Why Men and Women Have Eyelid Rejuvenation

The eyelids are subject to several conditions that can be improved operatively. First, some people are born with excess fat in the lids that presents as bulges, particularly of the lower lids, even in youth. More commonly blepharoplasty is performed for the correction of wrinkled, excess skin that develops as a result of the loss of elasticity that occurs with aging. Often, some bulging of eyelid fat begins to appear with aging. The correction then involves both the fat and the skin. Occasionally, the operation is performed on the upper lids because the skin hangs down so far that it interferes with upward gaze. The operation done for this condition may be covered by insurance if the condition can be documented by special tests done by an ophthalmologist. In other instances, the severe overhang of the lids is caused by drooping of the brow rather than excess eyelid skin. In this situation a brow lift, with or without a blepharoplasty, may be indicated.

Occasionally, patients develop weakness of the muscular attachments between the muscle that opens the upper lid and the lid itself, causing the lid to droop over the cornea. This requires a separate correction that can be done as a part of an aesthetic blepharoplasty. This condition, called acquired ptosis, usually results from the aging process, but is occasionally a result of injury to the lid and is usually covered by most health insurance policies.

Because no two patients have exactly the same problem or expectations, the operative procedures must be individually designed. The technique and results will vary according to the circumstances.

As is true of all procedures for aging skin, the result cannot be expected to remain unchanged as years pass. In general, however, the effects of blepharoplasty are quite long lasting, and many patients never feel that a secondary operation is required.

The Eye Lift

This is most frequently done as an isolated procedure, but it is often combined with facelift or brow lift. If done alone it is usually done as an outpatient procedure under local anesthesia and intravenous sedation. It usually takes about 90 minutes to do all 4 lids.

The upper lid operation usually involves removal of excess skin just above the eyelid crease. Depending on the problem presented, some muscle and fat may be removed as well. The scar can be expected to be a fine line at or near the upper lid crease. It will be pink for a few weeks after the operation but will fade and become quite inconspicuous in most patients. Make-up can be used over the scar after about one week postoperatively. The sutures are all removed by the fifth day postoperatively. Bruising should be expected and may last as long as 10 days.

The lower lid operation is more complex. The incision is just below the lower lashes and extends lateral to the eye in a “crow’s foot” skin line. Sometimes the lower lid is lax and needs to be tightened horizontally as a part of the operation. If this is necessary in your case, we will discuss it with you in as much detail as you wish. The skin wound is sutured. All sutures are removed by the fifth postoperative day. Bruising is often worse from the lower lid operation than in the upper lids.

After Eyelift Surgery

Most patients are surprised at how well they get along starting on the day after surgery. Usually, most activities are possible starting the day after the operation. We suggest that active exercises be avoided for a few days. If you do not want your friends to know that you have had the operation, it would be wise to avoid social activities for a week or so. After that, there may be some bruising, but it can usually be covered with makeup and the swelling has usually decreased to a socially acceptable level.

It is wise not to wear contact lenses for 10-14 days after eyelid surgery. In this initial healing period, the skin of the lids should not be pushed and pulled about.

After the operation the eyelids do not function normally for several days. You may experience some blurred vision as a result of this. Liquid tears are very helpful during this period. Immediately after the operation the lids may not close completely. This is entirely normal.

Cool compresses are important in your postoperative recovery. We will begin applying these to your closed eyelids almost immediately after the operation, usually in the operating room. They should be continued for the first 48 hours after the operation. They may help to minimize swelling and bruising but do not affect the healing process. You will be instructed about their preparation.

Occasionally the bruising extends to the white of the eye where it appears bright red. This will clear in about 10 days. The incisions will look very good immediately after the sutures are removed. They will become pinker over the next few weeks. After 6-8 weeks they will begin to fade until ultimately they become very difficult to find. This will take several months. In this period make-up is helpful thought the scars are in inconspicuous areas and are not easily noticeable. There is frequently a feeling of tightness in the lids for a few months. This is a part of the normal healing process and will gradually resolve.

You may shower immediately. You may wash the eyelids gently, even while the sutures are still in place.

Complications of Surgery

Complications are quite rare after this eyelid rejuvenation operation, but, as in all surgery, they exist. Hematomas and infections are very unusual, but if your lids are feeling worse with time, rather than better, you should call us. Also let us know if you have a fever or are otherwise sick. Hemorrhage behind the eye is very rare but it does occur. It is usually manifested by extreme pain in the immediate postoperative period. As with all cosmetic operations, the postoperative pain should be controlled with the medication we prescribe for you. If it is not, you must let us know. Hemorrhage behind the eye can cause visual problems, but this is exceedingly rare.

Is Eyelid Rejuvenation Right for You?

If you have questions or want to know more about blepharoplasty (or eyelid rejuvenation), give my office a call and schedule an appointment. I am happy to take the time to explain the entire procedure to you, so that you can decide if this is the right surgery for you.

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