These slides are from a talk I gave at the Korean Society for Aesthetic Plastic Surgery (KSAPS) meeting at COEX on April 7-8, 2018. When we operate on older patients, the upper lid often comes out looking heavy and the expression turns angry.
Angry Bird and dumpling, as the saying goes.
So how do we make this look natural?
The eyelid skin has two distinct layers, a thin layer and a thicker layer.
In the upper-left diagram, the thicker skin is excised at the subbrow level and a new crease is made for the eyelid. If we excise only the thin layer (the right diagram), we leave the heavy skin behind, and the result looks unnatural. When the skin overall is genuinely thin, the right-side approach alone can be enough. When it is not, the result looks like the figure below.
This material is based on a presentation I gave at the KSAPS meeting in April 2018.
