Eyelid Surgery

Eyelid Surgery

Contents


Introduction to Browlift & Eyelid Surgery


Blepharoplasty, or eyelid surgery can help restore a refreshed, youthful appearance by removing excess eyelid skin and fat in just the right proportion to give a natural and refreshed look. For patients with dark circles and deep tear troughs, a fat repositioning procedure is a volume-enhancing procedure to help soften the transition from eyelid to cheek. A lid tightening procedure is performed for patients with eyelid laxity.

The eyes are among the first areas to be affected by aging. You may have noticed a tired or severe look around the eyes that generally needs more than a good night’s rest. Patients with droopy eyelid skin, under-eye bags, and dark circles can benefit from surgery. Those whose brows have descended over time may also benefit from a browlift in combination with eyelid surgery.

Approaches & Techniques


Upper Blepharoplasty

An upper eyelid lift involves removing a strip of skin from the natural crease of the upper eyelid. The effect of this is to remove excess skin that is folding over and onto the upper eyelashes and to tighten any crepie skin. Also, any excess fat that creates a bulge may also be removed.

Lower Blepharoplasty

A lower eyelid lift involves removing a strip of skin and muscle from just below the eyelid margin and removing any lower eyelid fat that is forming a bag. This flattens the contour of the lower eyelid while tightening any crepie skin.

Fat Repositioning

The fat repositioning technique may be performed during a lower eyelid procedure. It involves moving the fat from a region of a lower eyelid bag into areas of volume loss under the eye (such as the dark circle or tear trough). In effect, we are moving areas of volume excess to areas of volume scarcity. We like to call it “moving the mountain into the valley to create a flat plain”. This advanced technique helps to blend the junction between the lower eyelid and upper cheek, which is gives an appearance of youth.

Eyelid Tightening

An eyelid tightening procedure, also known as a lateral canthopexy or canthoplasty, is a procedure to tighten the rim of the lower eyelid. Loss of eyelid tone (e.g. from aging) may lead to a droopy lower eyelid and watery eyes. By tightening the eyelid, we restore a youthful shape to the eye and may help tear function.

Planning Your Procedure


The Consultation

During the consultation, we really want to get to know you and understand what makes you tick. we will review with you the changes you would like to make and their potential impact on your eyes, tear function, and life. We will also review your medical history and the history of your current concerns. We will examine your eyelids to determine the optimal combination of procedures for you.

After the consultation there is a second visit prior to surgery called a "preop". At this visit we will go into much greater detail about how to best prepare for the coming surgery. We offer a wealth of information about optimizing your recovery, ensuring proper healing, resuming normal activities, and avoiding complications.

Duration of Surgery & 
Anesthesia Options

Eyelid surgery takes between 1 and 3 hours depending upon how much is done and what techniques are used. It may be performed with local anesthesia in the office, with the patient awake and eyes closed. Alternatively, the procedure may be performed under general anesthesia at the surgery center. This is an outpatient procedure.

Incisions

For the upper eyelid, the incision is concealed in the natural crease and extends a short distance in a natural squint line. For the lower eyelid, the incision is concealed just below the lashes and also extending into a natural squint line. For some, Dr. Patel is able to hide the incision on the underside of the lower eyelid. 

How It's Done

To achieve a natural look, it is important to remove just the right amount of skin and tissue to create youthful eyelids. Dr. Patel believes it important to be conservative in tissue removal to avoid a hollowed appearance. In patients with a deep crease under their bags, often called the tear trough, he will re-position tissue from an area where it is bulging to fill the crease. This helps to create a smooth, natural transition from the lower eyelid to the cheek.
Dr. Patel places long-lasting sutures to suspend the eyelid and this contributes to a long-lasting result. Also, some patients who have age-related laxity of the lids may also require a lid tightening procedure to strengthen support. In all cases, the goal is to preserve the pre-existing shape and tilt of the eye to maintain a natural look.

Recovery

The typical at-home recovery time is 5-7 days. Immediately after surgery, there will be protective strips of tape placed over any upper eyelid incisions and the incisions at the outer corners of the eye. These will restrict eye opening, but are very helpful in reducing swelling. They are removed the following day. Patients will normally be applying drops and ointment to the eyes around the clock to ensure proper moisture. By the end of the first week, all sutures are removed.

Pain

The first night after surgery, you will feel a dull ache and heaviness around your eyes. Everyday thereafter, any discomfort will reduce significantly. It is normal to take opiate medication for a few days after surgery, but most transition to regular Tylenol within the first week. A temporary dry eye sensation is normal while the eyelids are swollen and we will instruct you how to alleviate this.

Swelling & Bruising

Swelling and bruising are normal and mostly subside in the first week, though they may last a couple of weeks. Most bruising may be concealed with cover-up as it gradually fades. On average, 90% of the swelling subsides by 1 month after surgery. In the end, all swelling and bruising will go away.
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