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Eyelid Surgery

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Eyelid Surgery

Procedural steps:

An incision within the natural crease of the upper eyelid allows access to remove excess skin, muscle and underlying fatty tissue. Using an incision inside the lower eyelid, fat is removed or redistributed and muscle modified to correct a baggy lower eyelid. An incision just below the lower lash line allows excess skin to be removed. Laser resurfacing may be used to smooth lower lid skin. Your results: Bruising should subside in 5-10 days and swelling should subside in 2-4 weeks. Final results may appear in 1-2 months. Incision lines will continue to refine and fade for 1 year.

Your eyes are the most intriguing and revealing facial feature. They draw attention and convey expression. Through them, you not only see others but others see you as well. Your interest and how you feel physically or emotionally is reflected in your eyes. Unfortunately hereditary factors and the signs of aging can greatly impact the appearance of your eyes, so that what they reflect is not really how you feel. If you are bothered by upper eyelids with excess, drooping skin that makes you appear sad or angry, or by eyes that look tired due to puffiness or bags, cosmetic eyelid surgery may be right for you. In general, eyelid surgery corrects the excess skin, tissue and fat that contribute to puffiness and bags in both the upper and lower eyelids, revealing a more youthful and energetic appearance. This brochure presents an overview of cosmetic eyelid surgery. The best way to learn how eyelid surgery can help fulfill your personal goals is a consultation with Dr. Guarda who is certified by The American Board of Plastic Surgery.

  • Loose or sagging skin that creates folds or hides the natural contour of the upper eyelid
  • Excess fatty deposits that appear as puffiness in the upper eyelids
  • Bags under the eyes
  • Excess skin and fine wrinkles of the lower eyelid
  • Excess skin that hangs down from the upper eyelid, sometimes impairing vision
  • Repositions a low or sagging brow that is hooding the upper eyelid
  • Raises the eyebrows to a more alert and youthful position

What is eyelid surgery?

Cosmetic eyelid surgery, technically called blepharoplasty, is a surgical procedure to improve the appearance of your upper eyelids, lower eyelids, or both. Specifically, eyelid surgery can treat:

  • Loose or sagging skin that creates folds or hides the natural contour of your upper eyelid
  • Excess skin that hangs down from your upper eyelid, sometimes impairing vision
  • Excess fatty deposits that appear as puffiness in your upper eyelids
  • Bags under your eyes
  • Droopiness of your lower eyelids, showing white below the iris
  • Excess skin and fine wrinkles of your lower eyelid

These conditions typically appear as part of the natural aging process, or due to heredity. Where they are the result of heredity, individuals as young as their 20s and 30s may achieve a marked improvement in the appearance of their eyes through eyelid surgery. Eyelid surgery removes excess skin, eliminates bags and restores firmness to the area surrounding your eye, making you look more rested and alert.

Most commonly, eyelid surgery is performed on adult men and women who have healthy facial tissue and muscles and have realistic goals for improvement of the upper and/or lower eyelids and surrounding area. You are the right candidate for this procedure if you are:

  • Healthy individual who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smoker
  • individual with a positive outlook and specific goals in mind for improvement through eyelid surgery

In addition, the following medical conditions are essential to disclose if you are considering eyelid surgery:

  • Eye disease such as glaucoma, dry eye or a detached retina
  • Thyroid disorders such as Graves’ disease and under or over active thyroid
  • Cardiovascular disease, high blood pressure or other circulatory disorders or diabetes

Where do I begin?

A consultation with Dr. Guarda is the first step to learn how eyelid surgery can improve the appearance of your eyelids and the surrounding region. Your consultation with Dr. Guarda educates you fully about eyelid surgery in a non-pressured environment, and will include:

  • A discussion of your goals and an evaluation of your individual case
  • The options available for eyelid surgery
  • The likely outcomes of surgery and the potential risks and complications
  • The course of treatment recommended by Dr. Guarda

My eyelid surgery

Like any cosmetic procedure, eyelid surgery requires an individualized approach. Dr. Guarda will evaluate patient anatomy, the condition you wish to have corrected, what is causing the condition and your realistic goals for improvement. Eyelid surgery can offer dramatic improvement in the upper and lower eyelids and surrounding regions. This degree of correction of drooping eyelids, puffiness or bags can only be achieved surgically, by repositioning muscle, redistributing fat that has settled into contours and when necessary by removing excess skin.

Skin resurfacing techniques may be recommended to further improve the tone and surface appearance of skin surrounding your eye, and in some cases as a substitute for excision of minimal excess lower eyelid skin. Where a low positioned brow or crows’ feet at the outer corner of the eyes contribute to the aging appearance of the eyes, a browlift may be more appropriate than, or recommended in conjunction with eyelid surgery. In addition, a brow lift can also smooth a lined or furrowed forehead.

A midface lift, one that corrects sagging in the cheek region and pronounced nasolabial folds (creases from the nose to the outer corner of the mouth) may be performed through the same incisions as blepharoplasty. A facelift and neck lift may also be performed at the same time as eyelid surgery.

Preparing For Surgery

Dr. Guarda will carefully explain the eyelid surgery procedure recommended for your specific case. Prior to surgery, you will be given specific instructions that may include:

  • Pre-surgical considerations, diagnostic testing and medications
  • Day of surgery instructions and medications
  • Specific information related to the use of anesthesia

In addition, you will be asked to sign consent forms to assure Dr. Guarda that you fully understand the procedure you will undergo and potential risks and complications. Risks associated with eyelid surgery include poor healing or infection at the incision site, temporarily blurred or impaired vision and dry eye. Difficulty closing your eyes is also possible, and usually temporary. Ectropion, a pulling down of the lower eyelid may occur in a small number of cases and is often temporary. These risks and others, as well as the risks associated with anesthesia will be discussed prior to your consent. It is important that you address all your questions directly with Dr. Guarda. It is natural to feel some anxiety, whether excitement for the anticipated outcomes or preoperative stress.

What to expect

Eyelid surgery may be performed in Dr. Guarda’s accredited office-based surgical facility, an ambulatory surgical facility or a hospital. The decision for anesthesia will be based on the requirements of your specific procedure and considerations of patient and Dr. Guarda’s preference. Dr. Guarda and the assisting staff will fully attend to your comfort and safety.

Following surgery

Once your procedure is completed, lubricating ointment and cold compresses may be applied, and in some cases your eyes may be loosely covered with gauze. Before being released, you and an accompanying family member, friend or caregiver will be given specific instructions that may include:

  • How to care for the surgical site
  • 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 overall health

Progress and healing

Initial healing may include some swelling, bruising, irritation or dry eye and discomfort that can be controlled with medication, cold compresses and ointment. Irritation at the incision sites is also possible. These are all common conditions. Dr. Guarda will instruct you to keep your head elevated at all times until initial swelling has subsided and to wear sunglasses to protect your eyes from bright light, sun and wind. Follow all instructions carefully – this is essential to the success of your outcome. A return to light, normal activity is possible as soon as you feel ready, usually within a few days of surgery.

Healing of incisions may take 5 to 10 days at which time any sutures will be removed, if necessary. You will be ready to return to work and normal activity at this time, and to resume wearing contact lenses. Cosmetics can camouflage any bruising or redness that remains. Healing will continue for several weeks as swelling continues to dissipate and incision lines improve. Diligent sun protection and consistent use of darkly tinted sunglasses is essential.

Results and outlook

Initial healing may include some swelling, bruising, irritation or dry eye and discomfort that can be controlled with medication, cold compresses and ointment. Irritation at the incision sites is also possible. These are all common conditions. Dr. Guarda will instruct you to keep your head elevated at all times until initial swelling has subsided and to wear sunglasses to protect your eyes from bright light, sun and wind. Follow all instructions carefully – this is essential to the success of your outcome. A return to light, normal activity is possible as soon as you feel ready, usually within a few days of surgery.

Healing of incisions may take 5 to 10 days at which time any sutures will be removed, if necessary. You will be ready to return to work and normal activity at this time, and to resume wearing contact lenses. Cosmetics can camouflage any bruising or redness that remains. Healing will continue for several weeks as swelling continues to dissipate and incision lines improve. Diligent sun protection and consistent use of darkly tinted sunglasses is essential.