Eyelid Surgery (BLEPHAROPLASTY)

When you first look at someone else or meet them, chances are, the first thing you do is look them in the eye. It is not surprising that the appearance of one’s eyes is a large part of what defines an attractive face. It is no wonder then that eyelid surgery is one of the most popular cosmetic procedures done today. Fortunately, it is a fairly easy procedure to do, usually gets great results, and has a fast, easy recovery. As a surgeon, it is one of the procedures I enjoy the most because I love to see patients happy about the dramatic improvements I usually can get for them.

As we age, several things happen around the eyes. Both upper and lower eyelid skin stretches, causing folds and wrinkles. The eyebrows and forehead drops, pushing skin and tissue downward, causing a tired and heavy look to the upper eyelids and, in severe cases, can actually block peripheral vision. Tissues in both the upper and lower eyelids weaken, allowing fat pockets to bulge outwards, giving the eyes and face a fat, bloated appearance. For most middle aged individuals, correction of this does more to restore a youthful appearance to the face than any other one single procedure. To correct these aging changes, several things need to be done. First, the position of the eyebrows must be considered. Many people have good brow position and don’t need anything done to elevate their brows. Often, however, with aging the eyebrows drop, giving the person a somewhat angry look. To correct the aging upper eyelid, the eyebrows must first be sufficiently elevated. Doing this often dramatically reduces the amount of upper eyelid skin that needs to be removed.

Once the brows have been addressed, excess upper eyelid skin is excised. This is done, placing the incision in the upper eyelid crease. This, along with meticulous surgical technique, leaves a virtually invisible scar. Next the fat and excess tissue beneath the skin are removed and the skin is sutured. The result is a youthful, beautiful upper eyelid which looks totally natural and un-operated.

The lower eyelids are a little trickier. Most, but not all people, need fat excised. The amount of skin removed must be very conservative as excess skin removal can pull the lower eyelid down too far, creating an unattractive, over-operated look. The incisions can be placed inside of the eyelid if no skin removal is required or below the eyelashes. Proper surgical closure should again leave no visible scar.

Finally, the lower eyelid wrinkles and “crow’s feet” need to be addressed. I like to either laser or chemically peel these areas as these are much more effective at removing these wrinkles and get better results.

The recovery is usually pretty easy. The procedure is always done as an outpatient, with the patient going home the same day. Anesthesia can be very comfortably provided with either heavy IV sedation or, if preferred, going completely to sleep with a general anesthetic. These stitches are removed in three to five days and any residual bruising can usually be covered with make-up after one week. Most patients take a few pain pills the first few days, mostly just to help them sleep. If a chemical peel or laser skin resurfacing is done, some people take seven or eight days before make-up can be applied. The skin stays very red after resurfacing for a month or two, and direct sun must be avoided during this period.
As every person ages differently, it is absolutely critical to have a thorough consultation with your surgeon to determine what you want done, how it is going to be accomplished, and what kind of results you can realistically expect.
 

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