AESTHETIC SERVICES

Blepharoplasty

Blepharoplasty is a surgical technique that can dramatically eliminate the signs of aging and improve a tired or upset appearance by removing the excess skin, fat and tissue that cause droopy, baggy eyelids. It is one of the most popular aesthetic procedures performed in the United States, and has a tremendous impact on the overall appearance of the face. Several factors contribute to an appearance of aging around the eyelids, including loss of skin elasticity, years of sun exposure, downward pull of gravity, heredity, and thinning of tissue. These factors lead to a condition called dermatochalasis, or excess skin, wrinkles, fat, and tissue around the eyelids. Though dermatochalasis is often associated with aging, some patients may develop this condition earlier in life.

Blepharoplasty surgery is not only performed for cosmetic purposes to enhance appearance, but it can also improve function. Blepharoplasty is performed for reconstructive purposes to correct visual impairment caused by drooping of the upper eyelids, or ptosis. (see ptosis section for more details)

Before eyelid surgery, the patient may need to undergo a physical by their primary physician, and usually discontinues taking any blood thinner medications. Patients typically undergo surgery at an outpatient surgery facility. Surgery is usually performed under local anesthesia with intravenous sedation and lasts one to two hours.

For upper and lower eyelid blepharoplasty, the extra skin, fat, and tissue is removed. If the muscle that lifts the upper eyelids is involved, ptosis surgery is performed to shorten or tighten a weakened muscle. The skin incisions are then closed with suture at the natural eyelid crease in the upper eyelid and just under the lashes in the lower eyelids. Additionally, laser resurfacing, chemical peels, skin care products, or Botox injections can be performed in conjunction with surgery to smooth and tighten the surrounding skin.

Patients are instructed postoperatively to use ice packs, antibiotic ointment on the incisions a few times a day, ice for 2-3 days and to sleep on 2 pillows. Pain is usually controlled with oral pain medication. Bruising and swelling of the eyelids peak the first 48 hours, and can typically last one to two weeks after surgery. Sutures are either dissolvable or removed in the office 5-7 days after surgery. By two weeks, much of the healing is complete, with residual minor healing over the next few months.

The major risks of blepharoplasty are bleeding, infection, scarring, wound infection, asymmetry of fat or skin removed, or loss of vision. Removal of too much skin can cause serious problems relating to inability to completely close the eyelids and severe dry eye problems. Severe bleeding around the eye is a rare complication, but it can affect vision and should be reported to the physician immediately. In ptosis surgery, there are many factors that determine the overall outcome of the eyelid position, and consequently an adjustment of the eyelid may be necessary in some patients to achieve symmetry or proper position.

Surgeons who perform blepharoplasty and ptosis surgery must have an excellent knowledge of the anatomy of the eyelids and the face as well as an appreciation of the aesthetic and functional goals of each patient. Though traditional techniques of blepharoplasty should be known, the surgeon must customize the approach that best suits each individual patient. Facial rejuvenation is an evolving art and science, with new and improved techniques continually developing.