The most important aspect of any surgery is to make sure that the proper surgery is done in the first place. There is no point in doing a Blepharoplasty on someone who has Brow Ptosis and even though this is a much more expensive procedure, often times it is in fact the Brow Ptosis which gives a heaviness of the upper lids, rather than excess skin which is called Dermatochalasis. This needs to be properly assessed at the time of the initial consultation. Often the Brow Lift is combined with a Blepharoplasty and sometimes a Brow Lift alone is more appropriate. Again an Oculoplastic surgeon is the one with the most experience to help you make this decision.
Similarly if there is Midface Ptosis, it may be appropriate to do a Mid-Face Lift or a Cheek Lift at the time of doing a lower lid Blepharoplasty. It may also be prudent to do a fat transfer to volumise the cheeks. At the same time, Cheek Lifting can be done with absorbable threads or can be done with more formal techniques of Mid-Face Lifting. Mid-face lifting includes the use of Endotine, which is an absorbable anchoring device designed to hold the cheek up. Cheek implants may also be considered.
Many potential candidates who see me for Blepharoplasty are young or middle aged. This is driven through media, both social media and more formal advertising media. Dr Hollenbach thinks that one should be circumspect. He would not consider doing Blepharoplasties on anyone under the age of 30, unless it was absolutely necessary in terms of vision being compromised by excess skin. He actually can not remember any such case.
Dr Hollenbach believes Blepharoplasty can be done if needed after the age of 30 and of course the older one gets, the more skin is present and so there is no upper age limit for the procedure.
It should be noted that if the upper eyelid skin abuts the lashes, then the term functional Blepharoplasty is used where it becomes a medical procedure and not a cosmetic procedure. This can be partly covered under Medicare.