Eyelid cosmetic surgery, or blepharoplasty, is an operation which corrects drooping eyelids as well as puffy bags and bulges about the eyes. These conditions develop as a result of laxity of the eyelid skin and protrusion of fat around the eyes. It is not limited to older patients, as many individuals inherit a predisposition toward development of fat pouches at an early age. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes – features that make you look older and more tired than you feel, and may even interfere with your vision, a visual field impairment. In some cases a browlift or foreheadlift is also required to fully correct the problem.
In the caucasian upper eyelid the deeper layers of the eyelid converge 6 to 8mm above the eyelid margin/eyelashes and 3 to 5mm above the upper edge of the eyelid cartilage to create a fold. In the Asian or Oriental upper eyelid these layers do not converge so there is no fold. Additionally the fat descends into the eyelid giving the puffy look that is commonly seen in asian upper eyelids. The surgical procedure to correct this involves removing some of this fat and suturing these layers as well as the skin of the eyelid to the upper edge of the eyelid cartilage in order to create a fold. The puffy look is thereby also diminished. The suture used is absorbed by the body but the healing process keeps the new point of convergence intact.
The result is creation of a double lid. The inner corners of the eye remain unchanged so that an Asian look still exists. To treat the fold at the inner corner of the eyes if it is present and if the patient wishes it addressed it is best to augment the nasal bridge. This takes up the excess skin and gets rid of the inner corner skin fold without leaving any visible scar. Some minor surgical procedures have been devised to treat the inner corner fold but these leave scars in the area and do not address the cause of the problem which is insufficient nasal bridge in the Asian nose.
Filipino woman who under went upper eyelid blepharoplasty for impaired vision, covered by health insurance.
Chinese patient before and after upper and lower blepharoplasties of all 4 eyelids.
Japanese patient before and after upper and lower blepharoplasties of all 4 eyelids to remove excess skin and lower eyelid bags.
Blepharoplasty – eyelid surgery can enhance your appearance and your self confidence. Realistic expectations are important to be happy with any surgery. As each patient is an individual, different results can be expected in each patient.
The available alternatives depend on the exact problem. If the only issue is visible tear trough and palpebromalar grooves (lower eyelid creases) injectable fillers are a good though temporary non-surgical treatment. For mild eyelid skin excess or fine eyelid skin wrinkles alone radiofrequency, laser or chemical peel treatments are viable non-surgical options. They are however not risk free. If vision is impaired due to excess eyelid skin or the lower eyelids bags are severe with much excess skin there are no non-surgical alternatives.
As with any type of surgery there is the risk of infection or bleeding. There is the possibility of ectropion (a turning out of the lower eyelid) due to excessive skin removal and/or scar formation after surgery. If due to scar formation and caught early this can be resolved by manual traction on the eyelid or temporary placement of a Frost suture to counteract the downward pull of the scar tissue. There can be a temporary or permanent discrepancy in the level of the lower eyelids due to skin removal, swelling or scar formation. There is the very rare possibility of blindness. Malar pouches (redundant swollen skin over the cheek bones) can be lessened but cannot be eliminated. Xanthelasma (deposits of fat within the eyelid) may diminish with eyelidplasty but this cannot be guaranteed. Fine wrinkles and visible blood vessels cannot be completely removed with eyelidplasty. If sutures are used to tighten the lower eyelid connection to the outer eye socket rim they can break, loosen or become palpable.
Some patients develop swelling of the eyeball covering (chemosis) that resolves with eye drops containing an anti-inflammatory steroid.
Any of these complication may require additional surgery that may not be covered by health insurance if the original procedure was not covered. Close follow up after surgery can catch an early complication that with proper care can be resolved so that additional surgery is not required. It is imperative that patients comply with postoperative instructions and not miss office appointments after surgery in order to have a smooth complication free recovery.
The benefits include improved vision, a more youthful appearance, not looking tired all of the time and getting rid of eyelid bags.
Ice compresses are applied for the first 24 hours. You can place 3 wet washcloths in the freezer & serially apply them. Alternatively, a bag of frozen peas can be used as a compress. Artificial tears & eye ointment are prescribed for 4 to 8 weeks to prevent dry eye.
There will be discoloration about the eyes for several days, and in some cases this can persist for considerably longer periods. The head is kept elevated, no lying flat or head down position for 1 week. Lower eyelid massage is begun at 6 days after all the sutures are removed to prevent scar formation. False eyelashes can be worn beginning 6 days after the operation. Vigorous or strenuous physical activity is restricted for 2 weeks. Even jogging at 1 week can cause a problem. Most normal activities & work may be resumed within 1 week after the operation. Bruising usually resolves within 2 weeks and can be covered with camouflage make up beginning about a week after surgery.
Contact lenses should not be worn the day of surgery or after surgery until Dr. Stone clears you to wear them.
Dr. Aaron Stone
Call today for a consultation!120 South Spalding Dr, Suite 330
Beverly Hills, Los Angeles,CA 90212