Augmented Blepharoplasty: Combining Non-Surgical Tweakments with Surgical Blepharoplasty
As an oculoplastic surgeon, I often encounter patients seeking comprehensive rejuvenation of their eyes and the surrounding area. A frequent question I hear is, 'How should I schedule my anti-wrinkle injections around my eyelid surgery?' This is an excellent and very relevant question because, in many cases, we can achieve a truly outstanding result by strategically combining non-surgical 'tweakments' with surgical blepharoplasty. I call this approach 'augmented blepharoplasty' - where each modality offers complimentary and synergistic benefits, providing rejuvenation in different, yet synergistic ways.
Understanding the Synergistic Approach
Blepharoplasty, or eyelid surgery, addresses structural concerns such as excess skin and fat deposits that contribute to a tired or aged appearance. Anti-wrinkle injections, on the other hand, target dynamic wrinkles caused by muscle movement. By addressing both aspects, we can achieve a more refreshed and harmonious result.
Timing is Key
Anti-Wrinkle Injections Before Blepharoplasty: I typically recommend scheduling blepharoplasty surgery approximately three months after the most recent anti-wrinkle injections. While not totally essential, this allows the periocular tissues to settle and rest in their natural position at the time of surgery. This ensures that I can accurately assess the underlying anatomy and plan the surgical approach for optimal results. Anti-Wrinkle Injections After Blepharoplasty: Following surgery, there will be some residual swelling. It's important to allow this swelling to subside completely before administering anti-wrinkle injections. I generally advise waiting around three weeks post-surgery to ensure the tissues have healed sufficiently. Protecting Your Investment
For patients who are not already undergoing regular anti-wrinkle injections but are keen to protect their investment in blepharoplasty, I often recommend starting a treatment plan. Anti-wrinkle injections can help to smooth out fine lines and wrinkles and prevent the formation of new wrinkles, and enhance and prolong the results of the blepharoplasty.
A Word of Caution: Upper Eyelid Skin and Anti-Wrinkle Injections
It's important to note that patients with significant excess skin on their upper eyelids (dermatochalasis) may not be ideal candidates for anti-wrinkle injections prior to blepharoplasty. This is because many of these patients use a compensatory mechanism of raising their eyebrows to lift the excess skin and improve their field of vision. Anti-wrinkle injections, by relaxing the muscles responsible for this elevation, can sometimes augment and worsen the effect of the excess upper lid skin. In fact, it's quite common to see more pronounced horizontal lines and wrinkles across the forehead in patients with dermatochalasis (excess skin requiring blepharoplasty) prior to their surgery. This is a direct result of their habitual brow elevation.
Case Study
I recently treated a patient who perfectly illustrates the benefits of combining these treatments. She had undergone anti-wrinkle injections over a year prior to her consultation but had discontinued them because she felt they increased the heaviness of her upper eyelids.
She subsequently underwent upper eyelid blepharoplasty, and one month later, we resumed her anti-wrinkle injections. The results were truly remarkable. The skin on her forehead and around her eyes appeared much smoother, and her eyes looked significantly more alert and bright. The combination of upper eyelid blepharoplasty and anti-wrinkle injections provided a superb, synergistic result.
Conclusion
Augmented blepharoplasty, strategically combining non-surgical tweakments with surgical blepharoplasty, offers a powerful approach to facial rejuvenation. By understanding the interplay between these modalities and carefully planning the timing of treatments, we can achieve natural-looking, long-lasting results that enhance and harmonize the entire eye area.
Enhanced eye appearance after combining upper blepharoplasty (to address excess skin) with anti-wrinkle injections (to smooth forehead lines and crow’s feet).
