Eyelid Surgery - Why Small Does Not Mean Simple

In this episode of Beauty and the Beasts, plastic surgeons Dr. Sam Jejurikar and Dr. Salvatore Pacella take a deep dive into eyelid surgery and explain why one of the smallest operations in plastic surgery can also be one of the most complex.

Many patients think of eyelid surgery as a quick or minor procedure. In reality, successful eyelid rejuvenation requires precise judgment, careful technique, and a thorough understanding of how the brow, upper eyelids, lower eyelids, and surrounding structures age together. Dr. Pacella explains why lower eyelid surgery is often the most technically demanding area in facial plastic surgery and why prevention of complications is far more important than aggressive correction.

The conversation covers upper eyelid surgery and the importance of conservative skin and fat removal to avoid hollowing, dry eyes, and difficulty closing the eyelids. Dr. Jejurikar discusses how preserving volume and respecting brow position leads to more natural and youthful results.

The episode then shifts to lower eyelid surgery, where the surgeons explain why eyelid laxity is frequently underestimated and how improper technique can lead to ectropion, malposition, and shape changes that are difficult to fix. Different surgical approaches are discussed, including transconjunctival fat removal, conservative skin excision, laser resurfacing, and various methods of canthal support.

Dr. Pacella also shares insight into complex lower eyelid reconstructions, including rare cases where the eyelid support system must be rebuilt. Common postoperative issues such as chemosis are explained along with strategies for prevention and treatment.

Recovery expectations are addressed in detail, highlighting why upper eyelid surgery often has a short recovery while lower eyelid surgery can involve weeks of swelling and temporary vision changes. The surgeons also discuss ice, supplements, and other strategies that may help with healing.

This episode is ideal for patients considering blepharoplasty, anyone researching upper or lower eyelid surgery, and clinicians interested in nuanced eyelid decision making and complication management.