Am I suitable for eyelid surgery?

The best candidates for this type of intervention are people with drooping eyelids due to excess skin, and/or visible fat bags on lower eyelids, resulting in a tired, sad looking appearance. These candidates are usually people over the age of 35 years. Sometimes, however, younger people are the right patients because of a hereditary condition.

Before Surgery Prep:

You will obtain a copy of your doctor's protocol accordingly

• Do not take aspirin or anti-inflammatory medications (your doctor can provide you with a list of OTC medications to avoid)

• If you smoke, quit smoking for at least 2 weeks pre-op (and anticipate no smoking for the recovery, smoking greatly increases your risk of complications)

• Make arrangements to have someone drive you to and from the operation

• Arrange for someone to care for you the first 24-72 hours after surgery

• Fill prescriptions (especially pain medications) before surgery

• Purchase any homeopathic medicines (i.e. Bromelain and Arnica Gel, for swelling and bruising) Be sure to discuss this with your doctor

• Prepare Icepacks (can also use packs of frozen veggies) to reduce post-op swelling

• Eye Drops (after any surgery, eyes can be dry)

• Night before surgery, thoroughly remove all makeup

• Morning of surgery, wash face thoroughly and do not apply any products

• Bring sunglasses to wear on the way home from surgery

• On the day of surgery, wear loose clothing which will be easy to get off and on after operation (wear a shirt that buttons in front)

• Follow your physician's directions carefully regarding medications, eating & drinking, etc.

During Surgery

In some cases only upper lid surgery is performed and sometimes only lowers lid surgery. Upper and lower procedures can also be performed at the same time.

Blepharoplasty is performed in an operating room, within a clinic or hospital. During the operation, the surgeon makes incisions above and below the eye tissue. These incisions follow the natural folds of the eye and allow the surgeon to separate the underlying fatty tissue and muscle. The surgeon then removes the fat and excises the sagging skin and muscle.

The intervention usually lasts between 1 and 3 hours, or more when it is associated with other interventions. It is ok to have the upper and lower lids completed at the same time. The incisions are closed with very fine sutures.

Normally, it is not necessary to remain more than a few hours after the surgery in the clinic.

Recovery & Results

Recovery

Initial recovery takes anywhere from two weeks to one month, and the complete healing process takes up to six months as scars fade to thin white lines.

After surgery your eyes may feel tight, with minor discomfort that lasts for a day or two. Your eyes will be swollen and bruised. Your head should be kept elevated and cold compresses applied to reduce swelling and bruising. Your blood pressure will be monitored to avoid bleeding complications. Your eyes will be lubricated, which may blur your vision.

The incisions may be red and bumpy initially and will gradually flatten and fade. The swelling and bruising should disappear within 1-2 weeks depending on the extent of your surgery. During recovery, your eyes may be sensitive to light and your vision may be blurry the first few days. Your eyes may also experience, burning, itching, tearing or dryness. Your doctor will likely dispense eye drops to alleviate any discomfort.

Wear sunglasses home. At home, keep your head elevated and take it easy. Apply light ice packs (e.g. try frozen peas in a plastic bag) over your eyes continuously for the first 48 hours.

The eyelids may become swollen and stuck together. If this occurs, clean the eyelashes carefully with warm water on a Q-tip. Some oozing from the incision lines and crusting along the eyelashes is normal. However, if you have increased bleeding or decreased vision, call your physician immediately.

Be sure to follow your doctor's advice carefully and go to all post-operative visits.

Results

The scars can have a pink affect during the first months. Progressively they will be disappearing until becoming an almost invisible clear line. Surgical scars are permanent. However, the incisions are placed so that they are not normally noticeable except on very close observation. The scars run in the natural contours of the skin below the eye and in the upper eyelid. If only fat is removed, the incision may be inside the lower eyelid along the lower lash line, which is completely hidden. The scars should be almost invisible after 2 weeks.

The results of blepharoplasty are a fresher and wide-awake appearance, looking better and younger.

What are the risks and complications

Complications of eyelid surgery, while rare, can cause prolonged healing, change in or loss of vision, unpleasant-appearing and painful scars, the inconvenience and cost of further surgery, and the possibility of requiring eye drops or ointment, temporarily or permanently.

Blindness
The risk of permanent blindness is less than 1 out of 10,000. Vision loss is usually related to bleeding following eyelid fat removal.

Blurred vision
This is a temporary condition that occurs in less than 1% of surgeries.

Corneal abrasion
This condition is temporary and is easily treated by patching the eye for 1-3 days.

Double vision
This condition is temporary and occurs in less than 1% of surgeries.

Difficulty closing eyes
This condition is usually temporary in rare cases. In rare cases, corrective surgery is required.

Dry eye syndrome
Dry eye syndrome is potentially dangerous. In rare cases it leads to damage to the cornea of the eye and vision loss.

Inability to close eyes
This condition is usually temporary. In rare cases, corrective surgery is required.

Milia
Tiny skin cysts can form on the scar line. This is normally temporary, but in some cases requires surgical removal.

Retrobulbar haematoma
This is a rare complication in which a pocket of blood forms behind the eyeball.

How long before things return to normal

Reading and watching tv will be acceptable by the second or third day but you won’t be allowed to wear contacts as they would feel very uncomfortable.

Most people are happy to be back in the public and to work after the first week; you can disguise bruising with make-up.

Normal activities can be resumed in a few days; exercise needs to wait for about 3 weeks.

When will I see the final result

The scars can have a pink affect during the first months. Progressively they will be disappearing until becoming an almost invisible clear line, approximately after 3-6 months. The results will last for many years and will keep your eyes and appearance looking fresher and younger for many years.

What about guarantees

When this procedure is completed by a qualified plastic surgeon the complications are infrequent and of little importance. Nevertheless, there are always possibilities of complications with any surgery that can exist, like the anesthetic infection or reactions. The risks following surgery can be diminished using the instructions from your plastic surgeon. Complications can appear after blepharoplasties including the double or blurred vision during the first few days, temporary edema of the eyelids and slight asymmetries in the healing. After the surgery you may have difficulty completely closing your eyelids while you sleep; in rare cases this complication could be permanent. Another infrequent complication is ectropion, which can need surgical correction.