Is a Blepharoplasty the New Rite of Passage Surgery?

Aging eyes are the main reason patients seek blepharoplasty. But that is changing as more younger patients seek out the procedure, many of whom don’t see the effects of time yet. According to the Aesthetic Society, some plastic surgeons were predicting a boom of younger women pursuing eye surgery in 2022 due to the world of virtual meetings showing no signs of slowing down.

Nose jobs have often been the younger subset’s gateway surgery for years. And while rhinoplasty still rides high on the procedure list, more 20- and 30-somethings now opt for eye lifts. For example, influencers Cailyn Brooke and Arielle Lorre have been open about their blepharoplasties. Beverly Hills oculoplastic surgeon Christopher Zoumalan, MD says he has seen increased blepharoplasty requests in the past two years. “People are more drawn to their eyes than before since that’s the only part of the face not covered by a mask.”

Many plastic surgeons also believe the work-from-home lifestyle drives younger patients to jump on board. “It allows a patient to recover from home while still working and not letting everyone know they had something done,” says Dr. Zoumalan.

Where It All Started

In South Korea, blepharoplasty procedures like double eyelid surgery (it creates a more visible crease in the upper eyelid) are considered entry-level surgeries and even a status symbol. However, from teenagers to those age 35, upper blepharoplasty is about enhancing or opening up the eye, says facial plastic surgeon John Kang, MD. “The purpose is to achieve greater harmony and balance in an otherwise beautiful Asian face, emulating those who are born with a beautiful natural eyelid crease. There is no better analogy than Caucasian patients in their late teens to 30s getting a nose job to a slimmer nose for a better achieve profile,” he adds.

Boca Raton, FL, oculoplastic surgeon Steven Faigen, MD recalls when the average age of his blepharoplasty patients was 55. Now, he says, they’re in their early 40s, and half are younger.

Most plastic surgeons get a feel for the motivations behind a young person’s desire for surgery during a consultation. “Many tell me that their issues date back to their teenage years, despite no real change,” Dr. Faigen shares. A good portion hasn’t liked their eyes for years but couldn’t do anything about it because they were underage and required parental consent. “Now that they’re old enough to pay for surgery themselves and make their own decisions, they want to change what they don’t like,” he says.

The Common Concerns

Asymmetrical Eyes

Everything from selfies to Zoom videos makes genetic asymmetries in the eyes more apparent to the patient. But here’s the kicker (since we are all our own worst critics): the degree of asymmetry must be substantial enough to warrant surgery. Conversely, subtle or minor asymmetries may not provide enough of a noticeable difference post-procedure.

Upper Eye Dropping

In younger patients who come in for a correction, droopiness often has existed for years. “I see ptosis in younger patients where they have a droopy lid that they were either born with it or notice it getting worse in their young adult life,” says Dr. Zoumalan.

Upper Eye Hooding

Just like asymmetries result from genetics, so do hooded upper eyelids. “It’s the third common reason, in my practice, for surgery because it is a familial trait,” says Dr. Faigen.

The surgical approach to correcting the eyes in older and younger patients is relatively similar. “We measure the amount of skin to remove and suture it meticulously carefully,” says Woodbury, NY oculoplastic surgeon David A. Schlessinger, MD. “Some patients also need fat removal or fat transfer, so we tailor the surgery to the needs of the patient.”

Under Eye Bags

Small pockets of fat push up against the lower orbital rim, causing puffiness and bags and accentuating darkness under the eyes. Dr. Kang explains that the eyes appear more rested by removing the fat bag.

How Early Surgery Influences Aging

So here comes the million-dollar question: Does early eye surgery affect how the eyes will age? Dr. Schlessinger says a well-performed blepharoplasty shouldn’t affect the eyes’ normal aging process, and the results can last ten to 20 years.

However, Dr. Faigen explains one potential problem with early surgery is a conservative correction. “Being too conservative might have an effect on the results not lasting long enough, and the initial problem may present itself again,” he says.

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