Surgery around the eyes can be broken down into upper lid and lower lid procedures named blepharoplasty. Upper lid surgery is recommended for patients with too much skin on the upper eyelid. In extreme cases, the skin can hang down and rest on the eyelashes when you eye is open. These conditions worsen with age, sun exposure and even have genetic factors. Lower eyelid surgery is recommended for patients with excess skin in the lower eyelid leading to wrinkles and bags under the eye which are a result of fat bulging between the eye and the cheek.
During an evaluation of upper eyelid surgery, The amount and location of excess skin is evaluated. In addition, the position of the brow and bulging fat in the compartment nearest the eye needs to be carefully assessed. If your eyebrow is droopy, a browlift at the same time as upper eyelid surgery may be beneficial. Sometimes a browpexy can be done to slightly raise the outside portion of the brow through the same incision used for an upper eyelid surgery. If bulging fat is noticed, then the surgical plan will include removing pockets of fat to ensure a more restored look.
Surgery can be done under local anesthesia with a mild sedative in our operative suite. Incisions are carefully marked out before the procedure while you are sitting up. Excess skin and muscle are removed and fat is taken out if necessary. Swelling and bruising subside in 5-7 days and the sutures are removed at your first post operative visit.
During an evaluation of lower eyelid surgery, the main issue to be addressed is evaluated. If bulging fat is the main problem, an approach through the inside of the eyelid can be used avoiding a scar on the eyes and lessening the chance of the lid edge to become distorted. If there is a combination of bulging fat and excess skin creating wrinkles, then an incision just below the lash line is used.
Surgery is done in our operative suite. Fat is removed or repositioned in 3 under eye compartments. If there is a skin incision, the lower eyelid is suspended with a deep stitch and the incision is closed with fine absorbable suture to ensure a minimal scar which is barely noticeable. This is used to avoid any discomfort form removing sutures too close to the eye. Swelling and bruising subside in 5-7 days.
Results are obvious soon after surgery. The intended effect is to open and brighten the eye and eliminate features that can give you a tired look.