Eyelid Surgery: Overview
Procedure – Eyelid surgery, or blepharoplasty, restores the eyelids to a more youthful appearance through a combination of procedures and techniques, including removing excess skin and fat around the eye, adding fat when required and/or tightening stretched or loosened skin. Blepharoplasty is often used to correct eyelid ptosis (drooping) as well.
Eyelid Ptosis: what is it? – The upper eyelid is opened by the combined action of two muscles. For a variety of reasons, these muscles can lose some of their effectiveness and function, resulting in a droopy upper eyelid that covers the eye. This eyelid ptosis can make a person look tired, and can even interfere with vision. Many older patients have eyelid ptosis due to the loosening of the eye-opening muscles or due to a disconnection between the muscle and the eyelid. This type of ptosis, termed senile ptosis (or levator disinsertion), can be treated surgically in conjunction with a cosmetic blepharoplasty procedure.
Surgery and incisions – The operation itself takes 1-3 hours depending on what type of eyelid surgery you undergo. Most surgeries are performed in an outpatient or inpatient operating suite, under twilight or general anesthesia. Other procedures can be performed in the office with local anesthetic. Dr. Brown will discuss all options that are right for you during your consultation. In most cases, the incisions can be hidden in the natural skin creases of the upper and lower eyelids. Some lower eyelid procedures can be performed entirely through the inner portion of the lid (trans-conjunctival blepharoplasty) without any visible incision.
Good candidates for Blepharoplasty are healthy individuals without life threatening illness, non-smokers, individuals without serious eye conditions, individuals with a positive outlook on life and specific goals for eyelid surgery.
Eyelid Surgery: Before Surgery
Preparing for surgery – Tell Dr. Brown about any medical problems you have, and any problems you may have had with surgery in the past. A history of bleeding problems, nausea with surgery and high blood pressure are all important to disclose, because these are risk factors for post-surgical bleeding. You will be told which medications to stop and which to take before surgery. If you smoke, you will be asked to quit for a minimum of 4 weeks prior to surgery as well as 4 weeks after surgery. If you get sick or have any health issues in the days before surgery, please notify the office at once in case we have to postpone your operation.
Can I go home the day of the surgery? – Blepharoplasty can be done safely as an outpatient, and most patients will be able to go home the same day. In some cases, Dr. Brown may recommend that you spend a night in the hospital after surgery. Also, some patients may prefer to spend a night in the hospital if they have young children at home or live alone and do not have any help at home.
How much swelling or bruising can I expect? – Swelling and bruising are normal signs of the healing process. Swelling peaks at about 48 hours, and then rapidly decreases. By the end of the first few weeks, most of the swelling is gone. By 6-8 weeks, all of the swelling has diminished.
What restrictions are there? – Generally, you can shower in 1-2 days after surgery, but you should not submerge incisions in the bath, hot-tub, or swimming pool for 2-3 weeks. The first day after surgery is usually spent lying in bed or sitting in a chair. Most patients then begin walking around the house the day after surgery. By the end of the first week, you will probably be ready to leave the house for short trips and light walks. Vigorous activities should not be performed until 6 weeks after surgery. Also, you shouldn’t do any heavy lifting (over 10 pounds) during these 6 weeks.
These are only general guidelines, and Dr. Brown will give you more specific instructions at your consultation.
When can I travel? – You should wait to travel by air or long distances until after your first post-operative visit, which generally happens 5-7 days after surgery. Patients who are at high risk for developing a blood clot should not travel until instructed by Dr. Brown. Short car trips under 60 minutes can be done before the first visit. A good rule of thumb is when you are off the stronger pain medication and can get up without assistance you are ready to go for a short drive. You should not drive the car yourself, until your surgeon gives you clearance.
What if I have a problem? When should I call the office? – We always welcome calls from patients. If you have any concerns at any time, please feel free to contact our office. If it is an emergency, the answering service is available 24 hours a day, including weekends and holidays.