Upper Eyelid Lift The upper eyelid rarely needs surgical correction before the patient reaches their late 40s and 50s. Rather, it is the aging and falling of the heavier eyebrows and forehead that causes the deceptive appearance of extra eyelid skin. It is Dr. Ptak's firm belief that the aged appearance and extra skin folds of the upper eyelid are more correctly addressed by the endoscopic browlift and not by the more expedient removal of upper eyelid skin, because it is unusual to have true upper eyelid skin excess before the age of 50. If the upper eyelid procedure is truly indicated, a simple skin removal with little or no fat removal can easily be performed in most cases under purely local anesthesia with little or no extra sedation. Lower Eyelid Lift Dr. Ptak has long recognized that the lower eyelid is an integral part of the entire midface, which includes the bone and soft tissue of the cheek and the nasolabial fold. Dr. Ptak also feels that this entire facial unit needs to be addressed both functionally and cosmetically. Since 1993, this has been Doctor Ptak's philosophy when he felt that all of the lesser more "purely cosmetic" procedures were yielding less than satisfactory results and would sometimes even create a more aged, unnatural, or hollow (surgically corrected) lower eyelid. His innovative reconstructive approach scientifically addresses and reverses the aging process giving a more natural, youthful, and long-lasting appearance. The best candidates for eyelid surgery are men and women who have excessive sagging or wrinkled upper or lower eyelid skin, have excess upper eyelid skin that interferes with vision, have lost their natural upper eyelid crease, or have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance. The operation is done on an outpatient basis under sedation and local or general anesthesia. The incisions are made where the natural crease should be in the upper lids and below the lash line in the lower lids. The herniated orbital fat is rarely removed and is usually repositioned. Tightening of the lid margin, correction of sagging cheek fat pad, and removal of excess skin completes the procedure in the lower lid. All sutures are usually removed within 5-7 days. Initial mild discomfort is easily controlled with oral medication. Bruising and sensitivity to light last at least a week or two. Swelling progressively disappears over several weeks. Eye makeup can be used shortly after sutures are removed. Contact lenses can be worn when comfortable–usually within 1-2 weeks. Additional procedures that may enhance the result are: Forehead Lift, Face Lift, Chemical Peel or Laser Skin Resurfacing.