Blepharoplasty - Eyelid Surgery

Blepharoplasty Procedure - 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. 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.

Preparing For Your Blepharoplasty 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.

Where Your Surgery Will Be Performed

Eyelid surgery may be performed in a surgeon's office-based facility, 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.

The Eyelid 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.

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.

As people age, the eyelid skin stretches, muscles weaken and fat accumulates around the eyes, causing "bags" above and below.	Before surgery, the surgeon marks the incision sites, following the natural lines and creases of the upper and lower eyelids.
Underlying fat, along with excess skin and muscle, can be removed during the operation.	In a transconjunctival blepharoplasty, a tiny incision is made inside the lower eyelid and fat is removed with fine forceps. No skin is removed, and the incision is closed with dissolving sutures.
	After surgery, the upper eyelids no longer droop and the skin under the eyes is smooth and firm.

Your New Look

Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, they'll fade to a thin, nearly invisible white line.

On the other hand, the positive results of your eyelid surgery will be a more alert and youthful look that will last for years. For many people, these results are permanent.

After Your Blepharoplasty (Eyelid) Surgery

After surgery, the surgeon will probably lubricate your eyes with ointment and 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.

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.

Getting Back to Normal

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 sun block 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.

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.

Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent.