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.
The procedure is typically performed under light sedation or general anesthesia. Plastic surgeons use 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 eyes inside corner and extends to the crows 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, plastic surgeons make 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.
Some plastic surgeons recommend 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.
Eyelid Surgery Before After
Eyelid surgery, called blepharoplasty, is a type of cosmetic surgery that removes excess fat from the upper and lower eyelids. Age, illness, and even heredity can result in puffy or drooping eyelids that cause individuals to look tired and worn out. In extreme cases, sagging eyelids may even interfere with vision. Eyelid surgery can correct this by removing extraneous fat and trimming sagging skin and muscle tissue. Once the incisions have healed and the swelling has gone down, eyes look rejuvenated, more alert, and youthful.
Selecting a reputable plastic surgeon is critical to a successful surgery. The surgeon you select should be Board Certified and have considerable experience with blepharoplasty. Once you have selected a surgeon, the initial consultation is very important. Make sure to bring detailed copies of your medical records, since the doctor will need to complete a medical history. The doctor will perform a close examination of your eyes and eyelids, including a vision exam, as well as discuss your goals for the surgery. Your surgeon will also use the initial consultation to go over the details of the procedure, the expected results, the risks, and the costs involved.
If you are considering eyelid surgery, it is important to thoroughly research the procedure, even if this just means talking over the details with your surgeon. Blepharoplasty is a relatively safe procedure, although like all other surgeries, you do run the risk of complications. When performed by a qualified surgeon, complications resulting from blepharoplasty are infrequent and typically minor. Minor complications may include temporary swelling of the eyelids, excess tearing, temporary blurred or double vision, tissue tenderness, sensitivity to light, and scarring at the site of the incision. More serious complications include infections and a reaction to the anesthesia used in the procedure. Occasionally patients find that they have difficulty closing their eyes after blepharoplasty. Most often this is a temporary side effect, although there have been reports of the condition becoming permanent. In rare cases, patients may experience a pulling down of their lower eyelids, called ectropion, which requires additional surgical procedures.
Most eyelid surgeries are performed under a local anesthesia which is used to numb the tissue and muscles around your eyes. Your surgeon may also give you a sedative, either orally or intravenously, to help relax you since patients are kept awake during the procedure. Under local anesthesia, you will not feel any pain but may experience some tugging or pressure during the surgery. In certain circumstances, some surgeons opt to perform blepharoplasty under a general anesthetic, in which case the patient is asleep throughout the entire procedure.
The surgeries typically last from 90 minutes to 3 hours, depending on how many eyelids are to be corrected. During the procedure, the surgeon makes small incisions along the natural lines of the eyelids – just under the eyelashes on the lower lids and in the deep creases of your upper eyelids. Excess fat is removed through the incision, and sagging muscle and skin are trimmed to neaten your appearance. Once the trimming is completed, your surgeon will use tiny sutures to stitch up the incision.
Once the surgery is complete, your surgeon will advise you on how to care for the incision. You will likely to be told to keep your eyes lubricated with an antibiotic ointment and take pain medication to control any discomfort you feel during the healing process. Cold compresses can be used to minimize swelling and bruising although patients will find that even with the compresses the swelling, tenderness, and bruising will be present for several days and may even last up to a month. Your eyes may tingle and feel gummy or dry for several days as well. Expect to return for a follow-up visit to your surgeon a few days after the procedure for a checkup and removal of your stitches.
Remember that the healing process takes time and it may be several weeks before you are completely recovered. In time the incisions will become less and less noticeable, fading into a thin white line that will be barely noticeable. The end result of the surgery though, should be brighter more alert eyes that make you look well-rested and youthful.
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