This excess skin can occur above the eyes in the upper eyelids or below the eyes in the lower
eyelids. Extra skin and puffy eyelids can be present simply from being born with a tendency to form baggy eyelids. Saggy, stretched skin can also form as part of the aging process. Medical conditions like sinusitis or recurrent allergies can cause repeated swelling and contraction around the eyes as well. As skin stretches and descends, extra tissue accumulates around the eyes. Furthermore, the firm tissue that normally holds back the natural fat pads around the eyes can also stretch. The weakening of this tissue allows the fat pockets around the eyes to bulge forward, causing puffy bags to form around the eyes in conjunction with the hanging, loose skin.
The combination of hanging loose skin and puffy bags causes eye fatigue, blocks vision, and gives on
an older, tired appearance. It’s not surprising that loose skin around the eyelids gives the appearance of age and fatigue. Patients may complain they are looking more and more like their parents. Friends, relatives, and coworkers ask if they are tired or if they’ve had a poor night’s sleep. The discord between how a patient feels and how they look is by far the most common reason that patients have cosmetic eyelid surgery.
The extra hanging skin of the eyelids causes other symptoms such as blocked vision. Loose, saggy eyelids block vision by hanging over the eye and blocking the light rays coming into the eye. Typically, light rays coming into the eye from up above are the ones affected. Light rays coming from the sides of the eye can be blocked as well. When peripheral vision is constricted in this way it makes it harder to see. Patients complain of difficulty reading, problems driving, and trouble with most any task that requires vision.
When loose eyelids are hanging over the eyes a subconscious effort is made to open up vision. This is done by activating the muscle in the forehead and raising the forehead and brow. Openin
g the eyes in this way works well over the short run. Unfortunately, it also causes deep wrinkling in the forehead and makes the forehead very tired. Patients complain of very tired eyes and even headaches, unaware that their forehead muscles are undergoing the equivalent of a marathon.
A special problem that women have is that of wearing makeup. The space between the eyelashes and the natural fold of the eyelid is where many women place their eye shadow. This area is hidden for many women by the extra hanging skin above it. Some women give up wearing eye shadow altogether. One of the very nice affects of eyelid surgery is that this space becomes visible again, allowing a women to wear eye shadow again if she chooses.
Blepharoplasty, or cosmetic eyelid surgery, directly addresses the hanging skin and bulgy bags around the eyes. It gives the eyelids a more youthful appearance, reduces eye fatigue, and can help with vision.