If you look into the mirror and it reflects a tired and fatigued appearance instead of the healthy energetic person that you are, a Blepharoplasty should provide you the rested and refreshed look you desire. Bags under the eyes and drooping upper eyelids gives an aged appearance to the entire face If makeup, creams, and lotions no longer conceal these signs of eyelid aging, it is time to consider eyelid surgery. Blepharoplasty is a surgical procedure to improve and rejuvenate the appearance of the upper and lower eyelids.
What Blepharoplasty Can Improve:
- Loose and excess skin of the upper eyelids
- Puffy appearance of the upper eyelids
- Excess skin and laxity of the lower eyelids
- Bags under the eyes
- Laxity and drooping of the lower eyelids resulting in the showing of the white of the eye below the iris ( the colored portion of the eye)
What Blepharoplasty Will Not Improve:
- Low or drooping eyebrows
- “Crows Feet” of the lateral eyelids
- Wrinkling of the skin or dark discoloration of the lower eyelids
How is Blepharoplasty Performed?
There are several different surgical techniques that are used to perform Blepharoplasty. The actual procedure that is performed is individualized according to the specific condition and appearance of your eyelids. This will depend upon several factors including the amount of skin excess or laxity, the condition of the muscles of the eyelid, bony structure of the eye, and the amount and location of excess fat. Surgery may be performed with local, IV sedation (twilight sleep) or general anesthesia.
Upper Eyelid Surgery
An incision is made in the natural skin fold and crease of the upper eyelid. The incision extends laterally and into the skin creases of the lateral eyelid “crows feet”. Excess skin and adiposity above this incision are then removed. Because this incision is in the natural skin lines of the eyelid the resulting scar is usually inconspicuous.
“Bags” of the lower eyelids is the result of fat tissue that protrudes through weakened and stretched lower eyelid support tissue and muscle. It may be possible to remove or redistribute the protruding portion of the fatty tissue or fat bags through an incision made on the side part of the lower eyelid. With this procedure, there are no external incisions or visible scars. This is called a Transconjunctival Blepharoplasty. If there is a very minimal amount of skin wrinkling or skin laxity of the lower eyelid, this may be improved at the same time with either Fraxel Laser or a chemical skin peel such as the Obagi Blue Peel. If however there is moderate skin excess or lid or muscle laxity, an external skin incision will be needed for correction of these conditions.
Lower Lid Blepharoplasty
When there is a moderate or large amount of excess skin or laxity of the lower eyelid or muscle these conditions will require correction with an external skin incision. The incision is placed just below the lashes of the lower lid and usually extend slightly laterally into the skin creases of the “crows feet” of the lateral eyelid. The placement of this incision and the resulting scar is well concealed beneath the lower eyelid lashes and the natural skin lines of the lower lateral eyelid. If there is laxity of the muscle of the lower lid, this is corrected by elevation and suturing of the muscle to the bone or fascia in the upper lateral eyelid area. This effectively tightens the muscle and soft tissue of the lower eyelid. The excess skin is re-draped superiorly and removed. The incision is then sutured.
Laxity of the lower eyelid that usually results in the excessive show of the white of the eye, particularly in the lower lateral eyelid, is corrected by elevation and suturing of the lower lateral eyelid to the orbital bone that surrounds the eye. This procedure called a Canthopexy is often done as part of the Lower Lid Blepharoplasty.
Asian Eyelid Surgery
The Asian eyelid appears as if there is no eyelid crease in the upper eyelid. This is referred to as a “single eyelid”. About 50% of all Asians are born with this “single eyelid” type. Although there may not be visible a crease, this is often present but is obscured by skin that overhangs the eyelid. The overhanging skin draping to and over the eyelashes often causes obstruction to vision. The upper eyelid without a crease also looks smaller than the eyelid with a crease. The goal of Asian Eyelid Surgery is to create an upper eyelid crease that is youthful and attractive while retaining the Asian ethnic appearance. Most Asian patients do not want to look like their Caucasian friends.
How is Asian Eyelid Surgery Performed?
The position and height of the upper eyelid crease are marked by determining the upper position of the underlying tarsus. This tarsus is a semilunar shaped dense fibrous cartilaginous plate just above the lashes. This gives shape and support to the eyelid. The amount of overhanging skin is marked and removed along this upper eyelid crease line. Excess fat of the upper lid is removed. The skin of the upper lid is sutured to the tarsus to ensure a well defined upper lid crease.
Recovery From Eyelid Surgery
Immediately after surgery, there will be swelling, bruising and pain or discomfort. This will depend upon the type and extent of the surgery as well as your own health. Your eyes will often be more sensitive to light exposure.
When you go home it is recommended that you keep the head slightly elevated, limit vigorous physical activity, and apply cool compresses to the eyes till the swelling has resolved. An ophthalmic ointment is often prescribed to be applied to the eyelid incisions and to the eyes. Eyelid sutures are usually removed within the first week after surgery.
Depending upon the amount of swelling and bruising, most people can return to work in about 10 days after surgery.
Instructions will be given for massage of the eyelids and incisions so that you obtain the maximum result.