BLEPHAROPLASTY

OVERVIEW:

The delicate skin and supporting structures around the eyes stretch more easily as we age. The upper lids begin to droop, creating a “hooded” look. In the lower lids this drooping ispresent as “bags” and creates a tired appearance. Your vision can even be impaired in some severe cases. Severely sagging skin around your eyes can reduce your side vision (peripheral vision), especially the upper and outer parts of your field of vision. Eyelid rejuvenation surgery does not only involve the sagging eyelid skin but rejuvenation of the complete periorbital area. When this area loses volume and the skin becomes inelastic, it is the first sign of looking tired and you also lose your youthful bright appearance. Blepharoplasty surgery alone, involves the removal of eyelid skin. This is still indicated where you may n have loose skin and swollen, puffy bags. The goal is to enhance the face by improving the volume around the eyes and fill the loose skin and hollows in the upper and lower eyelids and temporal area. Fillers can be used to enhance facial features.The modern blepharoplasty, therefore, understands that ayouthful eyelid is a full eyelid. The surgeon will need to replace lost tissue and inflate the loose skin rather than only removing and tightening the skin.

WHY IT IS DONE.

You might consider blepharoplasty if droopy or sagging eyelids keep your eyes from opening completely or pull down your lower eyelids. Removing the excess tissue from your upper eyelids can certainly improve your vision. Upper and lower lid blepharoplasty can make your eyes appear younger
and more alert.

YOU MAY CONSIDER BLEPHAROPLASTY SURGERY IF YOU HAVE:
  1. Baggy or droopy upper eyelids.
  2. Excess skin on the upper eyelids that interferes with your peripheral vision.
  3.  Excess skin on the lower eyelids.
  4. Bags under the eyes.

You may also undergo blepharoplasty surgery at the same time as another procedure, such as a brow lift, face-lift or skin resurfacing.

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CONSULTATION

You will meet with a plastic surgeon and an eye specialist (ophthalmologist) to discuss your medical history as well as your expectations from the surgery. During your first consultation the surgeon will examine your eyelids for a loss of deep soft tissue and extra skin, the surgeon will simultaneously assess the overall tightness of the muscles.

YOUR MEDICAL HISTORY
Your surgeon will ask questions about the previous surgeries you may have undergone in the past and/or current conditions, such as dry eyes, glaucoma, allergies, circulatory problems, thyroid problems and diabetes. Your doctor will also ask about your use of medications, vitamins, herbal supplements, alcohol, tobacco and drugs.

YOUR EXPECTATIONS
It is extremely vital for you to be honest and forthcoming when talking to your doctor about your expectations when it comes to your eyelid surgery as this will help set the stage for a satisfactory outcome. Your surgeon will discuss whether the p

Before your eyelid surgery you will be asked to:
Stop taking warfarin, aspirin, ibuprofen and any other medication or herbal supplement associated with increased bleeding. Ask your surgeon how long before surgery you need to stop taking these medicines. Take only medications approved by your surgeon. • Stop smoking several weeks before your surgery. Smoking can decrease the healing time after your surgery. • Arrange for someone to drive you to and from surgery if you are having outpatient surgery. Plan to have someone stay with you for the first night after returning home from surgery.

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HOW YOU PREPARE


Before the procedure:
Blepharoplasty is usually done in an outpatient setting. Your surgeon injects numbing medication into your eyelids and administers intravenous medication to help you relax.
During the procedure:
The procedure takes between 1 - 2 hours and is performed as a day surgery and you will be placed under conscious sedation for the duration of the operation. If you have surgery on your upper and lower eyelids, the surgeon generally works on your upper lids first.

The procedure is completed in three steps:
1. Incisions - Small well-hidden incisions are made in the crease of the eyelid following the natural lines in the skin. These may extend into the “crow’s feet” or laugh lines. Alternatively, if you have a pocket of fat under your eyelids but do not need to have any skin removed, a different procedure may be optional for you.
2. Tailoring - Fatty deposits and excess skin around the eyes are removed in preparation for muscle tightening on the upper eyelid. Only the fat pockets that are visible are removed to prevent an operated and skeletonised look. An incision is made below the lash line, through which excess fat and skin are removed when working on the lower lid.
3. Finishing touches - Sutures are used to close the incisions, very thin surgical tapes are applied to the scars and your eyes are lubricated with ointment. Most patients return home on the same day. Arrange for someone to drive you to and from surgery if you are having outpatient surgery. Plan to have someone stay with you for the first night after returning home from surgery.

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AFTER THE PROCEDURE

After surgery you will spend time in the recovery room, where you are monitored for complications. You can leave later that day to recuperate at home.

After surgery you may temporarily experience:
• Blurred vision.
• Watery eyes.
• Sensitivity to light.
• Double vision.
• Puffy and numb eyelids.
• Swelling and bruising similar to having black eyes.
• Pain or discomfort.

Your Surgeon will likely suggest that you take the following steps after surgery:
• Use ice packs on your eyes for 10 minutes every hour the night after surgery. Use ice packs on your eyes four to five times throughout the day the following day.
• Gently clean your eyelids and use prescribed eye drops or ointments.
• Avoid straining, lifting heavy objects and swimming for a week. • Avoid strenuous activities, such as aerobics and jogging, for a week.
• Avoid smoking.
• Avoid rubbing your eyes.
• If you use contact lenses, don’t put them in for about two weeks after surgery.
•Wear darkly tinted sunglasses to protect the skin of your eyelids from sun and wind.
• Sleep with your head raised higher than your chest for a few days.
• Apply cool compresses to reduce swelling.
• After a few days, return to the doctor’s office to have stitches removed, if needed.
• Avoid aspirin, ibuprofen, naproxen sodium, naproxen and other medications or herbal supplements that may increase bleeding for about a week

Seek medical attention immediately if you experience any of the following:
• Shortness of breath.
• Chest pain.
• An unusual heart rate.
• Severe new eye pain.
• Bleeding.
• Vision problems.

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RESULTS

Once you have undergone the procedure and made a full recovery, you can expect to look more ‘refreshed’. You will also notice that your eyes appear wider and more youthful. Many people express satisfaction with the results of blepharoplasty, such as a more rested and youthful appearance and more self-confidence. An added advantage is that the results of this procedure are expected to last for years post-surgery, but droopy eyelids may recur in some people.

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