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Surgeries / Procedures

• Abdominoplasty
• Blepharoplasty
• Brachioplasty
• Breast Augmentation
• Buttock Augmentation
• Calf Augmentation
• Cheek Reduction Surgery
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• Rhinoplasty

 

Blepharoplasty is surgical modification of the eyelid. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery.

Blepharoplasty is often done as an elective surgery for cosmetic reasons. Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid "bags" and reduce the wrinkling of skin.

Blepharoplasty is sometimes needed for functional reasons. When an advanced amount of upper eyelid skin is present, the skin may protrude over the eyelashes and causes a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision.

Eyelid surgery (blepharoplasty or eye lift) is a popular cosmetic plastic surgery to remove excess skin, fat or muscle from droppy upper and lower eyelids. Blepharoplasty improves baggy skin under the eyes, sinking upper eyelids or drooping eyelashes that impair vision. The surgery can also treat a medical condition called ptosis (drooping eyelid), which is caused by poor muscle tone or nerve damage. Ptosis causes the eyelids to hang very low and block vision.

Why Eyelid Surgery?

As we age, excess skin forms in the eye area, and the skin loses elasticity. Fatty tissue can accumulate under the skin. Your eyes will "look older" because these aging processes leave the eyes appearing tired, wrinkled or puffy. Even with good skincare and eyecare, wrinkles, puffiness and drooping eyelids will catch up to you. Genetic factors and body chemistry can cause these aging effects in younger people. Plastic surgery may restore a youthful and refreshed appearance to your eyes.

Is Eyelid Surgery Right for Me?

The best candidates for blepharoplasty are physically healthy, emotionally stable and well-informed about the procedure. Ideal candidates are typically at least 35, though genetic factors may indicate treatment for younger people. Candidates may be excluded if they have any of the following conditions: dry eyes, high blood pressure, hypothyroidism, cardiovascular disease, diabetes, glaucoma, or Graves' disease. Your anatomy, including bone and supporting structure, may also affect your candidacy.

Any one or combination of the following conditions may indicate that you may be considered a good candidate for eyelid surgery:

• Excess skin obscuring the natural fold of the upper eyelids
• Loose skin hanging down from the upper eyelids, perhaps impairing vision
• A puffy appearance to the upper eyelids, making the eyes look tired
• Excess skin and fine, “crepe paper type” wrinkles of the lower eyelids
• Bags and dark circles under the eyes
• Lower eyelid droopiness

Aesthetic eyelid surgery can usually correct these problems, though other treatments may also need to be considered. Some examples follow. If the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of crow's feet may be accomplished with Botox®, chemical peeling or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with fillers such as Hyaluronic Acid or fat as well as bleaching solution or chemical peel. Your plastic surgeon can provide further information if you have an interest in any of these additional procedures.

How you prepare

Before scheduling blepharoplasty, you need to meet with a plastic surgeon to discuss whether the procedure is likely to work well for you. This meeting generally includes:

• Your medical history. Your surgeon asks questions about conditions you have or have had. Detailed questions may focus on dry eyes, glaucoma, eye-related allergies and other eye problems. Tell the doctor if you have circulatory problems, thyroid problems, diabetes or other serious medical conditions. Your doctor will also ask about your current medications, including over-the-counter medications. Make sure to tell your doctor about any herbal supplements you take, as some of them — including ginkgo, ginseng, garlic and ginger — may cause bleeding problems.
• Photographs. Your eyes will be photographed from different angles. These photos help with planning the surgery and assessing its immediate and long-term effects.
• A discussion of your expectations. An honest discussion will help set the stage for a satisfactory outcome. Be prepared to talk about your motivation for seeking blepharoplasty and what you hope the results will be. Your surgeon can tell you whether your expectations are in line with usual results.

Before blepharoplasty, you'll be asked to:

Stop taking aspirin, ibuprofen (Advil, Motrin, others) and other nonsteroidal anti-inflammatory drugs (NSAIDs), as well as herbal supplements associated with increased bleeding. It's best not to use these medications and supplements for two weeks before and after surgery. Take only medications approved or prescribed by your surgeon.

Avoid exposing your skin to excess sunlight for one week before surgery and two to three months after surgery.

Arrange for someone to drive you to and from surgery if you're having outpatient surgery. Plan to have someone stay with you for the first night after surgery.

The Blepharoplasty Procedure

Your surgeon will make incisions along the line creases of the upper eyelid and possibly along the outer lower rim of the eye's skin. When removing fatty tissue, but not skin, the surgeon may perform a transconjunctival blepharoplasty with an incision inside the lower rim of the eye's skin. These incisions often reach the outer corners of the eyes. The surgeon then divides the fatty tissue and muscle from the skin so that excess skin, fat or muscle can be removed.

Eyelid surgery is often performed under local anesthesia — while you are sedated, numbed and awake — in an outpatient surgery center, surgeon's office or hospital. General anesthesia (meaning, while you are asleep) may be used. Be sure to discuss the appropriate type of anesthesia with your doctor and the anesthesia provider.

Depending on the extent of the procedure, time in surgery may be up to three hours. Patients return home typically within hours of the surgery.

After Eyelid Surgery

Your eyes will likely be lubricated and covered with bandages after surgery. Oral medications will help with pain and discomfort. Report any unmanageable pain to your doctor immediately. The doctor will also prescribe an antibiotic to prevent infection.

You will receive a list of instructions to follow for several days, including:

• the proper way to clean your eyes
• use of cold compresses
• use of lubricating eye drops
• head elevation
• no makeup
• no alcohol
• no television
• no contact lenses

Stitches are removed about a week after surgery. Bruising and swelling will continue to decrease after stitches are removed. Sunglasses and protective sun block are required for several weeks.

Normal activities can resume after about 10 days, though strenuous activities such as lifting, bending and exercise can resume after about three weeks.

Complications and Risks of Blepharoplasty

Following surgery, you may experience tearing, itchy, burning eyes, dry eyes, light sensitivity and blurred or double vision, which can persist for several days. Lubricating eye drops. can relieve these complications. There will also be some swelling around the eyes. Scarring is another possible complication.

Sometimes patients have difficulty closing their eyes when asleep; though rare, this complication can be permanent. The lower lids may appear to be pulled down; this rare condition, called ectropion, may require additional surgery. The eyes may also look somewhat asymmetrical.

As with any surgery, there is a risk of infection or reaction to the anesthesia. You can avoid most complications by choosing the right plastic surgeon and following pre- and postoperative instructions. With proper precautions by the surgical team, complications are typically minimized or prevented.

Results of Your Eyelid Surgery

Aesthetic eyelid surgery has the effect of making you look more rested, refreshed and alert. Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months usually becoming barely visible. The results of aesthetic eyelid surgery are usually long-lasting, but they may be affected by heredity and lifestyle factors. Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur. The skin continues to age, however, and skin laxity along with the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows which mimics a recurrence of drooping upper eyelids. If this happens, correction may require a forehead lift or a secondary eyelid procedure. Even though the aging process continues, patients are usually happy with their appearance for many years following eyelid surgery. Some patients find that they want to make additional improvements at a later time.