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Eyelid cosmetic surgery (technically called blepharoplasty)
is a procedure to remove fat-usually along with
excess skin and muscle-from the upper and lower
eyelids.
Eyelid cosmetic surgery can correct drooping
upper lids and puffy bags below your eyes, features
that make you look older and more tired than you
feel, and may even interfere with your vision.
However, it won't remove crow's feet or other
wrinkles, eliminate dark circles under your eyes,
or lift sagging eyebrows. While it can add an
upper eyelid crease to Asian eyes, it will not
erase evidence of your ethnic or racial heritage.
Blepharoplasty can be done alone, or in conjunction
with other facial surgery procedures such as a
facelift or browlift. If you're considering eyelid
surgery, this page will give you a basic understanding
of the surgical procedure -- when it can help,
how it's performed, and what results you can expect.
It can't answer all of your questions, since a
lot depends on the individual patient and the
surgeon. Please ask your surgeon about anything
you don't understand.
The best candidates for eyelid surgery

As people age, the eyelid skin streches,
muscles weaken, and fat accumulates around
the eyes, causing "bags"above and below. |
Blepharoplasty can enhance your appearance and
your self-confidence, but it won't necessarily
change your looks to match your ideal, or cause
other people to treat you differently. Before
you decide to have cosmetic surgery, think carefully
about your expectations and discuss them with
your surgeon.
The best candidates for eyelid surgery are men
and women who are physically healthy, psychologically
stable, and realistic in their expectations. Most
are 35 or older, but if droopy, baggy eyelids
run in your family, you may decide to have eyelid
surgery at a younger age.
A few medical conditions make blepharoplasty
more risky. They include thyroid problems such
as hypothyroidism and Graves' disease, dry eye
or lack of sufficient tears, high blood pressure
or other circulatory disorders, cardiovascular
disease, and diabetes. A detached retina or glaucoma
is also reason for caution; check with your ophthalmologist
before you have surgery.
All surgery carries some uncertainty and
risk
When eyelid surgery is performed by a qualified
plastic surgeon, complications are infrequent
and usually minor. Nevertheless, there is always
a possibility of complications, including infection
or a reaction to the anesthesia. You can reduce
your risks by closely following your surgeon's
instructions both before and after cosmetic surgery.
The minor complications that occasionally follow
blepharoplasty include double or blurred vision
for a few days; temporary swelling at the corner
of the eyelids; and a slight asymmetry in healing
or scarring. Tiny white-heads may appear after
your stitches are taken out; your surgeon can
remove them easily with a very tine needle.
Following cosmetic eyelid surgery, some patients
may have difficulty closing their eyes when they
sleep; in rare cases this condition may be permanent.
Another very rare complication is ectropion, a
pulling down of the lower lids. In this case,
further surgery may be required.
Planning your Eyelid Surgery

Before surgery, the surgeon marks the incision
sites, following the natural lines and creases
of the upper and lower eyelids. |
The initial consultation with your surgeon is
very important. The surgeon will need your complete
medical history, so check your own records ahead
of time and be ready to provide this information.
Be sure to inform your surgeon if you have any
allergies; if you're taking any vitamins, medications
(prescription or oover the counter, or other drugs;
and if you smoke.
In this consultation, your surgeon or a nurse
will test your vision and assess your tear production.
You should also provide any relevant information
from your ophthalmologist or the record of your
most recent eye exam. If you wear glasses or contact
lenses, be sure to bring them along.
You and your surgeon should carefully discuss
your goals and expectations for this cosmetic
surgery. You'll need to discuss whether to do
all four eyelids or just the upper or lower ones,
whether skin as well as fat will be removed, and
whether any additional surgical procedures are
appropriate.
Your surgeon will explain the techniques and
anesthesia he or she will use, the type of facility
where the surgery will be performed, and the risks
and costs involved. (Note: Most insurance policies
don't cover eyelid surgery, unless you can prove
that drooping upper lids interfere with your vision.
Check with your insurer.) Don't hesitate to ask
your doctor any questions you may have, especially
those regarding your expectations and concerns
about the results.
Preparing for your Eyelid Surgery

Underlying fat, along with excess skin
and muscle, can be removed during the operation. |
Your surgeon will give you specific instructions
on how to prepare for cosmetic surgery, including
guidelines on eating and drinking, smoking, and
taking or avoiding certain vitamins and medications.
Carefully following these instructions will help
your cosmetic surgery go more smoothly.
While you're making preparations, be sure to
arrange for someone to drive you home after your
surgery, and to help you out for a few days if
needed.
Where your Eyelid Surgery will be performed
Eyelid surgery may be performed in a surgeon's
office-based facility, an outpatient surgery center,
or a hospital. It's usually done on an outpatient
basis; rarely does it require an inpatient stay.
Types of anesthesia
Eyelid surgery is usually performed under local
anesthesia which numbs the area around your eyes
along with oral or intravenous sedatives. You'll
be awake during the surgery, but relaxed and insensitive
to pain. (However, you may feel some tugging or
occasional discomfort.) Some surgeons prefer to
use general anesthesia; in that case, you'll sleep
through the operation.
The Eyelid Surgery
Blepharoplasty usually takes one to three hours,
depending on the extent of the eyelid surgery.
If you're having all four eyelids done, the surgeon
will probably work on the upper lids first, then
the lower ones.
In a typical procedure, the surgeon makes incisions
following the natural lines of your eyelids: in
the creases of your upper lids, and just below
the lashes in the lower lids. The incisions may
extend into the crow's feet or laugh lines at
the outer corners of your eyes. Working through
these incisions, the surgeon separates the skin
from underlying fatty tissue and muscle, removes
excess fat, and often trims sagging skin and muscle.
The incisions are then closed with very fine sutures.
If you have a pocket of fat beneath your lower
eyelids but don't need to have any skin removed,
your surgeon may perform a transconjunctival blepharoplasty.
In this procedure the incision is made inside
your lower eyelid,leaving no visible scar. It
is usually performed on younger patients with
thicker, more elastic skin.
After your Eyelid Surgery

The surgeon closes the incisions with fine
sutures, which will leave nearly invisible
scars. |
After surgery, the surgeon will probably lubricate
your eyes with ointment and may apply a bandage.
Your eyelids may feel tight and sore as the anesthesia
wears off, but you can control any discomfort
with the pain medication prescribed by your surgeon.
If you feel any severe pain, call your surgeon
immediately.
Your surgeon will instruct you to keep your head
elevated for several days, and to use cold compresses
to reduce swelling and bruising. (Bruising varies
from person to person; it reaches its peak during
the first week, and generally lasts anywhere from
two weeks to a month.)
You'll be shown how to clean your eyes, which
may be gummy for a week or so. Many doctors recommend
eyedrops, since your eyelids may feel dry at first
and your eyes may burn or itch. For the first
few weeks you may also experience excessive tearing,
sensitivity to light, and temporary changes in
your eyesight, such as blurring or double vision.Your
surgeon will follow your progress very closely
for the first week or two.
The stitches will be removed two days to a week
after surgery. Once they're out, the swelling
and discoloration around your eyes will gradually
subside, and you'll start to look and feel much
better.
Getting back to normal

In a transconjuntival blepharoplasty, a
tiny incision is made inside the lower eyelid
and fat is removed with fine forceps. No
skin is removed, and the incision is closed
with dissolving sutures. |
You should be able to read or watch television
after two or three days. However, you won't be
able to wear contact lenses for about two weeks,
and even then they may feel uncomfortable for
a while.
Most people feel ready to go out in public (and
back to work) in a week to ten days. By then,
depending on your rate of healing and your doctor's
instructions, you'll probably be able to wear
makeup to hide the bruising that remains.
You may be sensitive to sunlight, wind, and other
irritants for several weeks, so you should wear
sunglasses and a special sunblock made for eyelids
when you go out. Your surgeon will probably tell
you to keep your activities to a minimum for three
to five days, and to avoid more strenuous activities
for about three weeks.
It's especially important to avoid activities
that raise your blood pressure, including bending,
lifting, and rigorous sports.You may also be told
to avoid alcohol, since it causes fluid retention.
Your new look

After surgery, the upper eyelids no longer
droop and the skin under the eyes is smooth
and firm. |
Healing is a gradual process, and your scars
may remain slightly pink for six months or more
after the eyelid surgery. Eventually, though,
they'll fade to a thin, nearly invisible white
line.
On the other hand, the positive results of your
eyelid surgery the more alert and youthful look
will last for years. For many people, these results
are permanent.
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FCSC › surgical
procedures › Cosmetic
Plastic Surgery › Eyelid Surgery |
| False Creek Surgical Centre #600,
555 West 8 Avenue, Vancouver, British Columbia, BC, Canada |
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