8-West Cosmetic Surgery

About the Procedure

Cheek lift surgery is a cosmetic surgery procedure with two purposes: the first is to remove extra skin and fat of the lower eyelids in order to create a more youthful, rested eye appearance. The second is to use fat from the lower eyelid to fill a prominent groove (tear through) in the upper cheek area. Cheek lift surgery is done using the external approach to lower eyelid blepharoplasty and the fat repositioning is done through the same incision. With the EXTERNAL approach to blepharoplasty a small incision is made just below the lower lash line. The work on the lower eyelid skin and fat, and the cheek groove, are both done through the one incision. The incision fades with time to become virtually imperceptible. Which cosmetic eyelid surgery is right for you? The most appropriate approach depends on the specific lower eyelid features that you have, and the degree of sagginess of the lower eyelid bag. Dr. Buonassisi will assess your eyelid features during your surgical consult, clearly explain the pros and cons of each procedure, and recommend which approach is best for you.

Benefits of Cheeklift Surgery

Some people inherit or develop prominent grooves (tear troughs) under their eyes. This grove, combined with aging lower eyelids, can create an overall tired or worn appearance. The eyes are one of the first parts of the face to show the signs of aging. As we age, we begin to notice changes that contribute to an overall tired look. Following the surgery, your eyes will appear more youthful, rested and less puffy. The lower eyelid area will be more flat and smooth, and the lid skin will be tighter as it was when you were younger. More about The Science of Aging and Facial Changes can found in this website’s Knowledge Base.

How the Procedure is Performed

Facial Plastic Surgeon Dr. Thomas Buonassisi makes a small just below the lash line where it can be hidden from view.  The skin and underlying muscle is gently elevated to expose the fat that often bulges forward from the lower eye. Further elevation of the skin and muscles down onto the cheek is performed. The bulging fat is then slowly pulled downward into the cheek to fill the depression under the eyelid (the tear trough). Once the fat is repositioned under the cheek groove it is secured in place to permanently fill the tear trough with the patients own intact fat. The excess skin is removed and the underlying muscle is suspended upward and outward to support the tissues for long-term tightening of the lower lid.  The skin is closed with very fine stitches that either dissolve on their own or are removed at our office after one week. This procedure causes more bruising and swelling than a standard lower blepharoplasty but has the added benefit of filling the cheek groove. Lower eyelid blepharoplasty surgery with cheek lift typically takes from 2 – 2.5 hours, and patients can return home the same day.

Benefits of the Surgery

• Tightening of the lower eyelid skin
• Reduction in the bulging lower eyelid fat
• Filling and smoothing of the deep tear trough grove with the patient’s own fat
• A more rested and youthful looking eye appearance

Are You a Good Candidate

Lower eyelid blepharoplasty in Vancouver is most commonly performed on people aged 30 years of age and older, while some patients have the surgery in their late twenties if their eyelid skin has aged quickly. This is possible if there is a history of heavy sun exposure, or eyelid puffiness runs in the family. Many people with deep tear trough grooves inherit this feature from their parents, and the groove is apparent even in their teens or early twenties.

Physical Features

You may be a candidate for cheek lift surgery if you have any of the following physical features:

• Puffy lower eyelids
• Loose skin
• Laxity of the lower eyelid
• Prominent tear trough (deep groove between the cheek and lower eyelid)

General Health

You may be a candidate for cheeklift surgery if you are in general, in good health:

• You have normal blood pressure
  • You are not taking blood thinners, or your physician could safely recommend that you discontinue them for 2 weeks
  • You do not have significant dry eye syndrome
  • Your eye health is otherwise normal

Ideal Candidates for Cosmetic Surgery

Not everyone is a candidate for cosmetic surgery. Ideal candidates for cosmetic surgery demonstrate the following characteristics:

1. Internally motivated to have cosmetic surgery
2. Have realistic expectations
3. Comprehend the potential risks and complication
4. Motivated to follow pre and post operative instructions
5. Can comfortably afford the cost of cosmetic surgery

Recovery

Most patients describe the recovery period from blepharoplasty with cheek lift surgery to be quite easy. There is typically no discomfort, aside from some slight itching where the sutures are placed. Swelling and bruising is at its worst on day three following surgery, and usually subsides two weeks following surgery. The following information will give you a sense for what kinds of activities are safe during the recovery period.

Time Off Work

• Most people who work in the public eye take one week off work
• One week after surgery, some people have perceptible swelling and bruising, which can last for another week or so – these signs are easily covered with makeup or glasses
• People who work from home are typically feeling good and are able to be back at their desks two days after surgery

Back to Normal Activities

• You can resume normal activities, such as light household work and taking a gentle stroll, the day after surgery
• You can resume light fitness activities, such as jogging or yoga, one week after surgery
• You can resume vigorous fitness activities, such heavy weight training or high impact cardio, two weeks after surgery
• You should avoid bending over and lifting heavy objects for two weeks after surgery

Restaurant Ready

• Once your sutures are removed seven days following surgery, you will typically feel “restaurant ready”, meaning that you would feel comfortable meeting up with friends – however, you will still have some evidence of swelling and light bruising, which can be camouflaged with makeup

Complete Recovery

• Most people are feeling quite comfortable being out in public without much evidence of swelling or bruising two weeks after surgery – makeup or glasses can be used to camouflage these signs
• The incisions, which are carefully hidden in the natural eyelid crease, fade over time, often becoming imperceptible within 3 months of surgery

Risks & Complications

All surgeries have associated risks. Dr. Buonassisi will review the risks and benefits of the surgery in detail during your surgical consult. In general, complications of eyelid surgery, while not expected, include:

• Risk of infection
• Risk of bleeding
• Risk of poor wound healing
• Risk of eyelid asymmetry
• Risk of patient dissatisfaction with cosmetic result

Combination Eye Procedures

Blepharoplasty is often combined with other facial rejuvenation surgeries.  Many patients opt to have their eyelids and other facial features, such as jowls and neck, treated at the same time in order to save having to take time off work and recover from more than one surgery. Lower eyelid blepharoplasty is often performed with upper eyelid blepharoplasty, for patients who are dissatisfied with they upper and lower eyelid appearance and would like to have surgery just one. Blepharoplasty is often combined with non-surgical treatments to smooth away lines and add youthful looking volume to the face.

Alternative Eye Procedures

Sometimes large bags under the eyes are stretched out pockets of skin that tend to retain fluid. In this case Dr. Buonassisi may recommend Malar Bag Excision. Blepharoplasty surgery does not treat wrinkles around the eyes – if this is a concern, Dr. Buonassisi may recommend BOTOX® treatments for the Crow’s Feet area, or the area between the eye brows.

What Eyelid Procedure is Right for You?

While the information on this site is extensive, it is not designed the replace the skill and expertise of a board certified facial plastic surgeon. Use the information to help you explore the possibilities and educate yourself about the typical recovery period of cosmetic surgery. While this site provides general information about cosmetic surgery as it related to the average person, it cannot be used as a tool for people to decide which surgery is best for them. Only a thorough consultation with a board certified facial plastic surgeon can provide the specific information they require to make an informed decision about surgery. To find out which surgery is most appropriate for you, please Request a Consult.

Next Steps

Ready to Discuss Your Needs with Board Certified Facial Plastic Surgeon Dr. Thomas Buonassisi? Schedule a Consult

If you are ready to book a consult, please Request a Consult. If you would like to learn more about what to expect during a surgical consult, please go here.

Not Sure You Are a Candidate? Use our Virtual Consult Form

Not everybody is a candidate for cosmetic surgery. To save time, we have launched a Virtual Consultation tool. Upload your photos, provide some information about what you would like to change, and we will provide a complementary evaluation. Find out more about the Virtual Consultation here.