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BLEPHAROPLASTY
(Eyelid
Surgery) |
Eyelid surgery (technically called
blepharoplasty) is a procedure to remove fat
- usually along with excess skin and muscle
from the upper and lower eyelids. Eyelid
surgery can correct drooping upper lids and
puffy bags below your eyes - features that
make you look older and more tired than you
feel, and may even interfere with your
vision. However, it won't remove crow's feet
or other wrinkles, eliminate dark circles
under your eyes, or lift sagging eyebrows.
While it can add an upper eyelid crease to
Asian eyes, it will not erase evidence of
your ethnic or racial heritage.
Blepharoplasty can be done alone, or in
conjunction with other facial surgery
procedures such as a facelift or browlift.
If you're considering eyelid surgery, this
information will give you a basic
understanding of the procedure-when it can
help, how it's performed, and what results
you can expect. It can't answer all of your
questions, since a lot depends on the
individual patient and the surgeon. Please
ask your surgeon about anything you don't
understand.
The best
candidates for eyelid surgery
Blepharoplasty can improve your vision by
preventing the drooping lens from minimizing
your field of vision. It will also enhance
your appearance and your self-confidence,
but it won't necessarily change your looks
to match your ideal. The best candidates for
eyelid surgery are men and women who are
physically healthy, psychologically stable,
and realistic in their expectations. Most
are 35 or older, but if droopy, baggy
eyelids run in your family, you may decide
to have eyelid surgery at a younger age.
As people
age, the eyelid skin stretches, muscles
weaken, and fat accumulates around the eyes,
causing "bags" above and below.
A few medical conditions make blepharoplasty
more risky. They include thyroid problems
such as hypothyroidism and Graves' disease,
dry eye or lack of sufficient tears, high
blood pressure or other circulatory
disorders, cardiovascular disease, and
diabetes. A detached retina or glaucoma is
also reason for caution; check with your
ophthalmologist before you have surgery.
The
surgeon closes the incisions with fine
sutures, which will leave nearly invisible
scars.The
initial consultation with your surgeon is
very important. The surgeon will need your
complete medical history, so check your own
records ahead of time and be ready to
provide this information. Be sure to inform
your surgeon if you have any allergies; if
you're taking any vitamins, medications
(prescription or over-the-counter), or other
drugs; and if you smoke. (Note: Most
insurance policies don't cover eyelid
surgery, unless you can prove that drooping
upper lids interfere with your vision. Check
with your insurer.)
Don't hesitate to ask your doctor any
questions you may have, especially those
regarding your expectations and concerns
about the results.
Types of
anesthesia
Eyelid surgery is usually performed under
local anesthesia - which numbs the area
around your eyes - along with oral or
intravenous sedatives. You'll be awake
during the surgery, but relaxed and
insensitive to pain. (However, you may feel
some tugging or occasional discomfort.) Some
surgeons prefer to use general anesthesia;
in that case, you'll sleep through the
operation.
The
surgery
Blepharoplasty usually takes one to three
hours, depending on the extent of the
surgery. If you're having all four eyelids
done, the surgeon will probably work on the
upper lids first, then the lower ones.
Underlying
fat, along with excess skin and muscle, can
be removed during the operation.In
a typical procedure, the surgeon makes
incisions following the natural lines of
your eyelids; in the creases of your upper
lids, and just below the lashes in the lower
lids. The incisions may extend into the
crow's feet or laugh lines at the outer
corners of your eyes. Working through these
incisions, the surgeon separates the skin
from underlying fatty tissue and muscle,
removes excess fat, and often trims sagging
skin and muscle. The incisions are then
closed with very fine sutures.
If you have a pocket of fat beneath your
lower eyelids but don't need to have any
skin removed, your surgeon may perform a
transconjunctival blepharoplasty. In this
procedure the incision is made inside your
lower eyelid, leaving no visible scar. It is
usually performed on younger patients with
thicker, more elastic skin.
After your
surgery
In a
transconjunctival blepharoplasty, a tiny
incision is made inside the lower eyelid and
fat is removed with fine forceps. No skin is
removed, and the incision is closed with
dissolving sutures.After
surgery, the surgeon will probably lubricate
your eyes with ointment and may apply a
bandage. Your eyelids may feel tight and
sore as the anesthesia wears off, but you
can control any discomfort with the pain
medication prescribed by your surgeon. If
you feel any severe pain, call your surgeon
immediately.
Your surgeon will instruct you to keep your
head elevated for several days, and to use
cold compresses to reduce swelling and
bruising. (Bruising varies forn person to
person: it reaches its peak during the first
week, and generally lasts anywhere from two
weeks to a month.) You'll be shown how to
clean your eyes, which may be gummy for a
week or so. Many doctors recommend eyedrops,
since your eyelids may feel dry at first and
your eyes may burn or itch. For the first
few weeks you may also experience excessive
tearing, sensitivity to light, and temporary
changes in your eyesight, such as blurring
or double vision.
Your surgeon will follow your progress very
closely for the first week or two. The
stitches will be removed two days to a week
after surgery. Once they're out, the
swelling and discoloration around your eyes
will gradually subside, and you'll start to
look and feel much better.
Getting
back to normal
After
surgery, the upper eyelids no longer droop
and the skin under the eyes is smooth and
firm.You
should be able to read or watch television
after two or three days. However, you won't
be able to wear contact lenses for about two
weeks, and even then they may feel
uncomfortable for a while.
Most people feel ready to go out in public
(and back to work) in a week to 10 days. By
then, depending on your rate of healing and
your doctor's instructions, you'll probably
be able to wear makeup to hide the bruising
that remains. You may be sensitive to
sunlight, wind, and other irritants for
several weeks, so you should wear sunglasses
and a special sunblock made for eyelids when
you go out.
Your surgeon will probably tell you to keep
your activities to a minimum for three to
five days, and to avoid more strenuous
activities for about three weeks. It's
especially important to avoid activities
that raise your blood pressure, including
bending, lifting, and rigorous sports. You
may also be told to avoid alcohol, since it
causes fluid retention.
Click here for some of our patients before and after photos. |
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