EYE LIDS

Often, the eyes are the first part of the face to show signs of aging. Blepharoplasty, the clinical term for eyelid surgery is performed to counteract the effects of sum damage, heredity and gravity. Since the skin is rather thin around the eye area, fat accumulation under the eyes, saggy and crinkled skin is generally more noticeable.

Eyelid surgery can be performed separately or in conjunction with other facial procedures, such as a facelift. Occasionally, if the condition has persisted for a long time eyelid skin can interfere with vision. In those cases, insurance may pay for a portion of the surgery. Although most people consider eyelid surgery as a part of age-related cosmetic surgery, many younger people even in their teens can have eyelid surgery for the correction of extremely puffy eyes or due to excess skin.

Some important facts about blepharoplasty:

• Blepharoplasty is the second most common procedure performed on both men and women.
• Upper and lower "blephs" can be performed in conjunction with other procedures or by themselves.
• Eyelid surgery alone cannot eliminate the crow’s feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging brows.
• The position of the brows is not changed with eyelid surgery.

ALTERNATIVES TO SURGERY
Unfortunately, there are no alternatives to correcting saggy, baggy or puffy skin around the eyes. Occasionally, what may be perceived as droopy upper eyelids can be corrected with a brow lift, but surgery is generally required to achieve the desired look.

PREPARING FOR SURGERY
When considering eyelid surgery you want to ask your doctor about the surgical options available. Your initial consultation will include a review of your medical history, discussing the results you’d like to achieve and to explain the procedure to be performed. Your vision and tear production should also be tested by an ophthalmologist.
You will also be given pre-and postoperative instructions which will include information on eating and drinking and what prescription medications to take and those to avoid. Be sure you and your physician agree on the surgical approach and understand the potential risks and complications involved with the procedure.

THE PROCEDURE
Blepharoplasty can be performed on both the upper and lower lids at the same time. It is not unusual for a patient to have only lower or upper lids done, and then schedule surgery for the remaining lids at a later date. The doctor may mark your eyes with a surgical pen prior to surgery as a guide to the skin to be removed.

The upper eyelid incisions are disguised in the natural creases of the lids. The lower eyelid incision is made in one of two ways; it may be made close to the lash line which is often referred to as traditional or transcutaneous, or on the inside of the lower lid which known as transconjunctival.

The benefit of an external incision is that excess skin on the lower lids can be removed at the time of surgery. The advantage of the transconjunctival approach (inside the lower lid) is that the muscle under the eye is not disturbed avoiding the complication of lower lid retraction. Using either incision, the fatty tissue or fat pads are removed and the incisions are carefully closed. Most people who choose blepharoplasty heal quite easily rapidly and incisions are barely noticeable in a relatively short period of time.

Anesthesia
The type of anesthesia used during the blepharoplasty procedure is dependent on the extent of the procedure to be performed, the doctor’s choice, and the patient’s medical history or desires. In most cases, blepharoplasty is performed under local anesthesia along with oral or intravenous sedatives.

Length of Procedure
Blepharoplasty is usually performed on an outpatient basis and takes one to three hours, depending on the extent of the surgery. If you’re having all four eyelids done, the surgeon will probably workon the upper lids first, then the lower ones.

Level of Pain/Discomfort
Generally, with blepharoplasty there is minimal discomfort during the postoperative period. Some people experience absolutely no discomfort at all.

PRE- AND POSTOPERATIVE INSTRUCTIONS
The following suggestions are intended to make you feel more comfortable and help you heal:

• Stop smoking, discontinue the use of alcohol, and stop taking vitamin E and any medications containing aspirin or ibuprofen (two weeks pre- and postoperative is usually recommended). Check with your doctor regarding any other medications (including homeopathic/herbal products) that you are currently taking.
• Have someone stay with you the first night after surgery (twenty-four hours, optimally).
• Follow directions regarding any ointments to be applied.
• Avoid straining during a bowel movement.
• Sunbathing and tanning beds must be avoided a minimum of two weeks prior to surgery (for optimal skin care and health, these should be avoided completely). After surgery, if you must be in the sun, protect your eyelids.
• Wear sunglasses outside to protect your eyes from the light and wind.
• Most doctors instruct that, for at least the first week, cold compresses should be applied for twenty minutes every hour for a minimum of forty-eight hours.
• Rest and relax for the first week. Your blood pressure must not be elevated.
• Do not wear your contact lenses after surgery until your doctor instructs you.
• Do not apply makeup until your doctor instructs you.

RECOVERY
After surgery, your eyes will be lubricated with ointment. Your eyelids could feel tight and sore, and may be bruised and swollen. Cold compresses as instructed by your doctor will help with the swelling. Most pain, if any, can be controlled with Tylenol, or the pain medication prescribed by your doctor.

Within two days to a week, your stitches will be removed. Once they’re out, the swelling and discoloration around your eyes will gradually subside and you’ll start to feel much better. Most people feel ready to go out in public (and back to work) in a week to 10 days.

RISKS/COMPLICATIONS
Although problems are unlikely, you need to be aware of what can happen and what action you should take. Most risks/complications will be avoided if you make an informed decision, choose a qualified physician, and follow your physician’s instructions.

The types of complications that can occur with blepharoplasty are infection, bleeding, dry eyes, double or blurred vision which usually only lasts a few days and can be caused by the ointment, temporary swelling or asymmetry in healing or scarring. A larger risk, although rare, is ectropion or scleral show. These conditions can occur if the skin under the eyes tightens too much.

STILL YOU …ONLY BETTER
Eyelid surgery is one of the easiest surgeries from the standpoint of discomfort and healing. Having blepharoplasty performed is one of the surgeries that immediately takes away the years and can make a dramatic difference. They say the eyes are the windows to the soul, and with your new look, those windows will no longer be droopy and tired and foggy—they’ll look wide open and refreshed!