Eyelid Surgery (Blepharoplasty)

Dr. Julius Few performs upper and lower blepharoplasty (eyelid surgery) from his Chicago practice at the John Hancock Center. Upper blepharoplasty removes excess upper eyelid skin and, where indicated, prolapsed orbital fat to restore an open, youthful periorbital appearance and improve the upper visual field in functional cases. Lower blepharoplasty addresses under-eye puffiness caused by herniated orbital fat, fine skin creasing, and tear trough hollowing. Eyelid procedures are frequently combined with facelift or brow lift for comprehensive facial rejuvenation.

Eyelid surgery (blepharoplasty) at The Few Institute for Aesthetic Plastic Surgery in Chicago addresses both upper and lower eyelid concerns through procedures that are among the most precisely demanding in facial plastic surgery — given the functional importance of the eyelid structures and the unforgiving visibility of the periorbital region. Dr. Julius W. Few brings his Harvard training and 26 years of board-certified plastic surgical experience to each blepharoplasty, with a conservative approach aimed at restoring natural appearance rather than creating an over-operated look. Upper blepharoplasty is the most frequently performed eyelid procedure in the United States. With ageing, the brow descends and the upper eyelid skin — which is already the thinnest skin on the body — loses elasticity, accumulating as horizontal folds that drape over the eyelid margin. In mild cases this creates a heavy, tired appearance; in more significant cases the overhanging skin obstructs the superior visual field, constituting a functional deficiency that, when documented by formal visual field perimetry, may qualify the procedure for insurance coverage. The surgery is performed through an incision placed precisely in the existing upper eyelid crease, through which excess skin — and occasionally a horizontal strip of orbicularis oculi muscle — is excised, and prolapsed medial and central orbital fat pads are conservatively reduced or repositioned. Critical technical discipline lies in excising enough skin to achieve a meaningful aesthetic improvement while retaining sufficient to allow complete eyelid closure and prevent lagophthalmos. Lower blepharoplasty addresses the under-eye bags and hollowing that develop as the orbital septum weakens with age and allows the three orbital fat compartments of the lower eyelid to herniate forward. The transconjunctival approach — performed entirely through the inner surface of the lower eyelid without external incision — is preferred for younger patients with intact lower eyelid skin tone who present primarily with fat prolapse; fat is either conservatively reduced or repositioned over the orbital rim to simultaneously fill the adjacent tear trough hollow. Where lower eyelid skin crinkling or excess is also present, a subciliary approach with pinch skin excision or a skin-muscle flap technique addresses this component. Blepharoplasty is a natural complement to facelift surgery at The Few Institute, and the two procedures are frequently performed in the same operative setting for patients seeking comprehensive periorbital and facial rejuvenation.