Eyelid surgery Blepharoplasty
After the consultation, obtaining a medical history and planning your operation, a preoperative examination follows. Eyelid surgery is performed in the operating room under local anesthesia combined with sedation (twilight anesthesia) or general anesthesia.
Eyelid surgery is designed to remove excess skin and remove or reposition the fat that creates saggy bags and droopy eyelids. The “bags” we see on the lower eyelids, but also many times on the upper eyelids near the nose, are actually fat hernias. It is the fat that is normally located around the eye which starts to project forward when the membrane that holds it relaxes.
In some people this membrane is naturally weak and the herniation appear very early in life. This thin fat is very sensitive to fluid retention and so its size can change very quickly. When this happens, blepharoplasty is the treatment of choice.
On the lower eyelids, the incision is made just below the lashes and extends, if necessary, slightly sideways into a crows feet wrinkle. So we remove or reposition the fat and carefully remove the excess skin to stretch the lower eyelid. The scar under the lashes is very discrete. It actually vanishses after a few weeks to months.
On the upper eyelid we remove the excess skin, the fold that is formed above the lashes in its natural position, and if necessary the excess fat mainly near the nose is trimmed or redraped. The incision is located in the natural fold of the upper eyelid and is therefore hidden when the eye is open.
With closed eyes it may look like a small pink line for a few weeks. Makeup is allowed quickly and ussually in a month or two it is unnoticeable.
Minimally invasive eyelid surgery with immediate natural result and complete recovery in less than a week.
In eyelid surgery the anesthesia can be twilight anesthesia and local or general anesthesia. In the first case, the anesthesiologist administers intravenously an anesthetic that causes temporary sleep without the need to intubate the patient during which we perform local anesthesia.
When you wake up, the whole area is anesthetized and the operation progresses completely painlessly. In the second case the anesthesia is general and the patient is intubated.
The decision about the method we will use is made after consultation of the patient with me and the anesthesiologist and depends on his age, general state of health and peace of mind. People that are extremely anxious will not tolerate local anesthesia and the stress that may build up causes an elevation in blood presssure that is not desirable. Moreover, one may experience a panic attack so after screening i may advise someone to choose general anesthesia for the afforementioned reasons. You will stay with me for a few hours with your eyes closed. After a post op check, bandages will be removed and you will leave with your eyes open with steristrip tapes on the eyelids.
After eyelid plastic surgery, local care begins with cold compresses and ointment. The eyelids do swell quickly, which may worry you but the swelling disappears ususally in just a couple of days. Tearing can also bother you for a few days. Four days after the eyelid surgery, you will come to remove the stitches of the lower eyelid, after previously using some numbing ointment which makes the procedure painless.
The upper eyelid sutures will be removed three days later. Then you can use cold compresses that accelerate the full absorption of swelling and bruises.
Eyelid plastic surgery, even when done delicately, is an injury. This surgical wound manifests itself in two ways: bruising and swelling.
- Bruising is caused by the spread of a little blood under the skin. The gradual absorption of this blood makes the skin blue, green and then yellow. It is difficult to predict when they will disappear but ususally bruisses go away by weak two. It is certain that they will disappear, but it sometimes happens faster for some patients and some may have them for up to 3 weeks.
- Swelling is another way tissues react. This swelling often occurs quickly within the first 2 postop days. One week after the operation you will no longer have any swelling. However, you may have bruises, mainly on the lower eyelid, which will disappear completely in about 10-14 days. The use of makeup is allowed after the 6th day.
The purpose of the operation
You will not be unhappy in the end if you have realized that this surgery does not completely remove the wrinkles in the outer corner of the eye. It can eliminate most of them but a few will remain. The stretch we perform is very moderate because it is better to have a few small wrinkles than to deform the eyelid. A common complication for inexperienced surgeons with this procedure is an ectropion wich mean lower eyelid eversion with conjuctival show and inablility to shut the eyes. Both complications are due to excessive removal of skin and orbicularis muscle. I proudly must say that i have never had thsese complications as I take care of safety first. This operation gives us a stable result for many years. A second operation is possible and does not cause any problems although it is rarely necessary as the results last for more than 15 years.
From right to left immediate postoperative image without bruising (bruises).
Upper and lower eyelid surgery. Excess skin was removed from the upper and lower eyelids in order to soften the permanent wrinkles on the lower eyelids and the drooping fold of the upper eyelids.
- Eyelid surgery
- Duration of surgery
- -2 hours
- Recovery time
- 7-10 days