BLEPHAROPLASTY

As one ages, the upper and lower lid tissues begin to relax. These nonspecific changes may be accelerated by sun exposure, allergies or recurrent swelling and consist of stretching or senile elastosis of the skin. In some individuals, this process may be hereditary. The result is an excess of eyelid tissue referred to as “dermatochalasis”. Stretching and relaxation of the orbital septum will allow prolapse of the orbital fat into the eyelids. As a result, a “fullness” to the lid develops which increases over time. This excess lid tissue creates a tired look, may cause the patient to look older than they actually are, and may cause a heavy feeling or weight on the lid. With time, the excess lid tissues in the upper lid may hang over the lid margin and cause a visual field restriction. Patients may describe it as “something sitting there”, “like wearing a baseball cap”, or “like a shadow at the side”. In the lower lid, the excess skin and fat do not cause as much of a problem but can occasionally affect the bifocal portion of the glasses. Patients with excess skin in the upper lids causing a visual field restriction or in the lower lid affecting the bifocal segment have a functional defect that can be alleviated by surgical removal of the skin, and fat, leading to an improved and more comfortable field of view.