Listen, the endoscopic facelift, using this technique, especially when addressing the central part of the face, can replace a blepharoplasty or a repositioning of the eyebrow—in other words, a brow lift. It’s clear that diagnosis is very important here. Unfortunately, I often see patients in my office who come to have their eyes examined after undergoing blepharoplasty, when their real issue is eyebrow drooping.
In this case, the surgeon’s diagnosis is crucial. If there is truly an excess of skin on the upper eyelid—what we call dermatochalasis—then blepharoplasty is indicated because there is an actual excess of skin. But be careful, as this is less common than you might think. Very often, the skin resting on the eye isn’t due to eyelid skin but is instead often caused by two factors: the drooping of the eyebrow and the loss of volume in the upper eyelid sulcus.
Now, if the heaviness of the upper eyelid is caused by eyebrow drooping or orbital hollowing, it’s clear that performing a blepharoplasty is not only not the ideal or indicated procedure, but from an aesthetic standpoint, it produces the opposite effect. In other words, it does not enhance the appearance of the eyes but rather causes hollowing of the eyes, leading to an even older appearance.
Let me give you a very simple example: if you look at a photo of a young woman, her eyes appear full and vibrant. If you look at your grandmother’s eyes, unfortunately, her eyes look hollow and aged. So, when we perform surgery that hollows out the eye area, we are not enhancing the appearance but unfortunately creating a defect—what we call an iatrogenic condition, meaning caused by the surgery itself. Exactly.
https://www.gennaichirurgia.it/en/endoscopic-lifting-face-mivel/
