The most common cosmetic surgery procedures are eyelid operations and facelifts. In the opinion of this author they are also the most justified ones.

Eyelid operations and facelifts will not change the character of a face. They will just turn back the time. Both kind of operations will make the patient look younger, just what he or she looked several years before. In contrast, nose and chin operations as they are often requested by Asians will change the expression of a face, often enough not to the better.

A facelift is a much more excessive (and expensive) procedure, compared to eyelid operations. Usually, eyelid operations are recommended before a facelift is considered. The reason: a facelift without an eyelid operation will be much less effective in giving a younger look, as we seem to judge a person's age (consciously or unconsciously) by the presence of bags under a person's eye.

Furthermore, if comparing an eyelid operation and a facelift alone, the effect of the eyelid operation will often be more dramatic, even though it's a lesser procedure.

However, while eyelid operations are a lesser procedure when compared to facelifts, operations particularly on the lower eyelids require a lot of skill on the part of the surgeon. More than is the case with facelifts, lower eyelid operations carry a potential for less than perfect result. A less-than-perfect result can occur if to much skin is removed from the lower lid, so that the lower eyelid skin which covers the eyeball will no longer lie tightly on the eyeball. Rather, there will be a slight gap.

Unfortunately, if this less-than-perfect result is achieved, it doesn't make the person exactly look more intelligent. For lower eyelid operations, one therefore may want to tell a surgeon rather to err on the safe side, meaning to say, to better remove too little, rather than too much excess skin.

Reported the American weekly magazine U.S. News in its edition of October 14, 1996: "The hazards are not trivial. Rudolph, editor of Problems in Aesthetic Surgery, a standard text, says the risk of serious complications for most cosmetic procedures is as high as 2 percent, and some procedures are far more problematic. Up to 20 percent of patients who undergo eyelid lifts for sagging lids and puffy bags come out with "scleral show," according to a recent report in Survey of Ophthalmology--a condition in which too much of the white of the eye is exposed."

Another potential less-than-perfect result of lower eyelid operations are visible scars. While the scars from facelifts are hidden behind one's ears, and can easily be covered by hair, no such way out exists for the scars that could remain after a lower eyelid operation.

The scar for an upper eyelid operation is practically never visible. I lies in the fold of the upper eyelid.

After a lower eyelid operation, there will always be a slight scar. It will run close to the hairline of the lower eyelid and extend to the temples. A skillful surgeon will make it appear as a normal wrinkle.

Surgeons will usually tell their patients that the results of an eyelid operation will be good for 5 to 10 years. It may indeed take 5 to 10 years to become as bad as it was before the operation. However, a certain degree of deterioration will already be visible after some 2 or 3 years, and a good number of people will not wait 5 years to have a follow-up operation.

The reason is that they appreciate their good looks much more the second time around. So, when they do see eye bags reoccur after an initial operation, they are often even more eager to have them removed than they were before the first operation. People sort-of get addicted to their youthful looks.

Because of this, men and women who have had eyelid operations done will often take the next step as well, which is a facelift (provided they can afford it).

Facelifts are much more extensive operations than are those required for eyelids. Eyelid operations are often done in an operating room at a surgeon's practice. Facelifts, to the contrary, are almost always done at the surgery facility of a hospital. Eyelid operations typically take less than two hours. Facelifts often enough require around eight hours. Eyelid operations are practically almost done under local anaesthesia. For facelifts, it's usually full anaesthesia (though this is not necessary, and people usually go well through operations on a combination of local anaesthesia and tranquilizers such as diazepam).

The effect of a good facelift will be rather subtle. People one hasn't met for a few months shouldn't notice any real change in one's appearance. They should just comment that one looks good and healthy.

At what age should facelifts and eye operations be performed? Well, one definitely shouldn't wait until one is in one's sixties. Not only are major procedures such as facelifts less well tolerated than at a younger age. The effect will also be too drastic to be socially acceptable.

If a person in one's sixties has a full-scale facelift, his or her social environment will almost certainly be aware of the fact that a facelift has been performed. This clearly lessens the result that one wants to achieve. The basic difference between make-up and cosmetic surgery is the degree to which people believe that one's good looks are for real. However, the knowledge of one's facelift, or its visibility, will put the better looks resulting from the procedure on par with a good make-up, and therefore somehow diminish its impact.

The early or mid-fourties are a good timing to start with cosmetic operations. For people who are concerned about their continous good looks, eyelid operations and facelifts will not be one-time events. Just as with eyelid operations, people often want repeat facelifts. It's not that the good effect of a facelift would be lost after a few years. People who have had facelifts will look younger for many, many years, compared to what they would look like without the facelift.

Repeat facelifts are requested not because the results of a previous facelift would be lost but rather because a follow-up facelift will again improve one's appearance. After all, the idea is not just to look 10 or 15 years younger than one's actual age; the idea is to look around 30 at the age of 40, and to look around 30 at the age of 50, and to look around 30 at the age of 60.