BLEPHAROPLASTY, EYELID SURGERY
Eyes are a prominent facial feature, which aids in the portrayal of emotion during communication. It is the anatomical relationship of the surrounding tissues and skin, rather than the eyes themselves, that conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Age, sun exposure and hereditary factors all contribute to wrinkles, deep lines and puffiness around the eyes. The tissues around the eye weaken with age and allow fat around the eye to protrude and cause bags under the eyes.
The aging process can cause unwanted changes in expression, causing us to look permanently fatigued and cause a disconnect from how we want to be perceived to others. These changes in appearance can cause us to appear sleepy, run down, older and sometimes even cause visual impairment. Many people suffer from excess upper eyelid skin that causes visual limitations. Many women find that it becomes more difficult placing makeup on the upper eyelid due to the excess skin as they age. An eyelid lift, or blepharoplasty, is designed to restore a more youthful and rested appearance to your eyes. It may involve the upper lids, the lower lids, or both. Sometimes upper eyelid heaviness is not due to the upper eyelid itself but due to a heavy forehead and eyebrows that have dropped. In these cases we perform a brow lift instead of or in conjunction with an upper blepharoplasty to achieve our desired result. We are experienced in both simple and advanced blepharoplasty procedures. During the consultation we will evaluate your concerns, your anatomy and discuss what surgical options we recommend and discuss expected outcomes and post op care.
Upper Eyelid Blepharoplasty:
An incision is made in the crease of the upper eyelid. Once healed, it is not noticeable when the eye is open or during blinking. Upper eyelid skin and occasionally muscle or fat is removed to allow a natural beautiful upper eyelid. Occasionally you may have a sleepy upper eyelid, this is a result from weakening of the muscle that keeps the eyelid open. In some cases we perform an eyelid ptosis repair to help open the eyelid to allow more of the eye to be seen.
Lower Eyelid Blepharoplasty:
On the lower eyelid, the incision is made along the lash line, and is hidden by lashes when healed. This allows us to remove excess wrinkled skin under the eye. When patients suffer from bags under their eyes an incision is made just inside the eyelid and we can remove excess fat that is causing the bags under the eyes. With these techniques we are able to obtain smoother lower eyelid skin and contour. These results can be dramatic and help eliminate the tired appearing lower eyelid bags. Some patients have a weakened lower lid attachment that results in a weak and floppy lower lid. These patients will require a canthopexy or lower lid supporting procedure to keep the lower eyelid strong and in the correct position.
Laser resurfacing of the eyelids is another technique used separately or in conjunction with eyelid surgery to obtain amazing results. If eyelid heaviness is minimal laser resurfacing of the eyelids may delay the need for a surgical blepharoplasty or can be done to touch up the skin from a blepharoplasty performed years ago. It results in significant tightening of the skin around the eyes, but will not effect bulging fat around the eyes.
Your facial cosmetic surgeon is happy to evaluate and answer questions about which procedure is right for you.
This procedure along with many facial cosmetic surgeries can be performed under local anesthesia although is typically done with IV sedation or general anesthesia. This is to assure that patients are comfortable and don’t have to worry about watching someone do surgery on their eyes. The procedure is technique sensitive and this allows us to be able to focus on the procedure to obtain the best most predictable results possible.
This procedure is performed on an outpatient basis in our office or a surgery center. It is important to arrange for care after the surgery. Someone must drive you home and be available to care for you for the first 24 hours. Most patients will experience dry or itchy eyes for the first 1-3 weeks. These are typically managed with lubricating eye drops. Patients with a history of dry eyes will experience worsened symptoms for a few months following surgery and may have permanently worsened dry eyes in some cases. Please discuss a history of dry eye symptoms or watering eyes along with any eye problems with you surgeon during consultation.
Complications are unlikely when performed by a facial surgeon with extensive experience in blepharoplasty, but we are prepared to manage them and they rarely affect final results. These include: Worsened dry eye symptoms, watery or itchy eyes, bleeding, swelling, delayed wound healing, infection, drooping of eye upper or lower eyelid, asymmetry, or double vision. In rare cases referral to an opthalmologist is warranted.
RECOVERY: WHAT TO EXPECT
The area surrounding the eyes will remain swollen in the days following the surgery. It should begin to subside after a few days. Some vision blurring is normal and can last a few weeks. Do not obtain a new lens prescription for 3 months following the procedure as your prescription will not be accurate and will return to normal within a few months.
The stitches will be removed at one week. Swelling and bruising will persist for about 1-2 weeks, but you can begin wearing makeup to help conceal these concerns. You may expect to resume normal activity within a week to 10 days, and start enjoying your new rested look within approximately 10-14 days. It may take about 4-6 months for the scars to lose their redness and to see final results.
Some mild wrinkling tends to recur later in life as we continue to age, however it is unlikely that the “bags” will recur because the fat has already been removed. Deeper wrinkles around the outer eye or (Crows Feet) extend onto the temple and are not greatly affected by the eyelid lift. These areas may be treated with laser resurfacing and Botox® or other injectable neurotoxins.