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When Your Eyelids Need Tightened

Muscle Tightening Eyelid Surgery

Regain lost vision with eyelid surgeryFor individuals whose upper eyelids have slowly drifted down to cover part or most of the pupil, common factors include the aging process, muscle weakness of the elevating muscle of the upper eyelid, or in some cases, familial or genetic predisposition. An eyelid droop caused by muscle weakness is known as “true blepharoptosis.” More commonly, drooping eyelids are caused by the overhang of excess upper eyelid skin and fatty tissue, which is known as “pseudo-blepharoptosis.”

If we determine that muscle weakness is causing your droopy eyelids, two separate procedures can be utilized to correct this issue:

Muellerectomy Procedure

Dr. Justo performs the large majority of his upper eyelid “muscle tightening” procedures using a procedure known as conjunctival-muellerectomy surgery. This 15-minute outpatient procedure is performed under local anesthesia with minimal discomfort. The procedure involves a small, hidden incision underneath the upper eyelid, followed by placement of an absorbable suture that dissolves in approximately 10 days. The primary advantages of such a procedure are:

  • Short operation time
  • Minimal post-operative bruising and swelling
  • High degree of accuracy, reproducibility, and symmetry
  • Avoidance of post-operative “notching” of the upper eyelid
  • Avoidance of any skin incision or scar

The main disadvantages of a muellerectomy are:

  • Limited degree of elevation of the eyelid in cases of severe eyelid droop (blepharoptosis)
  • Does not correct any skin sagging that may co-exist with the muscle weakness

During your initial consultation, Dr. Justo will discuss your options in detail and help you decide on your best course of action.

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Levator Resection

If you show signs of marked muscle weakness with the eyelid clearly falling below the level of the pupil, or you require a secondary (repeat) muscle-tightening procedure, Dr. Justo will recommend a traditional levator aponeurosis advancement and tightening procedure. This procedure is also performed using local anesthesia although it is more time-intensive and requires a skin incision through the upper eyelid crease. The main advantages to the levator resection procedure are:

  • Can elevate the upper eyelid to a much higher degree than with a muellerectomy procedure
  • An upper eyelid blepharoplasty (removal of skin and fat) can be performed simultaneously using the same external skin incision through the upper eyelid crease

The primary disadvantages of the external levator resection approach are:

  • Requires longer surgical time, approximately 20-40 minutes per eyelid
  • Typically results in greater post-operative bruising and swelling than the muellerectomy procedure
  • Small risk of “lid notching” of the upper eyelid which can sometimes result in a slightly less than natural lid contour

Dr. Justo has performed hundreds of muscle-tightening eyelid surgeries since 1989. He states that “an eyelid lift is really a misnomer as most of the public views an 'eyelid lift' as the same term as a blepharoplasty for removing excess baggy skin and fat. However, performing a blepharoplasty does NOT truly elevate the position of the upper eyelid. The only real way of 'lifting' the eyelid is to tighten the muscle(s) of the upper lid so as to elevate lid position away from the pupil. Hence, in reality the true 'eyelid lift' is really a muscle-tightening procedure.”

Benefits of Muscle Tightening Eyelid Surgery

Tighter, firmer skin can make you look years younger, not to mention healthier and refreshed. Sagging eyelids can make you appear old, unhealthy, fatigued, and even depressed. All of these traits can have an impact on a person's demeanor and self-esteem. By performing eyelid surgery, we can not only improve your appearance, we can improve your self-confidence as well.

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Sun City West, AZ 85375

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