The upper and lower eyelids work together to function as a sphincter, the protectors of the eye, and from the anatomical point of view must be considered as one functioning unit, just like the upper and lower lips collectively form the sphincter of the mouth.
Form and substance are given to the lids by what might be considered their skeleton, for it is made of the same substance as bone, i.e. collagen, but it is not mineralized and its fibers are arranged in a linear manner. The structure is known collectively as the tarsal plate composed of upper and lower tarsus (plural tarsi). The name is derived from the Greek implying, “flat,” used for the wing of a bird, which conceivably was thought to flutter like the eyelid. If one squeezes the upper eyelid between finger and thumb the tarsal plate is readily discerned beneath the skin.
The semi-oval tarsus of the upper eyelid (superior tarsus) is 10mms in height in its center, tapering to 2mms at each end, with a thickened straight lower border. The tarsus of the lower eyelid (inferior tarsus) is about half the height of the upper, but otherwise of the same general shape. An orbital septum is a thin layer of fascia, continuous with the periosteum of the bony orbit, it fills the space between the orbit and upper tarsus, to which it is attached.
At what might be thought of as the corners of the eye, the united upper and lower tarsi are stabilized to the orbit by “ligaments,” bands of organized collagen fibers; the lateral palpebral ligament inserts into the zygomatic bone, the medial palpebral ligament is attached to the maxillary process at the medial orbital margin.
The broad tendon of levator palpabrae superioris muscle, which “opens” the eye, blends into the fibers of the upper third of the superior tarsus.
This case depicts a 45 year old woman who wished to address her "heavy" upper eyelids and the fact that others often perceived her as angry.
Dr. Belsley felt that she would benefit from elevating the position of her eyebrows in addition to having upper and lower eyelid lifts. The combination of the brow lift and eyelid lifts opened up her eyes and defined her.
Upper eyelid creases, while maintain a youthful fullness to the upper eyelid. The post-operative photographs depict her appearance at two weeks after surgery. Dr. Belsley performs brow lifts using a few short incisions within the hairline. The position of the eyebrows alone can be elevated using the incision through which an upper eyelid lift is performed.
This case depicts a 44 year old woman who underwent a lower eyelid lift in which the lower eyelid fat was rearranged rather than removed.
The result of this procedure is a smooth lower eyelid contour devoid of the bulging or "bags" that many individuals exhibit. The change can most readily be seen in the photographs in which an individual is looking upwards.
The post-operative photographs depict this woman's appearance approximately four months after surgery.
This case depicts a 59 year old woman who wanted to achieve a more youthful appearance. She was specifically concerned with her jowls and the fullness beneath her neck. She underwent an upper eyelid lift, a lower eyelid lift, a short scar face lift and ultrasound assisted liposuction of her neck and jowls.
The pictures show her approximately six months after surgery. The lower eyelid lift performed in this case did not involve removal of the fat that normally resides in the lower eyelid.
Instead, the fat was repositioned to fill in the hollows of the lower eyelids, making the transition from the lower eyelid to the cheek smoother and more aesthetically attractive.
This case depicts a 55 year old woman who wished to achieve a more youthful facial appearance. In addition, others felt that she often appeared "angry." She underwent an endoscopic brow lift, upper and lower eyelid lifts and a short scar face lift which addressed the skin and fat beneath the chin, the jowls and elevated the midface. The post-operative photographs depict her appearance approximately three and a half months after surgery.
A short scar face lift often requires no incisions behind the ears and can achieve an excellent result in appropriately selected cases. The recovery time ranges from two to four weeks, although some individuals return to work as early as one week after surgery.
This case depicts a 56 year old woman who wished to achieve a more youthful facial appearance. She underwent an upper and lower eyelid lift and a short scar face lift.
This short scar face lift addressed the skin and fat beneath the chin, the jowls and elevated the midface.The post-operative photographs depict the patient's appearance at just under four months after surgery.