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.
As you age, the skin around your eyes becomes lax and stretches, tending to narrow your eyes and in some cases impair your vision. 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 blepharoplasty you should have a complete eye exam by an optometrist or ophthalmologist.
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.
The visual improvements with eyelid surgery can be dramatic. “Opening” of the eyes can often eliminate a sad and tired appearance of the face.