ProvidersGeorge J. Alter, MD James H. Antoszyk, MD James G. Kaufmann, MD Usha P. Reddy, MD F. Brian Gibson, MD, FACS * Mark T. Weigel, MD *
* = Fellowship Trained
Your eyes are the focal point of your face. The aging process can result in wrinkles, fatty bulges around your eyes, and a drooping of the brow. These changes deprive your eyes of their rested youthful appearance and cause them to look smaller and tired. A blepharoplasty, also known as eyelid surgery, is performed to remove or reposition tissues in the upper and lower eyelid.
What is a blepharoplasty?
As you age, the skin around your eyes becomes lax and stretches, tending to narrow your eyes. The fat, which normally sits around the eyeball, herniates through weaknesses in the fine membranes, resulting in visible lumps or bulges. While these changes are inherited in some cases, for most people they start to develop in their early 30s. Blepharoplasty is designed to remove excess eyelid skin and protruding fat in order to accentuate the beauty of your eyes.
While the surgery itself should not affect your vision, before proceeding with this procedure, you should have a complete eye exam by an optometrist or ophthalmologist.
Functional Eyelid Surgery: Stretching and relaxation of the middle layer of the eyelid (orbital septum) allows fat to move forward, resulting in “fullness” to the eyelid. With time, the excess eyelid tissue in the upper eyelid may hang over the eyelid and cause a visual field restriction. If this restriction is significant enough to meet specific criteria established by insurance carriers and Medicare, then upper eyelid blepharoplasty may be a covered reconstructive procedure. Surgical removal of excess skin, muscle, and fat (if needed) may lead to an improved and more comfortable field of view for you. At times, only one eye may need this procedure.
Cosmetic Eyelid Surgery: Unfortunately, with aging, the upper and lower eyelids become droopy or baggy in appearance. Excess eyelid tissue may create a tired look, a heavy feeling to the eyelid area and make you look and feel older. Aesthetically, such conditions may detract from the overall attractiveness of your eyes. Removal of the excess skin and fat from either or both of the upper and lower eyelids can restore a younger, more rested facial appearance.
Your own results may vary – be sure to talk to your healthcare provider about what you can expect and when to schedule your next appointment.
The blepharoplasty Procedure
Upper eyelid correction may be done separately or in conjunction with lower eyelid surgery. It is generally performed under local anesthesia with intravenous sedation. The operation usually takes from 1-2 hours.
Your upper incisions are hidden in the natural creases of your eyelid. Lower eyelid incisions can be positioned either on the inner aspect of the eyelid, where it is completely concealed, or in a skin crease just below the eyelid margin when excess skin is removed. Given sufficient time for healing, these incisions are generally imperceptible.
You can expect little pain, but mild swelling and discoloration will develop around your eyes following surgery.
Upon completion of your surgery we will give you a list of detailed instructions for you to use at home. We do not place any bandages around your eyes. You will be able to reduce swelling and discoloration with cold compresses. This will gradually resolve over the next two weeks. You are encouraged to conceal the discoloration with large framed sunglasses.
You should not exert yourself for two weeks following surgery. This includes any exercise that results in an elevation of the heart rate or blood pressure – aerobics, jogging, bicycle riding, weightlifting, etc. Most people can return to work one to two weeks after their surgery.
Sutures will be removed one week following your surgery. Initially the incisions are prominent and slightly raised. However, they will gradually flatten and blend into the surrounding skin after several months. In most cases the fine scar can be readily camouflaged with cosmetics.
Eyelid surgery will not remove every fine wrinkle from under your eyes. Attempts to do this would result in pulling the eyelid away from the eye, creating an odd “surgical” look. “Crow’s feet," at the outer extent of the eye, are also not eliminated by this type of surgery. Residual wrinkling of the upper and lower eyelids would require correction with a chemical peel or laserbrasion, or a BOTOX injection.
Upper eyelid sagging can be aggravated by a laxity of the eyebrow, which is displaced below the bony orbital rim. If you have significant drooping of the brow, eyelid surgery alone may accentuate the distorted position of the brow. In such cases we would also recommend a browlift to provide the most pleasing aesthetic result.
Lines that are produced as a result of facial expression – smiling, grimacing, frowning, and the like are not alleviated. Such movements result from normal contractions of the facial muscles and are observed in all individuals regardless of age or skin type.
Post-operatively, soft tissue swelling or poor muscle tone may temporarily displace your lower lid downward away from your eye. This occurs infrequently and usually subsides with resolution of the swelling and improvement in muscle tone. In rare cases additional surgery is required to tighten the eyelid.
On occasion, you may experience a temporary impairment of your ability to make tears, resulting in a dry, irritated eye. This is corrected with lubricants until the swelling resolves and tear production returns to normal.
A collection of blood under the skin flap and around the eye can develop in a rare situation. Correction may require close observation until your body reabsorbs the fluid, aspiration, or open drainage. Permanent impairment of vision is an extremely rare event.
Risks will be discussed in more detail during your visit with your physician.
The visual improvements with eyelid surgery can be dramatic. “Opening” of the eyes can often eliminate a sad and tired appearance of the face.
CEENTA has doctors in SouthPark, Belmont, Blakeney, Concord, Huntersville, Salisbury, and Statesville offering consultations for this condition. They are skilled in the most up-to-date technology and treatment options and will come up with a care plan personalized for your needs.