Blepharoplasty
Blepharoplasty
Introduction
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. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or brow lift. 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.
Who is the best candidate for eyelid surgery?
The ideal candidates to undergo a blepharoplasty are people looking for an improvement, not for an absolute perfection in their appearance. If you have a good overall health, you are psychologically stable and realistic in your expectations, you would be a good candidate. Most patients are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age. Blepharoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
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.
Cosmetic surgery of the eyelid: preoperative appearance.
Planning your surgery
Good communication between you and your plastic surgeon is essential. In the initial consultation your surgeon will test your vision and assess your tear production, as well as your general health state. You must inform your surgeon if you have any allergy to any medication, if you smoke, if you're taking any vitamins or medication. You should also provide any relevant information from your ophthalmologist or the record of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along. You and your surgeon should carefully discuss your goals and expectations for this surgery. You'll need to discuss whether to do all four eyelids or just the upper or lower ones, and whether any additional procedures are appropriate. Your surgeon will explain the techniques and type of anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved. The catalog of Social Security benefits does not include cosmetic blepharoplasty. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. It is important for you to stop smoking at least one or two weeks before surgery. Carefully following these instructions will help your surgery go more smoothly. In addition, make sure to arrange for someone to drive you home after your surgery, and to help you out for a few days if needed.
The surgery
Blepharoplasty is performed in the operating room, within a clinic or hospital. Normally, it is not necessary to remain in the clinic for more than a few hours after surgery.
Blepharoplasty is usually performed under local anesthesia along with oral or intravenous sedatives or, less frequently, under general anesthesia, depending on the surgeon´s preferences. If the surgery is being performed under local anesthesia with sedation, you'll be awake during the surgery, but relaxed and insensitive to pain. If general anesthesia is used, you'll be sleeping through the entire operation.
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. 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.
In other cases, like in younger patients who only have a pocket of fat beneath the lower eyelids, the surgeon may perform a transconjunctival blepharoplasty of the lower eyelids. In this procedure the incision is made inside the lower eyelid, leaving no visible scar.
Highlight of the skin areas that will be removed.
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Excess fat and skin will be removed during surgery
Resulted incisions.
Returning to normality
After surgery, the surgeon will probably lubricate your eyes with ointment and, in some cases, may apply a bandage. You may feel some discomfort in your eyelids; if you do, you can easily control it with the pain medication prescribed by your surgeon (if you feel any severe pain, call your surgeon immediately). You will have to keep your head elevated for several days, and use cold compresses to reduce swelling and bruising. You'll be shown how to clean your eyes, and how to apply ophthalmic eye drops to keep the eyes hydrated, in case you need it. 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.
Most patients who undergo blepharoplasty start reading or watching television in 2 to 3 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 are ready to go back to work in a week to 10 days; then, you'll probably be able to wear makeup to hide the bruising that remains. It may be necessary for you to wear sunglasses and a special sunblock made for eyelids when you go out. You will have to keep your activities to a minimum for 3 to 5 days, and to avoid more strenuous activities for about 3 weeks.
In transconjunctival blepharoplasty the incision is made through the conjunctiva.
Are there risks? Are there any guarantees?
When eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery. The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring. Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.
The results
Your scars may remain slightly pink for first months after surgery. Eventually, though, they'll fade to a thin, nearly invisible white line. The results of your blepharoplasty, the more alert and youthful look, will last for years. For many people, these results are permanent.
Postoperative appearance.
Eyelid surgery: summary
Esthetic blepharoplasty is a procedure destined to correct the signals of eyelid aging: sagging skin, drooping upper lids and puffy bags below your eyes and in the inner portion of the superior eyelids.
The surgery is performed as an isolated procedure or as part of another surgery, usually a face lift. Depending on this, the operation is performed with local or general anesthesia.
Surgery starts with an incision in the skin of the eyelids to release and remove the excess skin and orbicularis muscle. Next, the right amount of fat is removed in order to eliminate the lid bags. Finally, the skin is sutured.
After the operation, which usually lasts for an hour and a half, apply ophthalmic ointment and a very cold compress with saline solution in order to reduce discomfort and inflammation. However, it is normal that swelling and bruising of the eyelids persist during the first week. Most patients can begin living their normal life in about 10-12 days.
Sometimes, after blepharoplasty, you may present some difficulty in sight accommodation, which disappears 2-3 weeks after the intervention. It may also develop conjunctivitis and subconjunctival hematoma which will disappear quickly with adequate treatment. In the first days after the surgery you may not be able to completely close your eyelids during sleep; this is normal, and when the orbicularis muscle recovers its tone (possibly with the help of appropriate exercise) it will function normally. The result of the surgery is very favorable and lasting, and, in general the bags of the eyelids usually do not recur.
The information contained on this page cannot, and does not replace the information provided individually by your plastic surgeon. In case of doubt, your plastic surgeon will provide appropriate clarifications. If you are planning to undergo an intervention or Aesthetic Plastic Surgery, see a specialist in Plastic, Reconstructive and Aesthetic Surgery.
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