Side Effects of Double Eyelid Surgery in Middle Age: Cases

As aging progresses, all tissues sag from top to bottom.

Among them, the tissues around the eyes sag the fastest, for several reasons;

changes in the eye area and eyelids and in the forehead and glabella differ in cause and also in how they appear.

To aid understanding, along with images of the changes around the eyes caused by aging,

we will look at cases of eyelid surgery for mature eyes, including upper blepharoplasty and brow lift.

① The tissues around the eyes are thin and soft.

② The attachment between the orbital muscle and the muscle layer beneath it is loose.

③ In the outer eyebrow area, a fat layer lies between the skin and muscle, so the skin slides and sags easily.

There is almost no fat layer between the skin and muscle, so rather than the skin sagging, movement of the forehead muscle

produces horizontal lines on the forehead, while at the glabella the frowning muscles become developed,

leading to vertical lines and a bulging contour near the eyebrows.

Some patients come for upper blepharoplasty because their eyes look closed-in once the eyelids sag and cover the double eyelid crease.

However, when performing upper blepharoplasty, that is, double eyelid surgery, the distance between the eyebrows and eyes must be assessed carefully. 

It is advisable to perform upper blepharoplasty when the distance from the eyebrow to the frame of the eye is at least 18 mm.

If double eyelid surgery is performed when the distance is narrower than this, however, the face often ends up looking fierce or closed-in like this, so caution is needed.

In such cases, a brow lift is the answer.