If you have excessive, sagging
or wrinkled upper or lower eyelid skin.
If you have excess upper eyelid
skin that interferes with vision.
If you have lost your natural
upper eyelid crease.
If you have puffy pouches of fat
in the upper or lower lids that create a tired or aged appearance.
A blepharoplasty
is an operation designed to remove sagging skin and muscle
from the eyelids, and to remove "bags", by trimming away
excess fat bulges. In some cases the upper or lower lids
can be treated alone. If indicated, all four lids may be
treated at the same time. At times, a forehead-lift and/or
a face-lift is done along with the eyelid surgery. Excess
drooping of the eyebrows and corners of the upper eyelids
may require a forehead lift to correct the area.
One of the first signs of early
aging is bagginess or puffiness around the eyes, often associated
with wrinkling of the eyelid skin. Blepharoplasty is designed
to correct this condition and to restore the youthful, alert
appearance of your eyes. This condition may be present in the
upper eyelids, lower eyelids, or both. It also may be associated
with looseness of the skin of the eyebrows or temple region.
Normally,
everyone has a small amount of fat around the eyeball. If
the quantity of fat increases, or the local tissues stretch
and weaken, the fat begins to bulge producing "bags". Occasionally
this bulging is seen in young patients and is an inherited
family trait, and not a result of aging. The laxity and wrinkling
of the eyelid skin may be seen alone or in conjunction with
excess fat. 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.
INTENDED RESULT
A more youthful and rested appearance
of the eyes.
Widening of visual fields if excessive
upper lid skin has partially blocked vision.
It will not remove or erase all
wrinkle lines. It will soften wrinkle lines.
PROCEDURE DESCRIPTION
WHERE ARE THE INCISIONS?
The incision in the upper lid usually lies in the lid crease.
The incision in the lower lid lies just below the eyelashes and
parallel to the lid edge. Both incisions may extend for a short
distance beyond the eyelids, toward the temple. In certain cases,
lower lid incisions may be made inside the lid (transconjunctival
incision). This is useful when only excess fat is removed and
eliminates external skin incisions. Excellent healing is characteristic
of eyelid skin, and once the wounds are mature they usually become
quite inconspicuous. The outer part of the incision -- the part
extending toward the temple -- is the slowest to mature, and is
sometimes noticeably pink for some months after the operation.
The stitches are removed in 3-7 days after surgery.
WHERE IS THE OPERATION DONE?
The operation is usually done in a surgicenter, on an outpatient
basis. A friend or relative should be available to take you
home and stay with you for at least 24 hours after surgery.
Some patients may be done in a hospital operating room, if other
medical conditions are present.
WHAT KIND OF ANESTHESIA IS USED?
A local anesthetic is used. The patient also receives sedation
so that the operation will be a relaxed and comfortable experience.
A general anesthetic may be indicated in some cases.
RECUPERATION AND HEALING
All sutures are usually removed
within 3-5 days.
Initial mild discomfort is easily
controlled with oral medication.
Eye makeup can be used shortly
after sutures are removed.
Contact lenses can be worn when
comfortable -- usually within 7-10 days.
Swelling, discoloration, and bruising
is to be expected. It is not unusual to have some difficulty
seeing during the first day or two after surgery because of
the swelling. 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.
OTHER OPTIONS
Additional procedures that would
enhance the result are: Forehead Lift, Face Lift, Chemical Peel
or Laser Skin Resurfacing.
INSURANCE GUIDELINES
Patients who have functional or
visual problems caused by excessive upper eyelid skin may have
coverage by their insurance policy. This usually requires documentation
by an ophthalmologist regarding the medical necessity of surgery.
Otherwise, these procedures are cosmetic and the patient is
responsible for payment.
NOTE
Sagging skin
or wrinkles may recur as the years go by, but it is unusual
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 dermabrasion or chemical peel.
The specific risks and the suitability
of this procedure for a given individual can be determined only
at the time of consultation. All surgical procedures have some
degree of risk. Minor complications that do not affect the outcome
occur occasionally. Major complications are rare.
