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If you're considering 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 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.
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.
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.
ALL SURGERY CARRIES SOME UNCERTAINTY
AND RISK
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. Tiny whiteheads
may appear after your stitches are taken out; your surgeon
can remove them easily with a very fine needle.
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.
PLANNING YOUR SURGERY
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.
In this consultation, your surgeon or a nurse
will test your vision and assess your tear production. 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, whether skin as well as fat will be removed,
and whether any additional procedures are appropriate.
Your surgeon will explain the techniques and
anesthesia he or she will use, the type of facility where
the surgery will be performed, and the risks and costs involved.
(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.
PREPARING FOR YOUR SURGERY
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.
Carefully following these instructions will help your surgery
go more smoothly.
While you're making preparations, be sure to
arrange for someone to drive you home after your surgery,
and to help you out for a few days if needed.
WHERE YOUR SURGERY WILL BE PERFORMED
Eyelid surgery may be performed in a surgeon's office-based
facility, an outpatient surgery center, or a hospital. It's
usually done on an outpatient basis; rarely does it require
an inpatient stay.
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.
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
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 from 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
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.
YOUR NEW LOOK
Healing is a gradual process, and your scars may remain slightly
pink for six months or more after surgery. Eventually, though,
they'll fade to a thin, nearly invisible white line.
On the other hand, the positive results of
your eyelid surgery-the more alert and youthful look-will
last for years. For many people, these results are permanent.
Back to Procedures
Information provided by American
Society of Plastic Surgeons. |
