Cosmetic dentistry

Keep your eyes open: A look at the second most popular plastic surgery procedures in America

I have always believed that low, sultry eyelids are a form of beauty

Lauren Bacall made a career out of it! Eyes down, then a flicker upwards, and two arrows pierced Humphrey Bogart’s heart. Can you whistle, too? Zandaya certainly can. Now, this smoldering sensation can be found in numerous high-end fashion ads, gracefully positioning eyes at half-mast. Terra Banks, the modern master of “smizing” coined on “America’s Next Top Model,” has transformed the ordinary into alluring, using purposeful eye smirks, strategically minimizing wrinkles.

Eyes are often deemed the windows to the soul, crucial for flirting, connecting, and engaging in both personal and professional realms. Last summer, social media was flooded with discussions about lifting and opening the upper eyelids – not a trivial matter. The allure of low lids – where is it? What’s with the whole wide-eyed thing?

Perhaps this isn’t breaking news. Maybe you’ve noticed your face in the black mirror of your phone, and it looks a bit… tired? Especially around your eyes? Maybe you didn’t even think your eyes were an issue, but now you’re wondering if they can be subtly, strategically, slightly improved. Just for myself?

To avoid thinking this is merely a social media scheme, eyelid lifts or blepharoplasty are the second most popular cosmetic surgery in the United States after rhinoplasty. Upper eyelids can trim excess skin, while lower eyelids are often treated for under-eye bags by shaping or repositioning fat.

Eyelid surgery, known as double eyelid surgery or a procedure that creates a fold on the upper eyelid, has been the most common cosmetic surgery in Asia for decades. Invented by a Japanese surgeon named Sushruta in 1896, it has long been thought of as an attempt to transform Asian eyes into a more Western appearance. However, as Elise Hu, author of the new book “Flawless: Perceptions of Beauty in Korea’s K-Pop Capital,” points out, Western influence was relatively minimal when developing the procedure. Sushruta himself stated that his goal was to emulate the Japanese beauty ideals established by ukiyo-e artists and novelists. As Hu noted in an email to me, Sushruta “said he wanted to open up the eyes to make them look more ‘lovely.'”

Regardless of the historical basis of the surgery, people from various backgrounds are looking to undergo some form of eyelid surgery. Robert Schwarcz, a double-board-certified oculoplastic surgeon, told me that in the past 15 to 20 years, he has performed eyelid surgery 40 to 50 times per month, mostly for patients aged 40 and above. However, in recent years, there has been a noticeable increase in patients in their 30s seeking consultations. He attributes this to the prevalence of Zoom grid settings. “You’re now comparing your face to your colleagues’ faces even when you’re supposed to be working,” he says. A Hollywood makeup artist friend told me she noticed several clients with noticeably tight upper eyelids, including some very prominent faces. “Unless you’re doing their makeup, you would never notice,” she says. “They went on vacation and came back looking… amazing.”

The natural crease of the eyelid often conceals any potential scars, and compared to the downtime required for other cosmetic procedures, the recovery period is relatively short. “People really want results where nobody can tell they’ve done anything,” oculoplastic and reconstructive surgeon Kami Parsa told me in his Beverly Hills office, where his services have a one-year waiting list. Schwarcz says eyelids are “a toe in the water,” and while in the early years of his career, he might have told someone in their 30s to come back in 10 years, now he tends to listen to what they’re pursuing. He told me that eyelids are the frame of the eyes: “If you have two side-by-side photos, and the frames look different, it looks off. Parsa calls it a “continuous, gentle mechanical trauma,” I call it being alive – makeup, makeup removal, washing your face, rubbing your eyes – can harm the thinnest skin on the body. Parsa points out that, like any type of baggage, some people are genetically predisposed.

But wait; not everyone should have eyelid surgery. Those who do should carefully choose their surgeon. “The major concern is when a surgeon is too aggressive and removes too much skin and orbital fat, which can limit eyelid closure and lead to issues with dry eyes and ocular surface diseases,” Emily Schorr, an ophthalmologist in Nevada, told me. Both conditions can severely affect vision and corneal health and make you look permanently startled (and startled). For its worth, she believes a bit of fullness around the eyes adds a pleasing youthful effect unless there is a noticeable sagging affecting your field of view.

The knife isn’t the only option. Non-surgical alternatives have recently surged: Upneeq is an FDA-approved prescription eye drop that treats ptosis or “upper lid sagging” by stimulating the muscles that operate the upper eyelid, lifting it by about a millimeter, roughly equivalent to the length of an afternoon. Influencers have popularized it, capturing the effect in ecstatic videos. Upneeq affects blood pressure and may increase the risk of glaucoma, requires a prescription but can be easily obtained through an online assessment. It’s easy to see it as a new Visine, a quick fix that’s eye-opening and brightening, but “it’s not something I would do every day,” Parsa told me. “If someone is going to a social event and wants to give it a try, by all means.”

I certainly am uncertain about surgery, and if not ready to take on the challenge, that’s fine. This is how I find myself bending over towards the bathroom mirror, playing around with a few small nail-sized stickers until I get it right. It doesn’t take long to understand why most people prefer the skilled hands of a professional. “How do I look?” I’d ask my partner once I emerge, eyelids artificially fixed. I attempt a (sticky) smize. “Oh!” he says, his eyes suddenly (naturally) widening. “Everything is… okay?” He later tells me that while I look “alert,” my gaze is more like a “hostage situation” than “hot.” Turns out, I’m not ready for eyelids just yet. Looks like I’ll just need to keep my eyelids in their original place. Alexa, play “Bette Davis Eyes.”

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