Blepharoplasty

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This operation involves the surgical removal of excess skin and fat tissue to give a more rested and /or youthful appearance to the eyes. This is done by removal of a pre-measured segment of skin and a thin strip of the underlying muscle which then allows visualization and removal of the excess fat. The skin is then closed by the placement of fine sutures.

The operation will take one to one and a half hours. It can be done under either general or local anesthesia. If you choose to have a local anesthetic, intravenous medications will also be given. This will help you relax and remain still during the operation. This operation is usually done as day surgery in a hospital setting, but because of the need for sedation you will need someone to drive you to and from the hospital. You will need to arrive about 1 1/2 hours before surgery and will stay in the recovery room about one hour after the operation. Your ride can pick you up following this period of time. The evening of surgery you will need someone to stay with you. This will help to ensure a safe recovery and they can assist you with the “duties” of the first night. These “duties” will include application of ice packs to the eyes which should be kept on almost constantly the first night and as much as possible for the next several days. This will help control bleeding and the amount of bruising and swelling will be reduced. Head elevation will also keep swelling and bruising to a minimum. This can be accomplished by sleeping on a recliner or by placement of several pillows behind your head. This is usually beneficial for the first week following surgery. You will also need to keep the incisions clean and apply antibiotic ointment (try to avoid Neosporin as this often causes an allergic reaction) to the sutures until they are removed after 4-5 days. You can shower and wash your face two days after surgery but try to avoid direct force on the incision. Two days following removal of the sutures, you may apply make-up directly to incision if it is of the non- allergenic type. Application of vitamin E, aloe or a good moisturizer will also aid in healing. Pain medication will be prescribed for the first several days but most people find Tylenol or Advil sufficient after the first couple days. Please avoid aspirin two weeks before and for one week after surgery as this is a potent blood thinner and can increase your chance of bleeding which will prolong your recovery.

With any operation there will be bruising and swelling. This operation will have visible bruising and some swelling of the eyelids and upper cheeks. Complete closure of the eyes is unusual. Most of the discoloration will be gone in two weeks however a tinting of the lids may persist for a month. This is also true of the swelling.

As with any incision into the skin there will be a resultant scar. The placement of the incision is such that the location of the scar will usually fall in the fold of the upper lid or just beneath the lashes of the lower lid. This scar will take several weeks to a month to heal and will fade in color to a fine line in most patients. Occasionally delays or complications in healing will result in a more noticeable scar. It may be reddened, elevated or thickened, wide, ugly, painful or associated with numbness in the skin next to the scar. Occasionally the scar may be a different color compared to the adjacent skin and although usually temporary there can be permanent discoloration. If unacceptable, a surgical operation may be required to alter the appearance of the scar. Numbness of the lid may last several months.

Due to the proximity of the incision to the lashes (in the lower lid) there is the possibility that damage could occur to the hair follicle resulting in the loss of the eyelashes. Although usually temporary, the loss of the lash may be permanent.

Because this operation involves the eyelid, there is always the possibility of damage to the eyeball or surrounding structures. This can result from a reaction to the disinfectant used to clean the skin preoperatively or from the operation itself. This may affect the apparent shape of the eye or the way it works. Dry and itchy eyes may result. This may require the long term use of eye drops to lubricate the eye to prevent discomfort or damage to the eye.

Abrasions to the eye could occur during the operation. Although some incomplete closure of the eyelids is expected immediately following this operation (due to swelling), increased scarring of the eyelids could result in the permanent inability to completely close the eyelids while at rest or sleeping. Any damage to the eye could result in change in your vision. Blindness, although extremely rare, has been seen by other surgeons following this operation. These changes could be permanent.

Scarring of the lower lid may cause a downward pull on the lid margin. This is called Ectropion. This condition may be associated with drying of the eye, abnormal appearance and occasionally pain. Additional surgery may be indicated to correct the problem if severe but if of a minor nature it will may return to a normal position with time.

In any operation there are risks to be considered. These include bleeding, infection, numbness, pain or discomfort, reactions to the medications or anesthetics, asymmetry, removal of too much or too little skin or fat and /or failure to achieve your desired appearance. Efforts will be made to reduce the risks of this operation. You must help by following all preoperative and postoperative instructions and by keeping all scheduled appointments. You must report any changes in your condition to the office so that treatment may be altered if necessary. If you smoke, your healing will be delayed and you increase the risk of a complication following your surgery. Any potential problems could result in the need for additional surgery and recovery time, time lost from work, possible hospitalization, financial loss, disappointment and/or psychological stress to you. Please take time to consider this operation carefully and to ask any questions you may have regarding the procedure, risk or healing.