Eyelid Surgery (Blepharoplasty)

Background

Your eyes are the most revealing feature of your face. When engaged in conversation, our eyes are the center of attention. Puffiness, dark circles around the eyes, or droopy upper eyelids give the appearance of fatigue and aging. In some individuals, the excess skin of the upper eyelids can actually obstruct the field of vision, which can be dangerous when driving for instance. A surgical correction can remove the excess fat and drooping skin of the upper eyelids, minimize bags under the eyes and tighten the lower eyelid skin. The result is a fresh, youthful, and more rested appearance. Eyelid surgery is performed on men and women of all ages who want to improve their self-image. The following concerns are easily addressed with eyelid surgery, blepharoplasty :

• Upper eyelid:
• Excess skin that hides the natural fold of the upper eyelids
• Loose skin that hangs down from the upper eyelids
• Puffiness in the upper eyelids that creates a tired look
• Lower eyelid:
• Excess skin and fine wrinkles of the lower eyelids
• Puffy "bags" and dark circles

In many instances, excess droopy skin of the upper eyelids is due at least partially to a lowered eyebrow. As we age, gravitational pull along with decreased elasticity of the skin leads to a downward fall or ptosis of the eyebrows. Naturally low set eyebrows may be genetic in some, in which case an endoscopic forehead lift or browlift is necessary at an earlier age. In others, an endoscopic forehead lift may be performed simultaneous to blepharoplasty. It is imperative, however, to address the low eyebrows in addition to blepharoplasty in order to avoid excision of excess skin of the upper eyelid. Returning the eyebrow to its aesthetic position decreases the amount of skin necessary for excision in the blepharoplasty.

Procedure

The procedure is typically performed under light sedation or general anesthesia. Dr. Sayah uses long acting local anesthetics to assure that you are pain free after the procedure.

The incision at the upper eyelids typically begins within the natural crease of the eye's inside corner and extends to the crow's feet or laugh lines. Through this incision, excess skin and fatty tissue are removed. The incision line follows the natural contour of the upper eyelid, and is camouflaged when healed. If the upper eyelids are droopy in addition to having excess skin, the muscles responsible for elevating the eyelid are repaired to achieve correction of upper eyelid position.

There are two components to the lower eyelid surgery depending on your individual needs. The first component is excess skin causing wrinkles or unevenness of the lower eyelid. To address this problem, an incision is made just below your eyelashes and the excess skin is excised. The remaining skin is re-draped over your eyelid and the wound closed to result in a well concealed scar. The second component of the lower eyelid is excess puffiness or bulge due to excess or protruding fat. To address this concern, Dr. Sayah makes an incision at the lower eyelid crease just at the base of the eyelashes, where eyeliner is normally applied, and excessive skin, muscle folds, puffiness, and fatty "bags" are removed. When neither skin nor muscle fold removal is required, puffiness and "bags" can be removed with a hidden incision made inside the lower eyelid without any visible external incision. Incisions are closed with very fine specialized plastic surgery stitches, some of which are actually absorbed by the body, while others are usually removed five to seven days after the operation.

After the Procedure

Dr. Sayah recommends ice-cold compresses for the first two days after surgery in order to decrease potential bruising or swelling. There may be some tightness at the eyelids due to swelling, and sometimes, the eyes may not completely close until the swelling resolves.

After you arrive home, maintain your head elevated at all times by placing several pillows under your neck and back. Try to avoid rolling onto your face as you sleep to avoid disturbing your wounds. You may drink fluids on this day, but progress your diet very slowly if you are not tolerating the fluids. On the evening of your surgery and for most of the next day, avoid reading, watching television, and vision-intensive pastimes. Rest your eyes as much as possible. Then progressively resume visual activities as comfort permits. Our staff will be contacting you daily to assure you are progressing well.

The day after your procedure begin walking around your house. You may advance your diet to regular food, but limit foods which require aggressive chewing such as apples or steak. Most bruising and swelling usually resolves by seven days. Incision lines may appear somewhat swollen and pink for several days to a few weeks. Once the stitches are removed at five to seven days, hypoallergenic make-up may be used as a camouflage. Contact lens wearers cannot wear their normal lenses for five to ten days following surgery. If corrected vision is required during that time, prescription glasses are suggested.