The eyes are said to be the window into the soul. They are the central focus of any social interaction and play a critical role in facial expression and emotion. As we age, your eyes undergo various changes. Bony resorption, fat atrophy and loss of skin elasticity all contribute to the appearance of an aged eyelid. Many patients describe looking tired, sad or even angry all the time as a result of these changes. Blepharoplasty, also referred to as eyelid surgery, aims to treat excessive or redundant eyelid skin, bulging or puffy appearing eyelids, hooded eyelids and wrinkles. It can be performed on the upper eyelids, lower eyelids or both.
Upper blepharoplasty primarily aims to tighten the upper eyelid skin by removing excess tissue and reducing the amount of “hooding”. This results in a rejuvenated, more alert appearance. Sometimes, the amount of redundant skin and hooding can obstruct one’s vision, in which case blepharoplasty can be a medical necessity. Other times, brow descent can exacerbate upper eyelid skin excess and hooding. If this is the case, a brow lift in conjunction with upper blepharoplasty would be the best approach.
Upper blepharoplasty begins by making an incision in the natural eyelid crease, which results in an incision that is imperceptible once healed. Excess skin above the incision is excised along with judicious removal of prolapsed fat. Careful attention is placed to ensure that the fat pads are not over resected resulting in a sculpted or hollowed appearance. If necessary, the remaining tissue is tightened and the incision is sutured close.
Lower blepharoplasty on the other hand can address under eye bags, bulging fat pads, extra skin and lower eyelid hollowing. There are various techniques and Dr. Hall will tailor his procedure to your specific needs.
Typically, an incision is made on the inner surface of your eyelid (transconjunctival approach) to gain access to the underlying fat pads. These fat pads can either be excised or repositioned to restore a smooth, youthful lower eyelid. If there is excess skin, a “skin pinch” excision can be performed just under the lash line to hide the resulting incision.
Sometimes, additional procedures are necessary to optimize results. These can include fat transfer or laser resurfacing, which address volume loss/hollowing and wrinkles respectively.
Following their procedure, patients are able to go home the same day. We recommend someone stay with you for the first 24 hours and can arrange for a home nursing service if desired. We see all patients the day after surgery to examine the healing process, clean any incisions, go over wound care and answer questions. If sutures were placed, the patient will return in one week for suture removal.
Bruising and swelling around the eyes is common following blepharoplasty. These symptoms gradually improve with time and are mostly resolved in 1-2 weeks. Cold compresses can help hasten their resolution. Residual bruising can be camouflaged with makeup or glasses at this time. Some patients experience dry or irritated eyes after their blepharoplasty. This also is transient and can be relieved with lubricating eye drops.
Most patients do not experience significant pain following the procedure. Pain medication is prescribed for pain relief but most patients are able to wean themselves off in 1-2 days, taking Tylenol only as needed. Severe pain or visual changes should be reported to the office immediately.
Determining which patients are best suited for the procedure is essential for a successful outcome. Not everyone is a candidate for blepharoplasty while some patients benefit from blepharoplasty alone and others require additional procedures for optimal results. An in person consultation and examination will be able to determine what is right for you. Whether it is excess skin, tired appearing eyes, bulging fat pads or volume loss, Dr. Hall will tailor his treatment plan accordingly.
Dr. Hall believes in providing a private, comfortable, honest environment to discuss each patient’s goals. He allots ample time for each consultation to not only address any and all patient concerns, but also to develop a strong rapport with each patient. He believes the keys to successful facial plastic surgery are natural, long lasting results coupled with a strong relationship between patient, surgeon and the rest of the staff.
At the beginning of your consultation, you will meet with a member of our staff who will tell you a little about our practice and what to expect going forward. They will also obtain your medical history which Dr. Hall will review so he can customize his treatment accordingly. Dr. Hall will then listen to your concerns and discuss various treatment options with you in detail. We are committed to providing you with all the information necessary for you to understand and make an informed decision about your treatment. At the conclusion of your consultation, you will be provided with a quote for the procedures or treatments discussed and you will have the opportunity to schedule if desired.
We know that questions arise after your consultation. We are happy to answer your questions via phone or e-mail and Dr. Hall is happy to see patient’s as often as necessary in follow up/second consultation.
Upper blepharoplasty can be performed safely in the office under local anesthesia with oral sedation if desired. Lower eyelid blepharoplasty is best performed with IV sedation to maximize comfort and is typically performed in an outpatient facility. Each procedure takes approximately 45 minutes to one hour to perform. General anesthesia is not required for either procedure.
While each patient heals a little differently, most patient’s are social around one week post operatively. You can resume work during this time, or earlier if desired, as long as your job does not require physical labor. At one week, you may also use makeup to cover any residual bruising. We recommend avoiding exercise and strenuous activity for at least 2 weeks. At two weeks, light, low impact activity may resume and at three weeks you have no limitations.