Mechanism
With age, upper eyelid skin loses elasticity, orbital fat herniates forward, and the orbicularis oculi muscle becomes lax—leaving the lids heavy, partially obscuring the palpebral fissure, and giving the eyes a tired appearance. Full-incision blepharoplasty addresses all three concerns: precisely resecting the pre-measured strip of excess skin, excising or repositioning herniated fat (avoiding over-resection to prevent a hollowed look), and creating a well-defined crease by anchoring the skin-muscle flap to the levator aponeurosis at an optimal height.
When Is Full Incision Preferred Over Mini-Incision or Non-Incisional Suture Techniques?
A full incision is indicated when excess skin extends across both the inner and outer canthus, when eyelid fat is thick, or in patients aged 35–40 and above with visible signs of periorbital aging. Non-incisional suture techniques and short-incision approaches cannot adequately remove substantial amounts of redundant skin and fat, often leading to suboptimal or short-lived results. Conversely, younger candidates with thin skin do not typically require a full-incision procedure.
Full-Incision Blepharoplasty Is Not 'Eye Enlargement'
The true objective is to create light, well-defined, and symmetrical eyelid creases with a naturally open palpebral aperture; the intrinsic size of the eye opening itself remains unchanged. Designing an excessively high crease or excising too much skin results in an unnatural, 'operated-on' look that is difficult to revise—our surgeons prioritize conservative resection while preserving harmonious proportions between the lid margin and the brow. Prior to surgery, the surgeon must rule out brow ptosis (which requires a brow lift first) and true blepharoptosis (which requires levator muscle repair)—performing blepharoplasty alone in either scenario will only make the eyes appear heavier.
Potential Risks to Consider
The incision line within the crease remains pink for 1–3 months; minor asymmetry; creases that are too high or too low; over-resection of skin or fat leading to hollowed eyes or incomplete eye closure (lagophthalmos); prolonged swelling and bruising; temporary dry eye; and rare instances of hematoma or infection. Most minor asymmetries resolve spontaneously once swelling fully subsides after 3–6 months.
The BonBoz Approach
A plastic surgery specialist evaluates you in person, measuring excess skin using precision calipers, assessing fat distribution, performing brow and levator function tests, and simulating the anticipated crease. Our surgical approach prioritizes tissue preservation: conservative skin excision, fat repositioning rather than aggressive removal, and intradermal suturing for a refined, discreet scar. The surgeon who examines you is the one who operates; incision placement, skin removal margins, recovery downtime, and potential risks are all thoroughly discussed before you make your decision.
