Blepharoplasty: what it is and how it relates to HOF
Quick facts
- Definition
- Eyelid surgery on the upper lids, lower lids or both.
- Treats
- Excess skin, fat pads and laxity.
- Who performs it
- A qualified surgeon, in a suitable setting.
- Difference from facial harmonization
- It is surgery; facial harmonization generally uses minimally invasive procedures.
- Role in facial harmonization
- An alternative or a complement, depending on the cause of the concern.
Blepharoplasty is eyelid surgery. It can treat the upper lids, the lower lids or both, and it removes or repositions excess skin and fat. It is not a facial harmonization procedure, but it comes up often in conversations about a tired look and about concerns in the periorbital area.
When is blepharoplasty considered?
When the concern comes from excess skin (dermatochalasis) or prominent eyelid fat pads. In these cases, filler alone can make the appearance worse, because it adds volume to an area that is already full.
| Concern | Common cause | Possible direction |
|---|---|---|
| Shadow under the eye | Volume loss in the tear trough | Consider filler, with vascular risk |
| Bag under the eye | Prominent fat | Consider surgery |
| Excess skin on the upper eyelid | Dermatochalasis | Consider surgery |
| Drooping eyelid | Eyelid ptosis | Specialist assessment |
Where does facial harmonization fit?
Facial harmonization can complement a surgery, or help avoid one, depending on the case. In the assessment, it is worth observing the brow position, the orbital septum and the eyelid crease. A drooping brow, for example, can be mistaken for excess skin.
How do you talk to the patient?
Explain that a tired look can have different causes and that each calls for a different path. Avoid promising that a filler will do the work of a surgery, and vice versa. If you make a referral, note it in the patient record.
Also called: eyelid surgery, eyelid plastic surgery.
Frequently asked questions
Does under-eye filler replace blepharoplasty?
Not necessarily. It depends on the cause: shadows from volume loss may benefit from filler, while fat pads and excess skin usually call for surgery. Only an assessment can tell.