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Eyelid Surgery

What is it?

Upper eyelid surgery (known as blepharoplasty) involves removing the sagging, excess skin over hanging the eye lid causing forehead fatigue, a decrease in peripheral vision (the so call blinder effect), a feeling of heaviness and sometimes irritation due to eye lashes being pushed into the eye or sweat collecting in the lid crease.

How long does it take?

The surgery is an in office procedure, which takes approximately 90 minutes.

What are the steps of the surgery?

First the excess tissue is marked and then numbing medication is injected to the area. Once you are completely numb we remove the excess tissue and then suture the lid back together. The suture stays in place for 1 week and then is removed.

What kind of anesthesia will I receive?

You will receive a subcutaneous (meaning: under the skin) injection of numbing medication to the upper eye lid and we make sure you are numb before proceeding. If at any time you are uncomfortable we can give you more numbing medication.

The only discomfort experienced during the procedure is the stinging and pressure you feel during injection of the numbing medication.

What kind of recovery and healing can I expect?

Expect to look significantly bruised and swollen for 2 weeks after the procedure. Consider wearing a big pair of mysterious dark glasses and don’t plan on any family portraits for the first two weeks after your surgery.

I warn all my patients that “you are going to look awful” for at least 2 weeks after this procedure. And, it takes at least 6 weeks before all the puffiness and swelling goes away and for the tissue to settle down to evaluate how you feel about your appearance. Be patient, this surgery looks better the more time you give it to heal.

Also, you should expect to not be symmetric after the surgery. No one’s face is symmetric, it wasn’t before the surgery and it won’t be afterwards either. I also tell people I cannot make them look like someone else, you will still look like you only with less saggy skin. I like people to look natural, not surgical.

How often do I need to be seen after my surgery?

We want to see you one day (to remove your bandages), one week (to remove your sutures) for suture and 6 weeks after your procedure.

When can I go back to my normal activities?

Work? 2 days.
After your procedure give yourself the rest of the day off and you will need to be seen in the office the next day – so usually most people want to take at least 2 days off for their procedure.

Exercise? 1 week.
We love how you keep yourself healthy by exercising, but, for the first week after your surgery take it easy. It is okay to walk, but, avoid heavy lifting, strenuous activity, and anything that involves lots of sweating.

When can I wear makeup again?

10 days. You can start wearing makeup again 10 days after your surgery. If you wear makeup regularly, I know it is hard to give it up, but, it is only for 10 days and you have less chance of infection if you avoid getting the makeup in your new incision.

Should I stop my blood thinners?

It all depends on why you are on them in the first place. Talk to your doctor about your individual case.

Will I ever need eye lid surgery again?

Gravity and aging will continue to operate after you’ve had the surgery, so, it is possible you may need another procedure, but, it is unlikely. In order to decrease your risk of additional sagging and stretching of the skin, avoid rubbing your eyes and protect yourself from the sun.

What are the risks of eyelid surgery?

The biggest risk of blepharoplasty is over- or under-correction.

Over correction means too much skin has been removed and you may have trouble closing your eyes. If you have trouble closing your eyes you will need to use artificial tears to keep them lubricated and comfortable. Gentle massage once your sutures are removed usually corrects this problem.

Under correction means not enough skin has been removed and you may have some residual sagging.

Infection
As with any surgery we also worry about infection. We prep your eye with an antibacterial solution prior to the surgery and use sterile technique during the procedure to avoid infection. We also place an antibiotic ointment to your incision and sutures at the end of the procedure. If any sign of infection is noted as you are recovering we can treat you with additional antibiotics

Bleeding
Some bleeding after surgery is normal, however, if your bandages become soaked call our office and speak with our on call doctor.

Loss of vision
An exceptionally rare complication of this surgery is bleeding behind the eye which could cause vision loss. We ask that you monitor your vision the evening after your surgery and if you notice a graying out of your vision to call our office immediately to speak with our on call doctor.

What will the day of surgery be like?

On the day of surgery you will come into the office and do paperwork. Then we will take you to our procedure room. A bonnet will be placed over your head to keep your hair out of the way. The skin to be removed will be marked by your doctor and then we will lay you back in our procedure chair, wash around your eyes with antibacterial solution and place plastic drapes around your eyes. No plastic drape will be placed over your mouth or nose – you will be able to breathe unobstructed. We will make sure you are numb prior to starting the procedure. The procedure itself will take about 1 hour. When we are done, compressive bandages will be placed over your upper lids insuring a small slit to look through to monitor your vision. You will need someone to drive you home.

What will it feel like afterwards?

Most people describe the discomfort after your surgery as a feeling like bad sunburn to that area. For pain the best thing to do is place a cool compress over the area and consider taking your normal over the counter pain reliever.

How will I take care of myself for the first day after surgery?

Go home and take it easy. No lifting more than 15 pounds for the next 24 hours. Leave your bandages in place. Keep your head elevated (sleeping in a recliner or with a number of pillows underneath your head is ideal) this will really help keep the swelling down. Also every hour for 10 minutes place cool compresses to your bandaged area – this will help with the pain and decrease the swelling. If you are very uncomfortable consider taking a dose of your normal over the counter pain reliever.

How will I take care of my surgery after the bandages are removed?

Do not rub your eyes or get any water to the area for 10 days after your surgery, this will prevent infection. Additionally, the suture material we use is very delicate and can easily break if you rub your eyes or try to wash them. Continue keeping your head elevated while you sleep – this will make the swelling go away faster. And, for the first day after the bandages are off consider continuing to use cool compresses every few hours to decrease the swelling. We recommend a vitamin C supplement for the first month after surgery to help with your healing. Also, to insure that your incisions heal well and don’t become noticeable scars, you should stay out of the sun.

How will I take care of my surgery after the sutures are removed?

Continue to not rub your eyes, to not apply makeup and to not get any water to your incision for another 3 days after your sutures come out. You can also start placing vitamin E oil to your incision, vitamin E oil truly helps you heal and decreases the appearance of scarring – just be careful if you get the vitamin E oil in the eye it can cause irritation (but, will not harm your eyes).