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Eyelid Lift
Eyelid surgery (technically called
blepharoplasty) is a procedure to
remove fat--usually along with
excess skin and muscle from the
upper and lower eyelids. Eyelid
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 information will give
you a basic understanding of the
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.
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The best candidates
for Eyelid Surgery
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 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. |
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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
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
whiteheads may appear
after your stitches are
taken out; your surgeon
can remove them easily
with a very fine needle.
Following 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 surgery
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
over-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
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
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
surgery
Your surgeon will give
you specific
instructions on how to
prepare for surgery,
including guidelines on
eating and drinking,
smoking, and taking or
avoiding certain
vitamins and
medications. Carefully
following these
instructions will help
your 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 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 surgery
Blepharoplasty usually
takes one to three
hours, depending on the
extent of the 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 surgery
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
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 10 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
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.
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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