuvenation of the eyes is a complex decision-making process.
Let us start with the Eyebrows. They are a very important component of facial expression. There can be the elevated eyebrow of surprise or the frowning eyebrow of anger and the partially elevated unilateral quizzical eyebrow of amusement.
Eyebrow height is commonly considered important. We will often elevate our eyebrows to improve our vision. Elevating an eyebrow will lift redundant skin on the upper lid and can assist with your peripheral vision. People often believe that their eyebrows have dropped as they have aged. For many of us, however, the brows have always been low. Most people even have asymmetry of their eyebrows with one eyebrow higher than the other.
Many celebrities considered attractive have low eyebrows. Tom Cruise, Chris Hemsworth and Paul Newman are prime examples of handsome men with very low eyebrows and Nicole Kidman, Margot Robbie, Jennifer Lopez, and Kate Blanchette all have low-set brows. Eyebrow shape is indeed more important than height. Cindy Crawford has long been considered to have iconic eyebrows for a middle-aged woman. They actually start relatively low at the central brow, arch upwards and outwards reaching a subtle peak at two thirds of their total length, before turning down for their last third as they proceed laterally. She also has a beautiful oval of fullness below the outer two thirds of the hair of the brow. Generally, beautiful brows, might mimic this shape but perhaps to a lesser degree.
This appearance starts with you and what you do with your brows. I guess if there were to be one simple thing to take from these concepts; it would be that you can contour your eyebrow to achieve that beautiful and stylish shape. This is perhaps best achieved with trimming, colouring and very judicious plucking. Thicker eyebrows are in vogue. Do not over-pluck! This will cause the hair follicles to die off over time.
Botulinum toxin is widely used in eyebrow shaping. It can be used to reduce frown lines and “crow’s feet” and to change the shape and position of the eyebrow, but once again it must be done very carefully to produce the above desired effect. Be sure to have it done by a well-trained injector under the direct supervision of a doctor.
On the other hand, surgery to the brow may be the best way to optimise its shape and fullness and to lift the eyelid skin fold up off the lashes. Lifting the brow in a shapely manner and building up that outer fullness using your own tissue, acquired from the lid itself, is a technically interesting procedure and produces a permanent structural improvement to both your brow and eyelid.
Then there is the Skin Fold of the upper lid to consider. This is actually a fold of skin and muscle. It can sit very low, down on the lashes, and even reduce your peripheral vision. Excision of this excess is the only really effective treatment.
Emphasising this problem can be excess fat within the bony socket of the eyeball. Once again excision of this fat is the only effective treatment.
These are the two main components of simply “Upper Lid Blepharoplasty”. They reduce upper lid excess tissue directly.
When the combination of the surgical techniques to the brow and eyelid are performed together, they produce an optimal dynamic and beautiful result. I refer to this as a “Vogue Blepharoplasty”.
The other part of the windows to your soul are the lower lids. The lower lids present their own problems. You may be troubled by “fatty bags” or by excess skin with wrinkles in the skin or both.
Your excess fat can be removed by an incision made inside the lower lid, called a trans-conjunctival approach.
I prefer an incision made in the skin below the lashes, however. It gives me much greater access to both the muscle and the fat and allows for tightening of the muscle and the excision of some skin when appropriate. The scar virtually disappears.
I also use a different technique to deal with the fat pads. Most lower lid operations rely on removal of the fat. I prefer to relocate the fat over the edge of the bone and into the cheek area. The lower eyelid should then drape smoothly without undue bulging to the lower bony margin of the eyeball socket. This bony margin should then have a subtle and even fullness extending down onto the cheek, with an increase in the fullness of the cheek especially filling the “tear trough”, an area where fillers are commonly used. The lid will then flow evenly down over the bone into the cheek. Furthermore, if this fat volume increases with weight gain, your cheek becomes a little fuller as opposed to your eyelid bags returning.
These are the features of classically beautiful orbital complexes. From a Plastic Surgeon’s point of view, paying attention to these details when performing surgery to enhance an eye is important and can be very rewarding.
So the bottom line is that not everybody can have eyes like Margot Robbie or Cindy Crawford, but attention to detail with the application of Cosmetics, careful trimming and shaping and if necessary Cosmetic Plastic Surgery can help any given individual attain their optimal look.
Dr Newton’s knowledge and experience will
guide you through the process of choosing the
right procedure for your body.