Of all the features on our faces, our eyes are the most prominent indicators of our mood, energy level, and youth. Sagging, drooping, or tired-looking eyes can make us look older than we really feel. Eyelid surgery, or blepharoplasty, is a plastic surgical procedure designed to improve the message our eyes send to those around us.
Patients who would benefit from a blepharoplasty include those who experience:
A blepharoplasty removes and adjusts this sagging excess eyelid skin, and removes the “bags” by trimming away or redistributing excess fat to augment the lower eyelid cheek junction (fat preservation blepharoplasty).
Everyone has some fat around the eye, but if the quantity of fat increases, or the local tissues stretch and weaken, the fat begins to bulge producing the “bags”. Occasionally this bulging is seen in young patients and is an inherited family trait, and not a result of aging. These changes have a striking effect on one’s appearance. An attractive face with these early signs of aging can affect a patient’s self image, attitude and sense of well-being.
The upper or lower eyelids can be treated alone, or if needed all four eyelids can be treated at the same time. At times, a Brow lift, Cheek Lift (mid face lift), and/or a Facelift is done along with the eyelid surgery. A cheek lift can be used along with repositioning the lower lid fat to decrease the dark depressed circles around the eye and give more fullness to the cheeks while decreasing the creases between the lower cheek and lip (nasolabial folds). Excess drooping of the eyebrows and corners of the upper eyelids may require a forehead or brow lift to correct the area.
There are a variety of blepharoplasty techniques including short scar, forehead reduction (for receding hairlines) and hidden scar (such as endoscopic brow lift) lifts behind the hairline that can be performed. It is crucial to select a highly skilled, board-certified plastic surgeon not only to perform your surgery but to determine which variety of eyelid surgery is right for you.
The best way to find out whether you are a good candidate for blepharoplasty is to consult with one of our surgeons.
Dr. Nichter or Dr. Horowitz will thoroughly examine the skin of your eyelids and around your eyes, and also evaluate the quality of the underlying tissues. Based on your goals and concerns, our doctors will make recommendations to achieve an optimal result.
Our surgeons may want to know about your past medical history, such as whether or not you have visited an opthamologist in regard to your eyes.
Blepharoplasty is performed on an outpatient basis under local anesthetic. A sedative will make the experience relaxed and comfortable. General anesthetic can be used in some cases.
For surgery of the upper eyelids, the incision is usually made in the natural crease of the lid. The incision typically extends just beyond the eye into the smile or squint lines. Excess skin and fat will be removed by means of this incision. The incision is done in a natural fold so that it is inconspicuous when healed.
Surgery of the lower eyelids involves an incision just below the eyelash line. Excess skin, fat, and tissue will be removed through this incision, or fat will be redistributed.
Complications from eyelid surgery are unusual and rarely serious. Dr. Nichter or Dr. Horowitz will discuss the risks involved with blepharoplasty in detail with you, and you will be given complete information on how to care for yourself following surgery.
Recovery time after eyelid surgery varies greatly between individuals.
Dr. Horowitz and Dr. Nichter usually use sutures for eyelid surgery which will dissolve on their own, without need for removal. Sutures which do need removal will be removed after 3–5 days.
Initial mild discomfort is controlled with oral medication.
Patients who wear contact lenses can usually wear them again after 10–14 days.
Swelling, discoloration, and some bruising are to be expected. It is not unusual to have some difficulty seeing during the first day or two after surgery because of the swelling and eye lubricants/ointment used during and after surgery.
Patients vary a great deal in their recovery rate, but usually can resume normal light activity or work 3–4 days after surgery, using dark glasses and make-up to camouflage the swelling and discoloration. The patient will usually be presentable without dark glasses in 10 days. A small amount of residual swelling persists for many weeks, but gradually disappears.
Sagging skin or wrinkles may recur as the years go by, but it is not common for “bags” to recur. The operation can be repeated as necessary. “Crows feet” (skin wrinkling at the corner of the eye, near the temple) is not greatly affected by this procedure; they may be helped with an ancillary procedure such as a laser, dermabrasion or chemical peel treatment.
Because blepharoplasty is such a varied procedure, the cost also varies. Factors which contribute to the cost of eyelid surgery include:
For more detailed information on eyelid surgery, to speak to an expert, or to schedule a consultation with one of our surgeons, please call our office at (949) 203 3812.