Eyes: The Window to the Soul

Woman before and after eyelid rejuvenation

William Shakespeare said it first: “The eyes are the window to the soul.” Scientists have actually validated this in revealing personality traits and mood. Our eyes give a message to others when we’re happy or sad, defeated or purposeful, and when we’re frightened. Some of us have eyes that give the wrong message–drooping in the brow or upper lid can give the message that you’re tired or angry even when you aren’t. If you happen to be one of those people, I have several ways to open up your eyes to reveal a younger you.

Causes of Drooping Upper Eyelids

Besides medical conditions such as myasthenia gravis, nerve problems or congenital ptosis of the eyelids, there are two primary causes of drooping in the upper lid: genetics and aging. Some people are born with upper lids that are a bit “droopier” than others or their eyebrows are genetically heavy, causing the appearance of a drooping eyelid. However, they are the minority of the patients who come to me about eyelid rejuvenation at my Indiana plastic surgery practice, most of whom are in their 40’s to 60’s and have age-related ptosis (ptosis means drooping).

Solutions for Drooping Upper Eyelids

Depending on my patient’s age and goals, upper eyelid drooping can be treated with the following options:

  • BOTOX® Cosmetic
  • Blepharoplasty, AKA eyelid rejuvenation
  • Brow Lift, with or without blepharoplasty


BOTOX® Cosmetic can be used in the eye area to soften fine lines and lift the brow, which has a subtle effect on the upper eyelid. Injecting BOTOX® in the crow’s feet and outer brow will lift the outer third of brow about 1-2 mm. Injecting over the brow can lift the entire brow about the same distance. There’s a subtle art to injecting BOTOX® for these purposes, as too much in the wrong area can actually depress the brow.

Blepharoplasty in my Indiana plastic surgery practice is the procedure of choice for those patients who have too much skin or laxity in the upper brow to respond to chemical peels or BOTOX®. It’s a simple procedure that takes about an hour on each eye and results in a much improve appearance.

A Brow Lift is exactly what it sounds like: a lifting of the brow to its formerly higher position to eliminate deep forehead wrinkles and to open up the eyes for a more youthful look. A brow lift is also called a Forehead Lift. Indiana men and women with age-related sagging in the brow and/or drooping of the upper eyelids often find that the combination of the forehead lift with a blepharoplasty is the perfect solution.

Does Insurance Cover Eyelid Rejuvenation?

A blepharoplasty and/or a forehead lift is considered an elective cosmetic surgery that generally is not covered by health insurance. However, if eyelid drooping obstructs your vision, it’s possible that your insurer will cover a blepharoplasty procedure. One generally needs to undergo what’s called a Visual Field Exam. It’s an easy exam that involves taping the upper lids to a higher position and then responding to flashing lights by pushing a button. It’s then repeated without the tape. The computerized test tracks false positives and negatives, so you’ll get a very accurate report. If the Visual Field Exam shows that your vision is improved when the eyelid skin is lifted up with tape, your insurer is likely to cover your procedure. Some insurance companies also require photos and a Letter of Medical Necessity before they authorize the surgery. Dr. Galante is quite familiar with this and can guide you in the steps to take if he thinks you might qualify for insurance coverage of your blepharoplasty.

How Eyelid Surgery is Performed

A blepharoplasty can be performed in the office with local anesthesia or under general anesthesia if that is your preference or because the blepharoplasty is part of another procedure such as a facelift. An incision is made in the crease of the upper lid and an ellipse of skin is removed. Depending on your anatomy and aging pattern, fat may be removed as well. If you’re having a lower blepharoplasty too, the incisions are made in the area just beneath the lower lashes. After healing, the thin scars from these incisions are extremely hard to detect, as one is in the upper eyelid fold and the other is hidden by the lower lashes. After Dr. Galante meticulously sutures the incisions, ointment is applied and the patient recovers at home. Recovery is generally rapid and uneventful.

A brow lift or forehead lift is always performed under general anesthesia. An incision is made over the top of the head from ear to ear and the muscle in the forehead area is lifted and excess skin is removed. Very fine sutures are inserted, creating a fairly invisible scar hidden by the patient’s hair.

If you are considering eyelid rejuvenation, visit with me at either my Valparaiso or Schererville plastic surgery office for a private consultation. Just call us at 800-721-3244 or complete our discreet online consultation form.

To your Health & Beauty,
Gus Galante, MD
Board Certified Plastic Surgeon in Indiana, Chicago, Schererville, Munster, Valparaiso


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