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A blepharoplasty (eyelid lift) procedure on the upper eyelid a combination of excess skin and fat is removed to restore a more youthful and refreshed look A blepharoplasty (eyelid lift) is one of the most commonly performed plastic surgical procedures. As aging occurs there is a tendency for an excess amount of skin and fat to accumulate along both the upper and lower eyelids. This may result in a "hooding" effect of the upper eyelid and at times a drooping of the eyelid. The lower eyelid will become full and sag with an excess amount of skin and fat resulting in a "baggy" lower eyelid and a tired appearance.
Surgery On the upper eyelid a combination of excess skin and fat is removed to restore a more youthful and refreshed look. This gives a more "open" look to the eyes and assist in correcting the "double eyelid" appearance. It is not uncommon for the excess skin of your upper eyelid to be a result of "drooping" of your eyebrows. In this instance, it may be necessary to perform a brow lift to lift up the position of the eyebrows and hence, correct the excess skin of the upper eyelids. On the lower eyelid, mostly fat and a small amount of excess skin are removed for the same purpose. This procedure is performed by itself or with another procedure to rejuvenate the entire face. It is not uncommon to have CO2 laser resurfacing or chemical peel be performed around the eyes at the same time as the blepharoplasty to help tighten up the skin and smooth out the wrinkles. Depending on the elasticity of your lower eyelids, it may be necessary to tighten the tendon at the corners of your eyes (canthoplasty). This will help reduce the potential for drooping of the lower eyelid margin postoperatively. A small incision is used on the upper eyelid in one of the natural skin creases. On the lower eyelid this may also be done, or an incision is made on the inner aspect of the eyelid, which leaves no scar on the visible side of the lower eyelid. Anesthesia The procedure is usually performed under local anesthesia as an outpatient. If you have other procedures performed at the same time, then general anesthesia will be necessary. If the blepharoplasty is the only procedure performed you will return home on the day of surgery. The anesthesiologist and the surgical facility will bill separately for their services. Duration of Surgery The operating time will vary depending on the patient and the extent of the procedure, and whether any additional procedures are performed. Generally, the time is approximately 1 hour. Before Surgery Do not take aspirin or products that contain aspirin for at least 3 weeks prior to surgery. Also refrain from any herbal supplements, as some may have an effect on increasing bleeding during the course of surgery. Remove all makeup and mascara from your eyelids. If you wear contacts lenses, it would be preferable that you wear glasses when you arrive to the surgery center.
After Surgery There are no dressings. Stitches are dissolvable and will be gone in 5 to 7 days. Ice packs and/or iced-soaked gauze may be applied to help reduce discomfort and swelling. There is usually a moderate amount of swelling and bruising after a blepharoplasty. You should try to sleep with your head and shoulders elevated to help reduce the amount of swelling. You may shower the day after surgery. Initial discomfort is controlled with oral medication. Do not wear your contact lenses after surgery. You may try to reinsert your contacts once the swelling subsides, but do not be discouraged if you are not able to initially. Return to Normal Activity Most people return to their usual activities and to work approximately 1 week after surgery. It is acceptable to apply make-up after 3 to 5 days. Strenuous sports and other activities should not be performed for 3 to 4 weeks, as this may raise your blood pressure and result in further swelling or bleeding. You may drive when you are no longer taking pain medication and when the swelling is no longer a concern. Photographs Photographs are taken at the time of your consultation. These are important aids in the preparation of surgery and become a permanent part of your record. Post-surgical photographs are also taken. Scars You should expect a scar on each upper eyelid. These are usually well concealed in an upper eyelid skin crease. The lower eyelid scar will likewise be concealed in a natural skin crease of the lower eyelid. In some cases, a lower eyelid incision is made on the inner aspect of the eyelid, in which case, there will be no visible external scar. All of the locations mentioned are tolerated quite well. All scars are however permanent. The width, height, and color of scars are unpredictable. Wear a sunscreen of at least SPF 30 or greater when outside to protect the scars from sunlight during the healing process. Swelling and Bruising Swelling and bruising of the eyelids or any site following surgery is normal. During the first 1 to 2 weeks your eyelids will feel and look swollen. The swelling will start to subside after the first postoperative week. It may take as long as 2 to 3 weeks for the last bit of swelling to recede.
Complications HEMATOMA This is the most common complication and occurs when a collection of blood forms under the areas of undermined skin. It occurs in about 1 to 2% of patients. The body will absorb minimal bleeding. Only on rare occasions will it require additional surgery. On very rare circumstances, bleeding could result in intense pain behind the eye and may lead to visual impairment or loss. EDEMA This is a normal consequence of surgery and is best treated simply by elevating the head of the bed. The application of ice packs or cold compresses is usually done for the first 1 to 2 days. ABNORMAL SCARS A small percentage of patients will develop scars that are unacceptable despite meticulous attention to detail, both during and after surgery. The scars may widen, remain red or raised. If the scars are problematic, a steroid ointment or injection may be used to improve their appearance. In rare cases, the scars may need to be surgically revised. INFECTION This complication is also rare. Prevention is the key, and antibiotics are given both before and after surgery. ASYMMETRY There is usually some asymmetry of the eyelids; in some people this is marked and is the reason they seek surgery. All efforts are made to have the eyelids as symmetrical as possible. A slight asymmetry may be acceptable after surgery; a greater amount of asymmetry may require additional surgery to correct. I mention these complications not to alarm or frighten you since the usual outcome after this surgery is quite favorable. The majority of patients are very satisfied. I present this information to you to fully educate you on the side effects, undesirable sequelae and complications no matter how remote they may be.
Dr. Morales Recommends Theraderm Skin Products for his patients before and after surgery.
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