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Blepharoplasty Eyelids Surgery

Blepharoplasty surgery is shown when the eyelids require recontouring. Specifically, blepharoplasty is most useful when excess skin needs to be removed, the muscles are enlarged or require tightening, or eye fat needs to be removed or redistributed. Upper eyelid lift surgery typically involves an incision made in the natural crease above the eye. Your cosmetic surgeon will remove a precise amount of excess skin and fat and adjust the surrounding muscles to make the desired improvements. Cosmetic surgeons can use a variety of surgical techniques to improve the lower eyelids; incisions are located on the outer edge of the lower eyelid, just beneath the eyelashes, or inside the eyelid. Depending on the case, I may remove excess, sagging skin or tighten the lower eyelid muscle to supply the most natural, effective results.
EYELIDS SURGERY-OR

What is Blepharoplasty?

Blepharoplasty surgery is shown when the eyelids require recontouring.

A fundamental understanding of the anatomy of the eyelid and periorbital region is critical to achieving an optimal aesthetic outcome and maintaining appropriate function. I can achieve sound surgical technique only with a thorough understanding of the intricate details of the periorbital structures.

With this foundation, appropriate surgical intervention can lead to satisfied patients and avoid significant adverse events that can threaten vision and impair quality of life.

Patient Selection and Preoperative Evaluation Blepharoplasty

As is suitable before performing any eyelid or periorbital procedure, the patient assessment begins with measuring visual acuity using a standard eye chart or a near card. The visual acuity is recorded in the table. The eyebrow position is assessed by placing the patient upright with the eyes gazing straight ahead. The eyebrows and forehead are assessed, noting height above the orbital rim, horizontal furrows, and skin photoaging.

The eyebrows are examined for the ROOF pad’s position, contour, and fullness as manifested by the prominence of the superior lateral orbital rim below the eyebrow. The position of the globe is noted relative to the orbital rim. In the setting of a flattened malar eminence, a shallow orbit, or axial myopia (seen in a near-sighted patient with a large globe), the eye will appear prominent, and the upper and lower eyelids may appear retracted.

In such cases, removing tissue from the eyelids must be performed with exceptional care as the proptosis appearance of the globe may be emphasized, creating an aesthetically unacceptable “staring” look and even limiting the ability of the eyelids to close completely. Ex-ophthalmometry measurements may detect true proptosis. I should then turn my attention to the upper eyelid itself.

blepharoplasty. pre-op examination
Blepharoplasty. pre-op examination

The eyelid position is observed, and retraction or ptosis is noted. The skin is inspected for evidence of medial canthal webs or epicanthal folds, wrinkling, old surgical scars, pigmentary change, and tumors or other defects, which may need to be addressed.

The superior sulcus is examined for fullness or concavity. Gentle pressure on the globe through a closed eyelid will demonstrate the size and position of the central and nasal fat pads. If the superior sulcus is concave preoperatively, I should avoid aggressive resection of orbital fat as this may produce excessive indentation of the superior fornix.

Next, the lateral portion of the eyelid is examined for the presence of fullness, which may represent brow ptosis, the descent of the ROOF into the eyelid, prolapse of the lacrimal gland, or a combination of these factors. The position and definition of the upper eyelid crease are noted. If the ridge is poorly defined or there is an asymmetry between the eyelids, I should use the mirror to demonstrate this difference.

The “normal” position of the upper eyelid crease is slightly higher in females than males but again will vary from one individual to the next. There are significant differences in eyelid crease position and contour between Asian and Occidental eyelids. Because of the social significance of this feature in most Asian societies, these differences must be recognized and respected.

Patients usually are much more likely to notice a difference between their eyelids after surgery due to the careful attention typically given to the lids during the postoperative recovery period. Finally, a comprehensive ophthalmic examination is completed.

Why Consider Blepharoplasty?

Our eyelids are home to the thinnest, most delicate skin on our bodies, so it’s no surprise that signs of aging will begin to appear around our eyes earlier than in most other areas. Aging eyelids can affect a person’s appearance in ways beyond just looking older—because so much emotion is expressed with our eyes, sagging, drooping eyelid skin can cause a tired, sad, or even angry appearance, also when a person feels great.

Cosmetic eyelid lift surgery is designed to help counteract these changes and restore a naturally refreshed, youthful appearance to the eyes. The results can be life-enhancing, helping patients feel more confident in their appearance. If others mistakenly perceive you as tired or upset, an eyelid lift can help your eyes more accurately portray your emotions. Also, if sagging eyelid skin obstructs your ability to see, eyelid lift surgery can eliminate the problem and open your eyes more fully.

Who is the Right Candidate for Blepharoplasty?

  • Good candidates for eyelid lift surgery include:
  • Healthy individuals with no medical conditions that can impair healing
  • Nonsmokers
  • Individuals with a positive outlook and realistic goals
  • Individuals without severe eye conditions

Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to the relaxation of the forehead skin and eyebrows. Sometimes stretching out of the upper eyelid muscle may cause a drooping eyelid. This is called eyelid ptosis and requires a different surgical treatment. Prof Moawad will evaluate your facial anatomy thoroughly and discuss what procedures might best remedy your concerns.

What should I Expect During a Consultation for Blepharoplasty?

During your eyelid lift surgery consultation, be prepared to discuss:

  • Your surgical goals
  • Medical conditions, drug allergies, previous medical treatments, and precisely any problems you have had with your eyes
  • Current prescription medications, including vitamins, herbal supplements, alcohol, tobacco, and drug use
  • Previous surgeries

Your Cosmetic surgeon will also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Take photographs
  • Discuss your eyelid lift surgery options
  • Recommend a course of treatment
  • Discuss outcomes of eyelid lift surgery and any potential risks
  • Discuss the type of anesthesia that I will use

It’s natural to feel some anxiety, whether excitement for your anticipated latest look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

What are the Risks of Blepharoplasty?

The decision to have plastic surgery is highly personal. You will have to weigh the potential benefits of achieving your goals with eyelid lift surgery’s risks and complications. Only you can make that decision for yourself. You will be asked to sign consent forms to fully understand the procedure and any risks and potential complications.

  • Anesthesia risks
  • Swelling and bruising
  • Bleeding from the incision lines
  • Dryness in the eyes
  • Sensitivity to the sun or other bright light
  • Difficulty closing your eyes
  • Ectropion, an outward rolling of the lower eyelid
  • Infection
  • Lid lag, a pulling down of the lower eyelid, may occur and is often temporary.
  • Temporary or even permanent change in vision and the infrequent chance of blindness
  • Changes in skin sensation or numbness of the eyelashes
  • Pain that may persist
  • The possible need for revision surgery
  • Unfavorable scarring

I will thoroughly discuss these risks and others before your consent. It would help to address all your questions directly to your plastic surgeon.

How should I prepare for Blepharoplasty?

  • Get lab testing or a medical evaluation.
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding and bruising.

Eyelid lift surgery should be performed in MSI office-based surgical facility. Be sure to arrange for a friend or family member to drive you to and from surgery and stay with you the first night following surgery.

Upper Eyelids Surgery or Blepharoplasty

The more tissue removed, the greater the magnitude of change. ThBasedn the desired result, the surgeon’s choice is the choice of skin only versus skin/orbicularis excision versus skin/orbicularis/fat excision. The following assumes that all three are resected.

Incise the skin with a blade and remove with sharp scissors, monopolar cautery, or laser or radiofrequency device as the surgeon prefers. The exposed orbicularis muscle may now be trimmed according to the surgeon’s judgment about whether it is better to debulk the eyelid or leave it to preserve fullness.

A substantial amount of the upper eyelid orbicularis can be removed, if necessary, without causing problems with closure. Exercise caution at the lower edge of the incision to prevent inadvertent resection of the levator aponeurosis, which is close to the undersurface of the orbicularis at this point.

If resecting preaponeurotic fat, now opens the orbital septum. With the fingers of one hand, push inferiorly on the upper eyelid near the lid margin. On the other hand, retract the upper skin edge superiorly while applying light pressure against the globe.

This maneuver pushes the globe posteriorly into the socket, displacing the fat anteriorly, where it now visibly bulges out under the septum. Cut the septum while still applying pressure, causing the fat to bulge through.

Cut the septum across the eyelid to expose the remaining fat. Next, separate the fine fibrous attachments between the fat and the levator. Anteriorly, the fat can be separated from the orbicularis up to the orbital rim if needed.

Resect the fat as planned and, if using scissors, clamp the fat pockets with a small hemostat, cut the fat, and cauterize the stump. Inspect for bleeding before releasing the fat. It is often necessary to give a supplemental injection of local into the fat pockets, especially the medial, to obtain complete anesthesia.

Do not resect fat above the level of the superior orbital rim. Doing so can result in adhesion between the levator muscle and the bone, with resultant mechanical ptosis and restriction of motility of the upper eyelid.

An alternative method to contour fat is to apply multiple minor points of cautery across the orbital septum. This shrinks and tightens the septum, thus pushing the fat posteriorly into the orbit, decreasing its prominence. Caution is advised with this technique since excessive septal contraction can lead to lagophthalmos.

Functional Upper Eyelid Blepharoplasty

Patients who present for upper eyelid blepharoplasty can fall into two categories that often overlap. Many older individuals are interested in functional improvement to alleviate complaints of visual obstruction from redundant upper eyelid tissues. Such patients complain of difficulties with activities of daily living such as driving and reading but will often add comments related to tasks performed on their jobs that are unique to their situations.

Symptoms are often vague, such as my eyes feeling tired, not seeming to get enough light in, or having trouble reading. When severe, they may complain of a frontal headache by day’s end due to constant use of the frontalis muscle in an unconscious effort to open the eyes to improve the superior and lateral fields of vision.

UPPER EYELIDS LIFT SURGERY
UPPER EYELIDS LIFT SURGERY

Patients frequently state that the upper lids feel heavy, especially by the end of the day. They will pull up on the eyebrow to demonstrate how vision improves when the brow and forehead are lifted since they usually do not distinguish between upper eyelid skin redundancy and brow ptosis.

Pointing this out to the patient allows the physician to explain the significant difference between upper eyelid blepharoplasty and brow or forehead lifting. When patients realize that these are two distinct but related blepharoplasty, they are sometimes confused about the best way to alleviate the functional problem.

Thus, the physician must help them decide on the best surgical option. Although the patient may state only want to see better, the aesthetic appearance is usually a remarkably close second, if often unspoken, to the goal of the blepharoplasty.

This is true even for those individuals in their ninth or tenth decade of life. No one wants to look bad after eyelid or facial blepharoplasty. Therefore, any cut placed on the face of the patient for any reason has an aesthetic component.

Often patients are reluctant to express their desires for aesthetic blepharoplasty for fear of being labeled as vain by family members or even the physician. Many have spent considerable time searching the Internet to educate themselves on precisely what to say to communicate that their vision is functionally impaired, hoping to obtain insurance coverage for blepharoplasty.

In an age where one can easily access web-based data on any topic, we should assume that patients have acquired at least a cursory education on presenting themselves at the initial consultation.

A simple inquiry by the physician, such as how important is it to you that the result looks attractive, can open the discussion up to the aesthetic component of blepharoplasty and reassure the patient that the physician is also concerned that the patient experience a favorable cosmetic outcome. I typically tell such patients that upon completion of the blepharoplasty, I expect they will see a significant improvement in their visual function, but they should look better.

Aesthetic Upper Eyelid Blepharoplasty

The second group of patients is those who are primarily seeking aesthetic improvement. I continue to be impressed that this group often presents shortly after the conclusion of a significant adverse life event such as severe illness or divorce.

It is essential to understand the underlying motivations of this group since they are more likely to be suffering emotional turmoil and are less likely to be satisfied with results that they view as not achieving the desired outcome. They may seek cosmetic blepharoplasty to help lift their spirits, as a reward for battling medical problems, or as a prelude to getting back into social dating.

Those patients often notice that their vision has improved after upper eyelid blepharoplasty. It is essential to inform them before blepharoplasty that insurance coverage may be possible.

Upper Blepharoplasty General Considerations

I always ask my patients what type of work they do since this may have a bearing on how long it takes to recover and return to total activity. A desk worker can often return to full activity the next day, whereas someone who performs heavy manual labor may need to be off the job for two weeks or more.

The patients must realize that there will be a variable and unpredictable period of bruising and swelling, during which they may feel that they do not want to appear in public. The answer to the question 􀂴How bad will I look after blepharoplasty is quite different from one person to the next, and the physician needs to have this discussion with each patient.

I also inquire whether the patient seeks blepharoplasty before a significant social event, such as a family wedding or class reunion. The patient may not have allowed enough time to permit adequate healing between the proposed blepharoplasty date and the social event. I caution patients to allow two weeks for bruising and 2months for swelling to resolve.

I tell them that we may need to do additional touch-ups in the months that follow for them to 􀂴get as close to normal and symmetric as possible. They should consider all of this when planning the timing of the blepharoplasty. It is expected that results in the patient deciding to wait until after the social event to have blepharoplasty.

Some patients will plan a vacation immediately after blepharoplasty to give themselves time to return to work or social engagements without others noticing that they had blepharoplasty. They are often surprised to find that they have significantly underestimated the time needed to return to work.

It is also essential to reiterate on the day of blepharoplasty. Some patients assume that the surgeon will use those stitches that fall out by themselves. Some patients may travel a long distance to have a blepharoplasty by a particular surgeon and ask, why can’t my doctor at home take out my stitches.

I caution all patients that upper eyelid blepharoplasty always leaves a scar that will be noticeable. I advise women that the incision in the upper eyelid frequently results in a degree of numbness in the pretarsal skin and eyelashes for at least 6 to 12 months, caused by cutting the sensory nerve fibers that run vertically from below the brow inferiorly to the lash line. Some women find that this temporary anesthesia is bothersome when applying eye makeup due to the lack of tactile feedback from the makeup brush.

BLEPHAROPLASTY. UPPER
BLEPHAROPLASTY. UPPER

If appropriately counseled, patients with thyroid eye disease, blepharochalasis syndrome, rosacea, dry eye syndrome, and essential blepharospasm may safely undergo blepharoplasty. Indeed, these can be some of the happiest patients after blepharoplasty.

Likewise, patients with pre-existent lagophthalmos, for any reason, should be carefully evaluated since the removal of additional upper eyelid tissue would exacerbate the problem. Lagophthalmos correction methods could be considered an adjunct to blepharoplasty in such cases.

The only absolute contraindications to upper blepharoplasty are uncontrolled coagulopathy or an inability to discontinue anti-clotting medications for enough time. It is a prerequisite to stop these medications at least ten days before and ten days after blepharoplasty to minimize the risk of orbital hemorrhage. I caution patients to discontinue all medications prescription, over-the-counter or herbal, which can interfere with the coagulation system.

For prescribed medications, the patients must supply written documentation from their physician that the medications can be safely discontinued and, if so, for how long. Suppose the patient’s physician is unwilling to hold such medications for a sufficient time to return the clotting status to normal. I should inform the patient of the relative risk of vision-threatening bleeding depending on the individual circumstances. Obviously, the greater the degree of anticoagulation, the greater the threat to vision. When informed of this possibility, some patients will decide not to have the blepharoplasty, no matter how remote.

As with any blepharoplasty, unreasonable expectations will invariably lead to dissatisfaction with the results and the surgeon. Unfortunately, underlying psychopathology is not always evident in the preoperative period but only manifests postoperatively.

Upper Blepharoplasty Postoperative Care

Patients are advised to avoid strenuous physical activity and heavy lifting. Frequent use of cool compresses helps minimize swelling, bruising, and pain. Twice-daily application of a bland ophthalmic ointment keeps the suture line clean and more comfortable.

The ointment is applied to the sutures. Some of it will melt, get into the eyes, and cause some blurring of vision for 24 hours after the last application.

Any ophthalmic drops usually prescribed for the patient are continued uninterrupted. The patients may get the sutures wet and read and watch television as desired. They may return to work the following day if desired.

They are instructed to call if they develop significant, uncontrolled bleeding or loss of vision. Acetaminophen usually suffices for pain control, but a small minority will require the addition of a mild narcotic.

Patients are instructed when to resume medications that interfere with the clotting system individually. Sutures are removed 5 to 7 days after blepharoplasty, and the patient is seen 1 to 2 months later after most of the edema has resolved.

Upper Blepharoplasty Outcomes

As with any other blepharoplasty, patients are satisfied with the overall results and pleased with the improved field of vision. Even 1 mm of asymmetry is very noticeable in the upper eyelids and is not well accepted by most patients. Touch-up blepharoplasty to remove tiny amounts of additional skin or fat for symmetry can be done one month after blepharoplasty. Patients should not require repeat blepharoplasty for at least ten years in most cases.

Lower Eyelid Blepharoplasty

Lower eyelid blepharoplasty is one of the most complex and challenging blepharoplasties in aesthetic surgery. Achieving optimal results requires careful preoperative planning and meticulous intraoperative blepharoplasty technique.

Besides evaluating the eyelids, the midface must also be assessed in the preoperative evaluation. Emphasis on routine lower lid support, the trans-palpebral elevation of the midface, and fat preservation and repositioning are crucial to achieving satisfactory results and avoiding complications. These areas profoundly affect periorbital aging and should be managed as one aesthetic unit.

Despite the frequency with which lower blepharoplasty is performed, the surgical technique remains a complex, challenging, and technically demanding one that should not be considered routine.

Minimizing complications and maximizing postoperative results depend on careful preoperative planning and meticulous intraoperative blepharoplasty. In addition to evaluating the eyelids, the surgeon must carefully assess the periorbital anatomy, including the midface, because midfacial aging can profoundly affect the appearance of the lower lid.

The lower lid and midface compose an aesthetic unit that is best treated together, and the standard lower lid approach provides an easy entry for midface rejuvenation. However, it is essential to individualize the operative plan to address individual patient needs. Identifying risk factors and concurrent medical conditions contributing to postoperative complications is essential.

I can achieve excellent blepharoplasty results through careful preoperative assessment and meticulous surgical blepharoplasty using an anatomic approach to aestheticizing aging changes in the eyelids and periorbital region.

BLEPHAROPLASTY-LOWER
BLEPHAROPLASTY-LOWER

Traditional blepharoplasty emphasized lower lid support or correcting acquired anatomic changes in the surrounding periorbital region. Fewer blepharoplasties emphasize lower lid support, such as routine canthopexy or canthoplasty, the trans-palpebral elevation of the midface, and fat preservation and re-positioning. In our patients, routine canthal anchoring has been the key to achieving good, predictable results and avoiding complications.

A classification system of periorbital aging may aid in selecting the appropriate surgical blepharoplasty for correction.

Type I patients demonstrate the earliest changes of periorbital aging, with findings confined to the lower eyelid. The presence of dermatochalasis includes acquired age-related folds of excess skin and muscle and apparent fat excess. However, the volume of orbital fat remains relatively unchanged from youth to middle age and is resistant to volume loss even in cachectic patients.

In contrast, facial fat, including the malar fat pad and jowl, undergoes redistribution with age, deflation, and descent. The perception of increased orbital fat volume is often affected by edema. In type I patients, the focus is to improve the appearance of the eyelids using upper and lower blepharoplasty, including fat resection by a transconjunctival or transcutaneous approach and possible skin resection resurfacing.

Alternative blepharoplasty is also appropriate, including resetting or tightening the orbital septum and re-positioning and retaining intra-orbital fat.

Type II patients have a combination of lower lid aging and early evidence of midfacial descent. As the malar fat pad descends, the lid–cheek junction becomes more evident, with the inferior orbital rim visible through attenuated soft tissue.

Midfacial descent is often associated with loss of upper malar fullness, which contributes significantly to the loss of lower lid support. I may consider modified superficial midface lift blepharoplasty with dissection in the supra-periosteal plane. These patients require augmentation of the infraorbital rim, either through arcus marginalis release and fat re-positioning or through elevation of the sub–orbicularis oculi fat (SOOF) to camouflage the infraorbital rim.

Type III patients display more advanced midfacial aging, with further descent of the lid–cheek junction and deepening of the nasolabial folds. Descent of the malar fat pad contributes to the formation of the nasolabial fold. It requires elevation, either with a subperiosteal midface lift or combined facelift blepharoplasty that elevates the malar fat pad.

Type IV patients have extensive midfacial aging changes, including malar bags, and often demonstrate lower lid malposition with lid laxity. Subperiosteal dissection is required, with the release of the orbito-malar ligament, retaining orbital ligaments, and the sub-zygomatic space to elevate the midface, along with lateral canthal support to correct lower lid laxity.

Lower Blepharoplasty Postoperative Care

At the end of the blepharoplasty, a 6–0 nylon suture can be placed as a temporary tarsorrhaphy along the gray line lateral to the limbus. Another option is to place a temporary Frost suture in the lower lid margin lateral to the lateral limbus and either suture to the eyebrow or suspend to a Steri-Strip (3 above the eyebrow.

Blepharoplasty will reduce corneal exposure in the immediate postoperative period and minimize chemosis. At the first postoperative visit, these sutures are removed 5 to 7 days after surgery.

Postoperatively, the patient’s head should remain elevated to reduce edema and ophthalmic pressure. I should apply an ice pack or cold compresses to the eyelids for 48 hours. The eyes should remain lubricated, using saline drops and lubricating ointment at night.

Lagophthalmos can be caused by periorbital edema; if this occurs, it resolves spontaneously in 1 to 2 weeks. Eye drops and ointment are essential to prevent corneal abrasions and exposure problems.

Before discharge, the patient’s vision should be evaluated and documented. Any signs of corneal irritation or decreased visual acuity require careful ophthalmologic evaluation, including slit-lamp examination using fluorescein eye drops to evaluate the cornea.

Patients are asked to avoid contact lenses and eyelid makeup on the suture lines for two weeks after blepharoplasty.

Persistent postoperative chemosis can be treated with the liberal application of ophthalmic ointments and steroid eye drops. I should limit these eye drops to 2 weeks to avoid the risks associated with prolonged treatment.

Severe chemosis that herniates through the palpebral fissure requires more aggressive management with liberal ophthalmic ointment, topical steroids, patching the eye closed for 24 to 48 hours, conjunctivotomy, or tarsorrhaphy.

Mild lid malposition may contribute to lagophthalmos and corneal exposure, which may require bandage contact lenses to protect the cornea and conservative massage of the lower lid margin until the patient has passed the critical 6-week postoperative period, which corresponds with the peak inflammatory phase of healing.

Lower lid ectropion or persistent lid malposition after six weeks of conservative management may require surgical intervention, including placement of a posterior lamella spacer graft and lateral canthoplasty.

Lower Blepharoplasty Outcomes

Surgical blepharoplasty has evolved and is today significantly more sophisticated than in previous decades. Lower blepharoplasty can no longer be considered a routine blepharoplasty. Careful preoperative evaluation is the initial step toward creating a specific and comprehensive treatment plan for each patient based on individual findings and desired outcomes.

Patients with medical or anatomic characteristics that are factors predictive of poor outcomes should be considered high-risk patients who require alternative blepharoplasty to minimize complications.

Blepharoplasty should be performed with precision once assessment and planning are complete. Emphasis is placed on maintaining the preoperative shape of the palpebral fissure, with particular attention to maintaining the lower eyelid position.

Lateral canthal support, most commonly with a lateral canthopexy, represents a crucial step in the blepharoplasty to maintain lid shape and reduce the risk of lower lid malposition or postoperative round-eye syndrome.

The tradeoff, which I should discuss with the patient before surgery, is that the lower lid may appear tight, lasting 2 to 3 weeks after surgery. The natural S-shaped curve of the lower lid and the palpebral aperture are preserved after healing is complete.

Complications associated with lateral canthoplasty have been minor and primarily include canthal angle webbing or asymmetry that requires surgical revision.

The risk of frank ectropion is significantly minimized with lateral canthal support.

In addition to minimizing the risk of complications, maximizing the aesthetic result is related to managing periorbital fat compartments, the orbicularis muscle, and SOOF. Elevation of the skin muscle flap and release of the orbitomalar ligament mobilize the SOOF, which is elevated with the orbicularis muscle. Using the orbicularis muscle as a sling with secure lateral orbital fixation is the key to maximizing the aesthetic appearance of the infraorbital region. This can be performed safely based on the anatomy of the lower eyelid.

Combining Blepharoplasty with Another Procedure

If you are like many patients, you may want to address aging in a few different areas of your face. While eyelid lift surgery alone can significantly rejuvenate your appearance, it’s common to have a facelift, brow lift, or both performed in conjunction with an eyelid lift to achieve more comprehensive facial rejuvenation.

What are the steps of Blepharoplasty?

An eyelid lift surgery procedure includes the following steps:

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. Your doctor will recommend the best option for you. The choices include intravenous sedation or general anesthesia.

Step 2 – The incision

The incision lines for eyelid lift surgery are designed so the resultant scars will be well concealed within the natural structures of the eyelid region. The upper eyelid can be corrected through an incision within the natural crease on the eyelid. This allows for removing or repositioning fat deposits, tightening muscles, and replacing excess skin.

I may correct the conditions of the lower eyelid with an incision just below the lower lash line. Through this incision, excess skin in the lower eyelid is removed. Again, the excess fat can be repositioned or removed. A transconjunctival incision, created on the inside of the lower eyelid, is an alternative technique to correct lower eyelid conditions and redistribute or remove excess fat. With this technique, no skin is removed.

Step 3 – Closing the incisions.

Eyelid incisions typically are closed with sutures or skin glue. Sutures are removed within one week. Prof Moawad may also suggest using a laser or chemical peel to reduce discoloration of the lower eyelids.

Step 4 – See the results.

The results of eyelid lift surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and the surrounding region and a more alert and rejuvenated appearance.

What should I Expect After Blepharoplasty?

During your eyelid lift surgery recovery, I may apply lubricating ointment and cold compresses. In some cases, I may loosely cover your eyes with gauze after completing your procedure. You will be given specific instructions that may include how to care for your eyes, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your overall health, and when to follow-up with your plastic surgeon.

Initial healing may include swelling, bruising, irritation, dry eyes, and discomfort that I can control with medication, cold compresses, and ointment. Irritation at the incision sites is also possible. You must practice diligent sun protection and use darkly tinted sunglasses until you fully complete the healing process.

What Results Should I Expect after Blepharoplasty?

The results of eyelid lift surgery will be long-lasting. While there usually is little pain involved in this surgery, there can be swelling or bruising. Most patients are presentable to the public in 10-14 days. However, it may take a few months before the final healing. While eyelid lift surgery can be expected to correct certain conditions permanently, you will continue to age naturally. Ongoing sun protection will help to maintain your results.

After eyelid lift surgery, you will have to make a few unique but straightforward modifications to ensure your newly rejuvenated eyelids heal optimally. It’s always essential to follow Prof Moawad’s instructions after any procedure. Expect your eyes to get tired more quickly than usual for the first few weeks, and it’s important to let them rest as needed. If your job requires you always to be at a computer, consider working part-time initially, then gradually increasing your workload as you continue to recover.

Wear dark sunglasses with frames that provide plenty of coverage whenever you go outdoors. It will help if you protect your eyes from the sun and wind. You will have to avoid lifting, straining, and bending down to pick things up for up to 4 weeks after eyelid lift surgery.

This can be an inconvenient restriction, but you mustn’t induce sudden increases in blood pressure until your incisions have healed adequately. Although satisfactory results are expected from your procedure, there is no guarantee. It may not be possible to achieve optimal results with a single surgical procedure, and another surgery may be necessary for some situations.

Cosmetic eyelid surgery results should last for years with a healthy lifestyle and good skincare habits. With the excess, sagging skin was gone, your eyes will always look better refreshed and more youthful than without an eyelid lift. Likewise, those puffy eye bags will be gone if you have lower eyelid surgery. While nothing can stop the normal aging process, your results will age naturally with you.

Your cosmetic surgeon can recommend the treatment options that best meet your needs. You can keep your eyes looking more youthful by wearing sunscreen daily, becoming or remaining a nonsmoker, and practicing proper nutrition and health habits. Non-surgical treatments, such as Botox or filler injections, or skin resurfacing, can also help you touch up your youthful appearance by smoothing wrinkles around the face and eyes.

Notes

This procedure’s specific risks and suitability for a given individual can be determined only when consulting with your cosmetic surgeon. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.

Eyelids Lift Surgery (Blepharoplasty) Results (before & after)

AROUND THE EYES REJUVENATION

Around the Eyes (periorbital)Rejuvenation

Results (before and after)

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