EYELID SURGERY - QUESTIONS AND ANSWERS
Because informed patients are so important to the success of any plastic surgery, Dr. Robert H. Stubbs, a Canadian and American Board Certified Plastic Surgeon has prepared this web info for you. The web info will give you a basic understanding of the procedure - when it can help, how it is performed and what results you can expect. It can not answer all your questions, since a lot depends on the individual patient and the surgeon. Please ask a certified Plastic Surgeon about anything you do not understand.
A: The commonest eyelid procedure is known as a blepharoplasty. A blepharoplasty reduces fat and removes excess skin and muscle from the upper and lower eyelids. Other procedures to improve the lids include - browlift, double fold creation for Asians and various chemical peels to improve skin quality.
If the eyebrows are ptotic (droopy), a blepharoplasty alone will not correct saggy, hooded upper lids. A blepharoplasty in combination with a browlift will produce the best result and the features which make you look older and more tired will be improved.
A: Blepharoplasty, like other cosmetic procedures, can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations - they must be realistic.
The best candidate for a blepharoplasty is physically healthy, psychologically stable, and realistic in his or her expectations. Most patients are 35 or older, but if droopy, baggy eyelids is familial, you may decide to have surgery at a younger age. A blepharoplasty may make you look younger and fresher, and it may enhance your self-confidence in the process. But it can not give you a totally different look, nor can it restore the health and vitality of your youth.
A: All surgery carries some uncertainty and risk. Blepharoplasties are normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is a certified Plastic Surgeon. Nevertheless, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. See the Special Consent to Eyelid Surgery.
A: A blepharoplasty is a very individualized procedure and most patients are seen at least twice before surgery. At the initial consultation, we evaluate your face, including the skin and underlying bone. Your eyebrow position, frown muscles and hairline are also assessed.
Be honest in discussing your expectations. We will be frank with you, describing the procedure in detail and explaining its risks and limitations. We will also explain the anesthesia used, the location where surgery will be performed and the total costs involved. During this consultation, be sure to tell us about any medications (especially aspirin or other pills that affect clotting), vitamins or other drugs you are taking. Smokers should consider giving up the habit before and after surgery. Then, a complete physical along with blood and urine analysis is arranged.
At the next consultation, or informed consent visit, the patient who is a suitable candidate has a chance to discuss the risks again or other details prior to the actual day of surgery.
A: The patient should not have had anything to eat or drink after midnight prior to surgery. Pre-op medications should have been taken. Also, transportation and post-op care arrangements should have been made.
Most eyelid procedures are performed under deep sedation and local anesthesia. A blepharoplasty usually takes 2-3 hours, but the time required may vary considerably depending on the amount of work being done. During this time, the patient is carefully monitored.
At surgery, incisions are made following the natural lines of your eyelids, in the creases of your upper lids, and just below the lashes in the lower lids. For some patients who only have lower lid excess fat, the approach may be transconjunctival (incision is made on the inner side of the lid and no visible scar is produced). Redundant tissue is removed and the incisions are then closed with very fine sutures.
The patient is then monitored in the recovery area for at least 3 hours prior to discharge. It is mandatory for a patient who has had deep sedation to have someone stay with them the first night after surgery. The medications may affect judgment and co-ordination for 24 hours.
A: Follow-up visits vary according to the patient and the procedure. Most patients are seen in 3-5 days post-op for suture removal. Early post-op instructions usually include taking prescribed medications and keeping your head elevated to reduce swelling.
There isn't usually too much discomfort after surgery; if there is, it can be lessened with the pain medications prescribed. Severe or persistent pain or a sudden swelling of your lids should be reported immediately. Some numbness of the skin is normal; it disappears in a few weeks or months. Do not expect to look or feel great right after surgery. At first, you are going to look much worse than before. The bruised and puffy skin you see initially will not last long and camouflage cosmetics can be applied shortly after the stitches are removed.
Most patients return to regular activities within a couple of days. Lids heal quickly and one is socially acceptable (minimal evidence) within a few weeks. Full healing takes many months and it is during this period that patients should guard against excessive sunlight or strenuous activities which might cause swelling. Once healed, the scars are usually fine lines that are difficult to see, even at close inspection.
A: The goal of eyelid surgery is a more alert and youthful look. For many people, the results are long lasting, even permanent. See the Surgical Art Gallery for examples of this procedure.
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