What is Eyelid Surgery (Blepharoplasty)?
Eyelid Surgery, also known as Blepharoplasty, is a procedure that allows Dr. Barrera to address drooping or aging eyes. As you age, the thin skin near your eyes may sag or become wrinkled. Through the removal of excess skin, patients can experience an appearance that makes them look years younger!
Am I a Candidate for Eyelid Lift Surgery?
Any one or combination of the following conditions may indicate that you may be considered a good candidate for eyelid surgery:
- Excess skin obscuring the natural fold of the upper eyelids
- Loose skin hanging down from the upper eyelids, perhaps impairing vision
- A puffy appearance to the upper eyelids, making the eyes look tired
- Excess skin and fine, “crepe paper type” wrinkles of the lower eyelids
- Bags and dark circles under the eyes
- Lower eyelid droopiness
Aesthetic eyelid surgery can usually correct these problems, though other treatments may also need to be considered. Some examples follow. If the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of crow’s feet may be accomplished with Botox, chemical peeling or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with fillers such as Hyaluronic Acid or fat as well as bleaching solution or chemical peel. Your plastic surgeon can provide further information if you have an interest in any of these additional procedures.
Eyelid Surgery Results
Aesthetic eyelid surgery has the effect of making you look more rested, refreshed and alert. Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months usually becoming barely visible. The results of aesthetic eyelid surgery are usually long-lasting, but they may be affected by heredity and lifestyle factors. Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur.
The skin continues to age, however, and skin laxity along with the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows which mimics a recurrence of drooping upper eyelids. If this happens, correction may require a forehead lift or a secondary eyelid procedure. Even though the aging process continues, patients are usually happy with their appearance for many years following eyelid surgery. Some patients find that they want to make additional improvements at a later time.
During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help Dr. Barrera to understand your expectations and determine whether they can realistically be achieved.
You should come to the consultation prepared to discuss your medical history including previous surgeries, past and present medical conditions and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems, diabetes, etc. should be reviewed as these medical conditions may increase some risks associated with eyelid surgery.
Your plastic surgeon will want to know if you have allergies, especially if they affect your eyes. He or she may ask whether you have ever tried and were unable to wear contact lenses.
It will be necessary for Dr. Barrera to know if you were ever told by an ophthalmologist that you have a condition called “dry eye” or if you have any other problems with your eyes.
Preparing For Eyelid Surgery
The goal of Dr. Barrera and the entire staff is to make your surgical experience as easy and comfortable for you as possible.
If you are a smoker, it is highly recommended to stop smoking well in advance of surgery. Smoking can impair your ability to heal. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Dr. Barrera will provide you with additional preoperative instructions.
Aesthetic eyelid surgery is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for the next 24 hours.
The Day of Eyelid Surgery
Dr. Barrera performs all aesthetic surgery procedures including eyelid lift at his Accredited Ambulatory Surgical Facility (AAAASF) under IV sedation and local anesthesia, without the need for general anesthesia (painless during the procedure and minimal pain afterwards). This provides added safety and faster recovery. Most patients are able to go home within an hour from the end of the 1 to 2 hour procedure with minimal discomfort.
One of several surgical techniques may be suggested to improve the appearance of your eyelids. The particular technique that Dr. Barrrera recommends will depend on many factors such as the amount of excess fat and skin in the eyelid areas, the position of your eyebrows, and the condition of muscles around your eyelids. Because of individual factors, not everyone will achieve the same results from eyelid surgery. Dr. Barrera will select the surgical technique that he feels will obtain the best outcome for you.
For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it usually is inconspicuous.
For lower eyelid surgery, often an incision is hidden just below the lower lashes. Through this incision, excess skin, muscle and fat are removed, or fat may be redistributed to eliminate puffiness or bulges. Other adjustments to correct special problems such as muscle laxity may be performed.
As in upper eyelid surgery, placement of the incision in natural crease lines allows for the scar to usually heal in an inconspicuous fashion. In some cases, you and Dr. Barrera may decide that the best approach for removing excess fat is through an incision placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. A laser may sometimes be used in conjunction with this method to tighten the lower eyelid skin.
Eyelid Surgery Recovery
It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first few days after surgery, you should rest quietly with your head elevated. Dr. Barrera may instruct you to apply cold compresses to your eyelids. Remember, you must not take aspirin or certain anti-inflammatory medications. Initially, you may feel a “tight” sensation around the eyes and some mild discomfort that can be controlled with oral medication. During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. Some patients find that mild swelling persist for several weeks, while others may see swelling resolve in as little as one week. Bruising typically disappears within seven to ten days. Within the first week or so, you will be permitted to use makeup, if desired, to conceal any discoloration. Stitches are usually removed within a week of surgery.
Your vision may continue to be somewhat blurry for a few days or longer. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. Dr. Barrera may recommend eye drops to help relieve any burning or itching. You may then want to wear dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation.
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within ten days or less. Although you might feel like going back to work just a few days after surgery, your vision may still be slightly blurry which could make reading or other paperwork more difficult.
Eyelid Surgery Risks
Fortunately, significant complications from aesthetic eyelid surgery are infrequent. Every year, many thousands of people undergo eyelid surgery successfully, without experiencing any major problem.The subject of risks and potential complications of surgery is best discussed on a personal basis between you Dr. Barrera or with a staff member in Dr. Barrera’s office. The risks in most surgeries are similar. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection, changes in sensation, scarring, allergic reactions, damage to underlying structures, need for revisions, unsatisfactory results possibly necessitating additional procedures and medical risks. Following the surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. Following surgery, there is a possibility of impaired eyelid function that sometimes may need to be corrected by additional surgery.
You can help minimize certain risks by following the advice and instructions of Dr. Barrera, both before and after your eyelid surgery.
Blepharoplasty Before & After
What type of anesthesia is necessary for Eyelids surgery (Blepharoplasty)?
I always do my eyelids under a twilight IV Sedation and Local anesthesia. There is No pain at all during surgery and little to no pain afterwards. It is extremely rare to have nausea or vomiting after surgery, which allows a faster recovery to go home or to a local hotel the same day soon after the procedure. This also eliminates the risk for Deep Vein Thrombosis and Pulmonary emboli which may occasionally occur when done under General Anesthesia with gases.
I do not like to use General anesthesia especially because, it is not necessary. When you receive General Anesthesia you would need to be paralyzed, and intubated so you breathe. With IV Sedation and local, you are not paralyzed and you are breathing on your own. With General anesthesia, the recovery is much slower with a higher risk for nausea and vomiting, and often requires an overnight stay in the hospital. There is also the risk for more bruising, and risk for infection when done at a hospital as opposed to a private facility where only healthy patients are treated.
How long am I going to have bruising after my eyelids surgery?
It varies from patient to patient, some within 7-14 days look great already with minimal to no bruising. In other patients (especially if they have high blood pressure or tendency to bruise easily may take 2-3 or even weeks, this is rare,
How soon can I return to work?
Most patients are able to go back in about a week, (sometimes sooner) and may need some make up as the bruising can sometimes last a little longer.
Is eyelid surgery safe?
It is very safe if performed by an experienced, careful and well qualified Plastic Surgeon it is very safe.
What are the most frequent complications of Eyelid surgery?
1) Malposition of the lower lid margin (Scleral show or Ectropion) is the most frequent complication after lower eyelid surgery. I make sure to always prevent this by using a very secure safe suspension technique, securing the margin to the lateral orbital wall.
2) Temporarily, your eyes may be tearing or feel dry. Slight blurring of the vision for a few days may occur.
3) Swelling of the conjunctiva and or Subconjunctival hemorrhage (thin redness of the conjunctiva) which is rare and self resolves.