Facial Procedures - Blepharoplasty / Eyelids

Blepharoplasty / Eyelids

How do I know if I need an upper eyelid lift or a browlift?

It depends on the position of the brow. During the initial consultation to evaluate the upper eyelids, the doctor uses his hands to raise the patient’s forehead skin to an appropriate level. When the forehead skin is raised, if most of the upper eyelid skin disappears, a patient would most likely benefit from a forehead lift. If raising the forehead skin has little or no effect on the upper eyelid skin, an upper eyelid lift (blepharoplasty, the technical term for eye lid lift) may be all that is in order. If improvement is noted when the sagging brow is lifted and excess skin remains on the eyelids, a combination of browlift and upper eyelid blepharoplasty may be recommended to achieve a more youthful appearance.

Will I still look like “me” after surgery?

Many of our patients report that, upon return to work and routine daily activities, friends and acquaintances make the following remarks: “Gee you look great. Did you change your hairstyle?” or “Have you been on vacation?” Retaining your uniqueness is the sign of a successful procedure. Although the change may be significant to you, it’s not uncommon that friends and family don’t really notice the specific changes.

Eyelid  incisionsWill I have any incisions in my skin?

For traditional lower eyelid blepharoplasty, it is common that an incision is made in the lower eyelid skin (photo A) with removal of excess skin and fat to achieve a refreshed look. Eyelid skin is one of the most “forgiving” areas of the body and these incisions typically heal extremely well.

An advanced technique that has been performed successfully for the past five years is the transconjunctival blepharoplasty (photo B). With this approach, the incision is made just inside the lower eyelid and no external skin incision is required. Through the incision the offending fat (which is responsible for the “bags” or “circles” under the eyes) can be removed.

Will a blepharoplasty take away the crows feet and all the fine wrinkles?

Some patients find that, along with baggy eyelid skin, an additional source of concern is textural or surface changes (fine little lines) in the skin around the eyes. Patients who elect to combine blepharoplasty with a skin resurfacing procedure also remove textural imperfections and crows feet. Skin resurfacing, performed to address textural changes on the skin surface, includes laser skin resurfacing and chemical peels.

Will I be awake during surgery?

Using IV sedation (medicine administered through an IV) and a local anesthetic (numbing medication administered in the operating room), patients are asleep during surgery. Patients do not hear or feel anything and are comfortable during surgery. Patients wake up very soon after the operation is completed.

Is it painful?

After any surgical procedure, some discomfort can be expected. All patients are provided with prescriptions for pain medication. Patients sometimes use the prescription medication two to three days after surgery and then switch to Extra Strength Tylenol. It is uncommon for patients to report unmanageable pain after surgery.

How long does my surgery take?

The length of surgery depends on several factors including the complexity of each person’s eyelids.

Can I drive myself home after surgery?

NO. Because of the effects of anesthesia, patients are not able to drive themselves home after the surgery.

What do I look like when I wake up from surgery?

Following the procedure, you will have soaked iced saline eye pads on your eyes with antibiotic ointment in your eyes. Your eyelids will be swollen. You may have some bruising under your eyes, however, this typically is more pronounced 24-48 hours after the procedure.

What does it feel like when I wake up from surgery?

Your eyes will be swollen and it will be difficult to see. We will make sure you are not nauseated or queasy. Our nurses will be right there with you as you wake up from surgery to give you special attention.

When can I go back to work?

Most patients take two weeks off work but occasionally a patient returns after one week. After two weeks, any residual bruising and swelling can easily be camouflaged with make-up. Patients who are more concerned with privacy prefer two weeks off work.

How long will bruising and swelling last?

Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of bruising or swelling may take two to three weeks. However, you may camouflage bruises fairly easily at seven to ten days with concealer stick.

I’m not ready for cosmetic surgery. Is there anything I can do to improve my eyes?

Skin resurfacing including Botox, Collagen and light skin peels may be the treatment of choice for patients who for many reasons may not be ready to undergo surgery.  A brow lift or Contour Thread Lift may be the less invasive answer for you as well.  Learn more about the many alternatives on our Facial Rejuventation page.

When will I look “normal?”

Most of our patients tell us that they look “normal” at about two to three weeks. You will look better at six weeks and even better still at six months. Final results are evaluated at one year. However, at two weeks you know you are well on the way to recovery. After three months, most patients have about 90% of their final result.