|
Blepharoplasty (upper and/or lower eyelid lift)
Eyelid surgery (technically called blepharoplasty) is a procedure to correct drooping upper lids and puffy bags below your eyes - features that can make you look older and more tired than you feel.
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.
When eyelid surgery is performed by a qualified oculoplastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anaesthetic.
I usually perform upper lid lifts under local anesthesia--which numbs the area around your eyes, sometimes with intravenous sedation. You'll be awake during the surgery, but relaxed and insensitive to pain. (However, you may feel some tugging or occasional discomfort.) For all 4 lids I recommend intravenous sedation in all cases, unless you prefer to use general anesthesia; in that case, you'll be asleep through the operation.
Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, I usually work on the upper lids first, then the lower ones. If you would benefit from a small incision brow lift this can be done at the same time.
In a typical procedure, I make 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, I separate the skin from underlying fatty tissue and muscle, remove or redrape excess fat, and often trim 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, I usually recommend 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. It cannot enhance the fine lines on the lower lid skin however, but can be used with a chemical peel or CO2 laser to subsequently treat these lines.
After surgery, I 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 usually control any discomfort with paracetamol. If you feel any severe pain, call me immediately.
Post-operative I recommend you to keep your head elevated for several days, and use ice packs 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.)
The stitches will be removed 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.
Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing, 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 sunblock when you go out.
Keep your activities to a minimum for three to five days, and 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. Minimise alcohol, since it causes fluid retention.
Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they'll fade to a thin, nearly invisible white line. You will always be able to find your scars, but I aim for strangers to be unable to see them at 6 weeks, and your friends unable to see them by 6 months.
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.
|
