Overview

Blepharoplasty

Every year, one hundred thousand men and women choose blepharoplasty to improve the way they look. Droopy eyelids can make you look older and can also impair vision. Blepharoplasty corrects these problems and also removes puffiness and bags under the eyes that make you look worn and tired. This procedure cannot alter dark circles, fine lines and wrinkles around the eyes, nor can it change sagging eyebrows.

Though blepharoplasty is often performed as a single procedure, your surgeon may also recommend a browlift, facelift, or skin resurfacing to achieve the best results. If you are wondering how blepharoplasty can change the way you look, you need to know how eyelid surgery is performed and what you can expect from this procedure.

This pamphlet can address many common questions and provide you the information to begin considering blepharoplasty. Successful cosmetic surgery is a result of good rapport between patient and surgeon. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. Your surgeon can answer specific questions about your specific needs.

As with all cosmetic surgery, good health and realistic expectations are prerequisites. Blepharoplasty removes the excess fat, muscle, and skin from both upper and lower lids. The results can be a refreshed appearance, with a younger, firmer eye area. People with circulatory, ophthalmological, or serious medical conditions must rely on the diagnostic skills of their own personal specialists to determine whether blepharoplasty is an option to consider.

The patient must also make the commitment to follow the pre-surgical and post-operative instructions of the surgeon. During the pre-surgical consultation, you will be examined or asked to answer queries concerning vision, tear production, use of lenses, and your desires for surgery. Your surgeon will explain what you can expect from blepharoplasty and take a complete medical history.

Factors to be weighed include age, skin type, ethnic background, and degree of vision obstruction. Furthermore, you can expect an open and honest exchange between you and your surgeon, which will establish the basis for a successful outcome. After a mutual decision is made by both you and your surgeon, the technique indicated for your individual surgery will be discussed. The type of anesthesia, the surgical facility, any supportive surgery, and the risks and costs inherent in the procedure will be outlined.

In upper eyelid surgery, the surgeon first marks the individual lines and creases of the lids in order to keep the scars as invisible as possible along these natural folds. The incision is made, and excess fat, muscle, and loose skin are removed. Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar. In lower eyelid surgery, the surgeon makes the incision in an inconspicuous site along the lashline and smile creases of the lower lid. Excess fat, muscle, and skin are then trimmed away before the incision is closed with fine sutures.

Eyelid puffiness caused primarily by excess fat may be corrected by a transconjunctival blepharoplasty. The incision in this case is made inside the lower eyelid, and excess fatty material is removed. When sutures are used to close this kind of incision, they are invisible to the eye. They are also self-dissolving and leave no visible scar. Under normal conditions, blepharoplasty can take from one to two hours.

Immediately after the surgery has been completed, your surgeon may apply tiny sterile bandages. This is not done for transconjunctival blepharoplasty. It is not crucial that the eyes be covered. However, an ointment to prevent dryness of the eye area may be used. A certain degree of swelling and bruising is normal. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort.

Your surgeon will prescribe medication for discomfort. For a week and a half following blepharoplasty, you will clean the eye area (the eyes may feel sticky, dry, and itchy). Eyedrops may be recommended. Your surgeon will also list activities and environments to avoid in the weeks immediately following surgery. The stitches will be removed in three to five days after surgery. Self-absorbing stitches will dissolve on their own.

Cosmetic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, cosmetic surgery can help change how you feel about yourself.

FAQ's

  • What is a Blepharoplasty? The commonest eyelid procedure is known as a blepharoplasty. A blepharoplasty reduces fat and removes excess skin and muscle from the upper and lower eyelids. Other procedures to improve the lids include - browlift, double fold creation for Asians and various chemical peels to improve skin quality. If the eyebrows are ptotic (droopy), a blepharoplasty alone will not correct saggy, hooded upper lids. A blepharoplasty in combination with a browlift will produce the best result and the features which make you look older and more tired will be improved.
  • Who are the best candidates for a Blepharoplasty? Blepharoplasty, like other cosmetic procedures, 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 - they must be realistic. The best candidate for a blepharoplasty is physically healthy, psychologically stable, and realistic in his or her expectations. Most patients are 35 or older, but if droopy, baggy eyelids is familial, you may decide to have surgery at a younger age. A blepharoplasty may make you look younger and fresher, and it may enhance your self-confidence in the process. But it can not give you a totally different look, nor can it restore the health and vitality of your youth.
  • What are the risks? All surgery carries some uncertainty and risk. Blepharoplasties are normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is a certified Plastic Surgeon. Nevertheless, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. See the Special Consent to Eyelid Surgery.
  • What happens before surgery? A blepharoplasty is a very individualized procedure and most patients are seen at least twice before surgery. At the initial consultation, we evaluate your face, including the skin and underlying bone. Your eyebrow position, frown muscles and hairline are also assessed. Be honest in discussing your expectations. We will be frank with you, describing the procedure in detail and explaining its risks and limitations. We will also explain the anesthesia used, the location where surgery will be performed and the total costs involved. During this consultation, be sure to tell us about any medications (especially aspirin or other pills that affect clotting), vitamins or other drugs you are taking. Smokers should consider giving up the habit before and after surgery. Then, a complete physical along with blood and urine analysis is arranged. At the next consultation, or informed consent visit, the patient who is a suitable candidate has a chance to discuss the risks again or other details prior to the actual day of surgery.
  • What happens on the day of surgery? The patient should not have had anything to eat or drink after midnight prior to surgery. Pre-op medications should have been taken. Also, transportation and post-op care arrangements should have been made. Most eyelid procedures are performed under deep sedation and local anesthesia. A blepharoplasty usually takes 2-3 hours, but the time required may vary considerably depending on the amount of work being done. During this time, the patient is carefully monitored. At surgery, incisions are made following the natural lines of your eyelids, in the creases of your upper lids, and just below the lashes in the lower lids. For some patients who only have lower lid excess fat, the approach may be transconjunctival (incision is made on the inner side of the lid and no visible scar is produced). Redundant tissue is removed and the incisions are then closed with very fine sutures. The patient is then monitored in the recovery area for at least 3 hours prior to discharge. It is mandatory for a patient who has had deep sedation to have someone stay with them the first night after surgery. The medications may affect judgment and co-ordination for 24 hours.
  • What happens after surgery? Follow-up visits vary according to the patient and the procedure. Most patients are seen in 3-5 days post-op for suture removal. Early post-op instructions usually include taking prescribed medications and keeping your head elevated to reduce swelling. There isn't usually too much discomfort after surgery; if there is, it can be lessened with the pain medications prescribed. Severe or persistent pain or a sudden swelling of your lids should be reported immediately. Some numbness of the skin is normal; it disappears in a few weeks or months. Do not expect to look or feel great right after surgery. At first, you are going to look much worse than before. The bruised and puffy skin you see initially will not last long and camouflage cosmetics can be applied shortly after the stitches are removed. Most patients return to regular activities within a couple of days. Lids heal quickly and one is socially acceptable (minimal evidence) within a few weeks. Full healing takes many months and it is during this period that patients should guard against excessive sunlight or strenuous activities which might cause swelling. Once healed, the scars are usually fine lines that are difficult to see, even at close inspection.
  • What are the results? The goal of eyelid surgery is a more alert and youthful look. For many people, the results are long lasting. See the Surgical Art Gallery for examples of this procedure. Back to PSURG Home Page
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    Eyelid ptosis surgery (Eyelid lift surgery, eye lift)

  • What is it? Ptosis surgery is surgery on the upper eyelid to correct an eyelid that is too low, obscuring vision or just looking too low. It may also address loose skin in the eyelids or include a brow lift.
  • Who has a blepharoplasty? Men, women and occasionally children with an upper eyelid that is hanging too low. While often only one side is affected, in older people both sides may be affected.
  • Am I suitable? You need to be sensible, honest about your reasons, happy with your informed decision, and be as healthy as possible. You should have normal vision (apart from needing glasses) and have no other problems with your eyes. The reason for your droopy eyelid must be one that has a surgical cure, and not due to a medical condition. Dr.Chaudhari can usually assess this but you may also need to see an ophthalmologist.
  • What would stop me from having the surgery? You should not be smoking, under stress when making your decision, or have a medical condition that would make surgery unsafe.
  • How is it done? Ptosis surgery is done in a fully equipped operation theatre. The type of surgery depends on your specific form of ptosis. The commonest form requires repair or tightening of the eyelid opening mechanism through an incision in the upper eyelid. Occasionally some skin is removed and the upper eyelid fold recreated.
  • What are the benefits? This is entirely a personal matter, but if your eyelids interfere with vision or look asymmetric then surgery may help a lot.
  • What are the risks? All surgery carries some element of risk. You can minimize your risk by being as healthy as possible and as psychologically prepared as possible, by selecting an experienced and qualified surgeon, and giving yourself a stress free time during which to recover. Despite this there are some risks that you will need to discuss. The most common of these is some residual mild asymmetry after surgery, which can usually be corrected within a few days with a minor adjustment. There are other risks common to all surgery, and you should be aware of these.
  • Are there scars? The incisions for the surgery are always present, but fade over the first six to twelve months. As a rule the incision lines are inconspicuous unless specifically searched for, and seem to fall naturally into the fold for the upper eyelid.
  • How long am I in hospital for? Usually after eyelid surgery you can go home the same day. While not particularly painful, some people are uncomfortable the first night. You will be given plenty of medication if it is required to keep you comfortable.
  • How long will I need to recover? This varies but usually ranges from one to two weeks. You must not drive until you are fully recovered from both the anaesthetic and the discomfort of surgery so as you are fully capable. If in doubt, don't.
  • Do I need anything else after surgery? No. It may help to use gentle cool compresses for the first few hours, and some eye lubricating ointment may be required while your eyelid gets used to its new position.
  • Will I need to be seen after surgery? Yes. We will keep in close contact with you by telephone for the first few days and then will see you about five days after surgery, then at three weeks, then at three months. You are of course welcome to call or visit anytime with any concerns.
*Disclaimer - Results may vary from person to person.