The Best Candidates
- Heavy upper eyelids or excess skin of your eyelids
- Suffer from eye fatigue at night
- Puffy bags or excess skin of your lower eyelids
- Have up to date lens prescriptions and do not suffer from dry eyes
- Do not have a history of serious eye trauma, Grave’s disease, or uncontrolled glaucoma
- Healthy, non-smoker, and not taking any blood thinner medication
The Options
The gold standard for eyelid rejuvenation is surgical removal of excess skin and tissue. Upper eyelid surgery entails removal of the upper eyelid skin, a small amount of muscle, and occasionally some fat. Other treatment modalities to rejuvenate the upper eyelids and surrounding areas include laser therapy, injectable fillers, fat grafting, and neuromodulators such as BOTOX® Cosmetic and Dysport®. Although these complementary procedures provide a measure of eyelid rejuvenation they are often not as effective as blepharoplasty.
Lower eyelid surgery is less commonly performed due to these alternative treatment options which can be effective and less invasive. Lower blepharoplasty can be performed through an incision in the lower eyelid skin or via an incision on the inner aspect of the eyelid depending on your surgical goals.
The expert surgeons at Restore SD will perform a thorough evaluation and partner with you to develop an eyelid rejuvenation plan that will effectively and safely optimize your results.
The Surgery
Upper blepharoplasty can be performed in the office setting with local anesthesia, at an ambulatory surgery center setting under sedation, or with general anesthesia. The type of anesthesia is dependent on your comfort level and safety standards that account for any medical conditions you may have. The surgery generally takes about an hour. Once the anesthesia is in place the surgeon will make incisions in the upper eyelid and carefully remove the skin and a small strip of muscle. Rarely, some fat is also removed through this incision. Your surgeon will then close the incision with a very fine suture and apply eye ointment. You will have ice packs applied immediately after surgery and be positioned with your head elevated.
Lower blepharoplasty is typically performed in conjunction with upper eyelid surgery and accomplished in the ambulatory surgery center under general anesthesia. This surgery takes 1-2 hours. Your Restore SD plastic surgeon will make a lower eyelid incision either in the skin (if excess skin is to be removed) or through the inner eyelid (if fat only is being removed). The excess tissue is carefully removed and the remaining skin and fat is re-draped to smooth the lower lid contour and blend the lid-cheek junction. The lower lid is usually supported with an internal suture and the incision is carefully closed with very fine suture. Ice packs and ointment are applied to assist in your comfort during recovery.
Certain laser treatments can be effective in tightening and smoothing the lower eyelid skin. Not everyone is a candidate for this form of therapy and your Restore SD surgeon will discuss the best options with you to help you achieve your goals.
The Recovery
Once you have recovered from the anesthesia you can return home, as blepharoplasty is an outpatient surgery. You should arrange to have a responsible adult drive you home and stay with you for the next one to two days. Some surgical pain is expected and treated with pain medications. In the immediate post-operative period, your eyelids are swollen and vision is blurry due to the ointment, usually returning to normal over the next day. Most patients can return to work after 1 to 2 weeks. It is generally safe to start applying makeup after 2 weeks. Normal activities such as showering, eating and light activity such as walking can be resumed within 24 hours after surgery. Some post-operative swelling is normal and resolves in the first 4 weeks in the typical patient. You should refrain from intense physical activity for 4 weeks. During the recovery period, you will have follow-up with your Restore SD surgeon and will be guided back to your usual activities. Most complications occur from getting too active too early, so select a surgical date that allows an appropriate amount of time to heal and gradually return to your more vigorous activities.
The Combined Procedures
Blepharoplasty is often performed in conjunction with other facial rejuvenation procedures, most commonly brow lift and facelift. It can be combined with laser resurfacing, BOTOX® Cosmetic, dermal filler injections, or fat grafting. Blepharoplasty can also be combined with breast augmentation, tummy tuck, liposuction, or surgery to enhance other areas. In your consultation, Dr. Katerina Gallus will talk with you about which procedures can be safely performed at the same time.
