The No-Bleph Bleph?

is there such a thing? I humbly submit an argument

Welcome readers, old and new!

Please tap the ❤️ above for a reminder that it’s never to late—or too early—to connect with your loving self.

Recently, I’ve rediscovered the pleasures of humility. I’m being only a little sarcastic, as the pleasure/pain principle (as it relates to humility) feels most like a loving breakup. Which I guess in a way it is.

I’ve been induced to let go, reluctantly, of my attachment to endless walking. One friend visiting me in Tokyo remarked he felt like he had to endure a forced march every morning; L, my accidental muse, suggested she felt uncomfortably competitive when she read I walk eight to 10 miles a day. (I typically don’t do it all at once.) Anyway, that’s over for now. I have tendonitis in my right glute, which is no picnic—especially a picnic I’d have to walk to—so I’m laying off the miles for a while.

“What causes this?” I asked the doctor after she’d examined me, nodding in recognition at my wince each time she prodded what turned out to be a painful spot. “Too much walking,” she said. “It’s very common.” She didn’t say, “You’re 75. Too much walking at 75,” for which I’m grateful, but I suspect that’s part of the problem.

So I’m limping a fine line between pushing myself, or even just enjoying the exercise I’m accustomed to, and appreciating new awareness of my body’s limits. I suspect many HNTFUYF-ers are familiar with the effort that goes into finding ways to maintain progress while walking this line; please share your wisdom in the comments. 🙏

Call me crazy, but I think we may have hit peak Instagram/Mar-a-Lago face and are now trending toward a more… human look. Why this conclusion? You can read what I wrote about it in Allure.

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A recent post about blepharoplasty (upper and lower eyelid surgery) generated many reader questions, among them one about the effect of cataract surgery on blepharoplasty.

Q: Did anyone’s surgeon mention waiting to do blephs until after cataract surgery? My eye doctor said cataract surgery can undo some bleph work, resulting in the need to re-do it. I saw my eye doctor because one of my upper lids is drooping more than the other, giving me an unfortunate “Bill the Cat” look (my husband says that’s not true, but I am sensitive). I have mild cataracts-in-waiting at the moment and am trying to make it to 65 (I’m 63) for Medicare before I do anything. Does this come up when discussing upper eyelid surgery?

A: Oculofacial plastic surgeon Robert Schwarcz’s response:

Cataract surgery doesn’t reverse the tissue changes from a prior blepharoplasty. While it can temporarily affect eyelid position or eye measurements, which may influence how the lids look, there’s no evidence that it undoes the actual surgical removal of skin or fat. However: Cataract surgery can temporarily change eyelid function (e.g., brief ptosis or upper eyelid droop) that might make an operated-on lid look different for a while.

There’s no evidence that cataract surgery dissolves or undoes the prior excision and re-contouring done during blepharoplasty.

In some individual cases, a patient might feel that their eyelid position appears different after cataract surgery because of swelling, muscle effects, or how the eye anatomy settles post–cataract procedure. These are functional changes, though, not a reversal of cosmetic surgery.

Cataract surgery can affect eyelid position temporarily. Scientific evidence shows that ptosis can develop after the surgery due to use of the instrument that holds the eyelids open and surgical manipulation of the eyelid muscles, but it’s typically resolved about six months after surgery.

Upper eyelid surgeries do influence corneal shape and measurements. Upper blepharoplasty changes eyelid pressure on the cornea and can alter corneal curvature. This can slightly change the measurements used to calculate the power of the intraocular lens (IOL) for cataract surgery. In one study, upper eyelid blepharoplasty altered corneal curvature enough to change IOL power calculations in some patients, though on average the changes weren’t clinically significant.

Timing matters. Because changes in eyelid position from bleph can affect how the cornea ‘presses’ on the surface, surgeons often advise waiting (a general recommendation might be allowing at least three months between blepharoplasty and cataract surgery, so eyelid-induced corneal changes stabilize).

Patients occasionally decide to have additional eyelid surgery for their own reasons, but this isn’t because cataract surgery ‘undid’ the blepharoplasty. It’s usually because eyelids continue to age or change independent of cataract surgery.

Have we exhausted our questions about blepharoplasty? I hope so!

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Beckoning behind the paywall, recommendations for treating the eye area when a bleph isn’t on the menu.

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