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Upper Eyelid Blepharoplasty
Fact: In year 2006, more than 230,000 people in the United States underwent cosmetic eye surgery. Blepharoplasty has become the most sought-after facial plastic surgery procedure, surpassing rhinoplasty, face lift, facial implants, and forehead lift.
Why? The contours of the eyelid skin and fat pockets account for a large part of the expressiveness of the face. If the eyelids are droopy or bulging, the face projects a look of fatigue and lack of vigor despite adequate rest and good health.
Blepharoplasty is an operation that can freshen up the eyes as well as an aging face. If your eyes look bright and alert, the effect of a sagging jaw line or neck becomes less important.
The goal is to still look like yourself. Just better.
Q: Are the eyelids really that crucial in determining how a person looks?
A: Two-thirds of adults consider their eyes to be their defining facial feature.
Q: Why do the eyelids become baggy?
A: Sun damage, smoking, stretching from swelling or obesity, "wear and tear" from blinking and rubbing, age-related loss of elasticity, and heredity all contribute to changes in the eyelid skin, muscle, fat, and support system.
Q: Is there a "perfect age" for blepharoplasty?
A: Since eyelid skin is much thinner than that on the rest of the face, the eyes are usually the first facial component to demonstrate a deterioration and loss of attractiveness. A person is ready for blepharoplasty whenever the effects of Mother Nature or Father Time bother him or her enough that an improvement is desired.
Q: What type of anesthesia is used?
A: Most people report minimal discomfort during blepharoplasty performed under local anesthesia. Compared to general anesthesia, local anesthesia is associated with less bleeding during eyelid lift surgery, enhanced precision, faster recovery, increased safety, and more predictable results.
Q: Is there much discomfort after surgery?
A: The majority of patients report mild aching or burning, which is usually well controlled with the use of Tylenol and cold compresses.
Q:How long does the swelling last?
A: Swelling peaks on the morning after surgery and mostly resolves over the next 7 to 10 days. A small amount, however, may persist for several months.
Q: How noticeable is the bruising?
A: Although variable, most people experience moderate discoloration that begins to fade soon after surgery and is mostly gone by 7-10 days.
Q:How long do I need to be off work?
A: Most normal activities may be resumed within two days. Strenuous activity should be avoided for at least one week. Most people prefer to "lay low" for about ten days.
Q: Are the scars very noticeable?
A: In the upper eyelid, the incision line is hidden in the crease. In most cases, the lower eyelid incision is placed along the back of the eyelid and leaves no external scar. While full thinning and whitening of any scar on the body may take six months or more, eyelid keloids are rare.
Q: Do many men undergo cosmetic eyelid surgery?
A: Puffy eyelids look just as bad on a man as they do on a woman. In today's competitive and youth-oriented world of business, both men and women have come to appreciate that while they may be well-qualified, they also "post their resumes" on their faces.
Q: How long does the improvement last?
A: In contrast to procedures designed to fight gravity (facelift, brow lift, etc.), blepharoplasty lasts a long time. In the large majority of patients, cosmetic eyelid surgery needs to be performed only once.
Dr. Conti offers free consultations in the office to evaluate and discuss your options for eyelid rejuvenation.
Upper Eyelid Blepharoplasty Technique:
The ellipse of extra skin to be removed from the upper eyelid is marked out after the patient is lying down, thus allowing for the scalp to pull back and exert any lifting effect.
The bottom edge of the ellipse follows the line of the natural eyelid crease and extends from the area just above the tear duct medially to the outer edge of the eyelid opening temporally, where it then angles slightly up and outward into an existing laugh line.
The skin above the incision is gently pinched while the eyes are closed to determine the maximum amount of skin that can safely be removed without pulling up on the upper eyelid margin or down on the brow. To avoid a stark outcome, the actual amount of skin that is removed is always much less.
Upper eyelid skin is removed using a scalpel and fine scissors and forceps (the laser is not used, as the final scar may be compromised). If orbital fat is clearly bulging, a structural layer known as the orbital septum is opened. One or both fat pads are thinned conservatively to avoid hollowing. The upper eyelid's opening muscle (levator muscle complex) located below the fat is identified and avoided during surgery. Bleeding is meticulously controlled with electrical and thermal cautery.
The skin incision is closed using a combination of interrupted and continuous (baseball) dissolving stitches.
Routine Instructions After Eyelid Surgery
- Rest as much as possible, preferably in bed on two pillows or in a recliner. Avoid straining or bending over. A bandage over the eye is not necessary. Getting up to eat dinner and watching a little television in the evening are acceptable.
- A small amount of blood oozing out of the blepharoplasty incision is not unusual.
- Apply cold compresses as much as possible until you go to sleep.
- An antibiotic ointment should be placed on the stitches at bedtime.
- Tylenol is usually adequate for control of any discomfort.
- Swelling after blepharoplasty is usually at its worst on the morning after surgery; bruising generally peaks on the second day. Tear and mucus production will be increased for five to ten days.
- Discontinue the cold compresses after 2 days and begin warm compresses for several minutes three times a day.
- Moderate normal activity may be resumed, although avoid vigorous bending over or straining for at least three days. If you go outside, wear sunglasses.
- Vision after blepharoplasty may seem slightly blurry from the swelling and the ointment. Reading fine print or working at a computer may be difficult, but doing so is not harmful to your eyes or eyelids.
- You may shower and wash your hair but try to avoid getting soap on the incision.
- Continue to apply the antibiotic twice daily for at least 7 days.
- Application of artificial tears may feel soothing.
- Modest exercise such as walking may be resumed after three days. Vigorous activities such as jogging or aerobics should be avoided for at least one week. Avoid swimming for at least two weeks.
- Blepharoplasty sutures are self dissolving over 7 to 10 days.
- The light application of a concealer make-up to the cheek area may help to camouflage any bruising. Regular eyelid cosmetics may be applied after ten days.
- Contact lens use may be resumed in one week.