Blepharoplasty
What is Blepharoplasty?
Over time, many people develop excess eyelid skin. Eyelid skin is the thinnest skin of the body, so it tends to stretch. Blepharoplasty, or eyelid surgery, is a procedure to remove 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.
What happens before surgery?
Dr. Stark will give you specific instructions on how to prepare for surgery, including guidelines for drinking, eating, medications, etc. The surgery will be performed in a surgical center and will be done as an outpatient.
What happens during surgery?
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.)
Blepharoplasty usually takes approximately 45 minutes, depending on the extent of the surgery. In a typical procedure, Dr. Stark will make incisions following the creases of your upper lids. The incision may extend into the crow's feet or laugh lines at the outer corners of your eyes. Working through the incision, he separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incision is 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, you may be a candidate for 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.
What happens after surgery?
After surgery, Dr. Stark will place an antibiotic ointment over the incision and then place a cool compress over your eyes Your eyelids may feel a little sore as the anesthesia wears off, but you will be given a prescription for pain mediation to control any discomfort. If you feel any severe pain, call immediately.
You will be instructed 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 resolves by the end of the second week) You'll be shown how to clean your eyes, which may be gummy for a week or so. We may recommend eyedrops, since your eyes may feel dry at first and your eyes may burn or itch.
Your progress will be followed very closely for the first week or two. The stitches will be removed one 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. 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, 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. You will 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.
Am I a candidate for Blepharoplasty?
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.
What are the risks of Blepharoplasty?
Complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection, reaction to the anesthesia and extremely rarely visual loss due to hemorrhage. You can reduce your risks by closely following your instructions both before and after surgery.
The minor complications that occasionally follow blepharoplasty: 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.