If you're considering Eyelid
Surgery...
Eyelid surgery, technically called
blepharoplasty, is a procedure to remove
fat--usually along with 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. However, it won't remove crow's
feet or other wrinkles, eliminate dark circles under
your eyes, or lift sagging eyebrows. While it can
add an upper eyelid crease to Asian eyes, it will
not erase evidence of your ethnic or racial
heritage. Blepharoplasty can be done alone, or in
conjunction with other facial surgery procedures
such as a facelift or browlift.
If you're considering eyelid surgery, this
information will give you a basic understanding of
the procedure-when it can help, how it's performed,
and what results you can expect. It can't answer all
of your questions, since a lot depends on the
individual patient. Please ask your doctor about
anything you don't understand.
THE BEST CANDIDATES FOR EYELID SURGERY
Blepharoplasty can enhance your appearance and your
self-confidence, but it won't necessarily change
your looks to match your ideal, or cause other
people to treat you differently. Before you decide
to have surgery, think carefully about your
expectations and discuss them with
your
doctor.
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.
ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK
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When eyelid surgery is performed by a qualified
surgeon, like
our
surgeons, 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 doctor'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;
your
surgeon can remove them easily with a very fine
needle.
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.
PLANNING YOUR SURGERY
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The initial consultation with
your
surgeon is very important. He or she 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 us if you have any
allergies; if you're taking any vitamins,
medications (prescription or over-the-counter), or
other drugs; and if you smoke.
In this consultation, your vision and tear
production will be tested. 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.
We
will explain the techniques and anesthesia used, the
type of facility where the surgery will be
performed, and the risks and costs involved. (Note:
Most insurance policies don't cover eyelid surgery,
unless you can prove that drooping upper lids
interfere with your vision. Check with your
insurer.)
Don't hesitate to ask
your
surgeon any questions you may have, especially
those regarding your expectations and concerns about
the results.
PREPARING FOR YOUR SURGERY
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We
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. Carefully
following these instructions will help your surgery
go more smoothly.
While you're making preparations, be sure to
arrange for someone to drive you home after your
surgery, and to help you out for a few days if
needed.
LOCATION OF YOUR SURGERY
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Eyelid surgery may be performed the outpatient
surgery center located across the hall from our
clinic. It's usually done on an outpatient basis;
rarely does it require an inpatient stay.
TYPES OF ANESTHESIA
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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.)
Dr. Henthorn or Frankel may prefer to use
general anesthesia; in that case, you'll sleep
through the operation.
THE SURGERY
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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.
In a typical procedure,
your
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, he 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.
If you have a pocket of fat beneath your lower
eyelids but don't need to have any skin removed,
your
surgeon may perform 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.
AFTER YOUR SURGERY
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After surgery,
your
surgeon will probably lubricate your eyes with
ointment and may apply a bandage. Your eyelids may
feel tight and sore as the anesthesia wears off, but
you can control any discomfort with a prescribed
pain medication. If you feel any severe pain, call
our
office immediately.
We
will instruct you to keep your head elevated for
several days, and to use cold compresses to reduce
swelling and bruising. (Bruising varies fron 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.
your
surgeon may recommend eye drops, 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.
We 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.
GETTING BACK TO NORMAL
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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.
We 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.
YOUR NEW LOOK
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Healing is a gradual process, and your scars may
remain slightly pink for six months or more after
surgery. Eventually, though, they'll fade to a thin,
nearly invisible white line.
On the other hand, the positive results of your
eyelid surgery-the more alert and youthful look-will
last for years. For many people, these results are
permanent. |
