As we all know, the eyes are a prominent facial feature. Although the eyes are expressionless structures, the surrounding skin conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Unfortunately, wrinkles and deep lines as well as puffiness under the lids develop as you age. In addition, exposure to the sun as well as hereditary factors contribute to the aging process, all resulting in changes of expression. In many cases, people may look fatigued, worn out and older than their true age. Beyond possible visual impairment, these changes in your appearance can cause stress and anxiety.
Dr. Holmes is trained in several surgical procedures, such as blepharoplasty, forehead lift and brow lift in order to eliminate the majority of these problems.
Before Surgery
To better understand your overall health, we will evaluate your medical history prior to surgery. In addition, a complete examination of your eyes and face are made in order to take the most effective surgical approach. The amount, distribution and type of excess skin to be removed are carefully reviewed.
Dr. Holmes will provide you with pre-operative instructions that may include the elimination of specific drugs containing aspirin several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection.
The areas that will be excised are marked and digital photographs and computer imaging is performed in order to determine the amount of improvement after surgery.
Blepharoplasty (eyelid lift)
Eyes are a prominent facial feature. It is the surrounding skin, rather than the eyes themselves, that conveys emotion. The tissue, muscle, fat, hair and lashes all contribute to the wide array of expressions. Age, sun exposure and hereditary factors all contribute to wrinkles, deep lines and puffiness around the eyes.
The aging process can cause unwanted changes in expression, causing us to look permanently fatigued and older than we really are. These changes in appearance can cause emotional distress and sometimes even visual impairment. An eyelid lift, or blepharoplasty, is designed to restore a more youthful appearance to your eyes. It may involve the upper lids, the lower lids, or both.
New and Traditional Techniques
Traditional Blepharoplasty: An incision is made in the crease of the upper lid toward the temples. Once healed, it is not noticeable when the eye is open. On the lower lid, the incision is made along the lash line toward the temples, and is hidden by lashes when healed.
The Transconjunctival Approach: This is a newer technique for lid blepharoplasty, involving an incision inside the lower lid. Fat can be removed through this incision, but excess skin cannot be eliminated.
Laser resurfacing of the eyelids is a non-surgical alternative that may delay the need for a surgical blepharoplasty. It results in significant tightening of the skin around the eyes, but will not effect the fat around the eyes and may even accentuate it.
Please ask your doctor if you have any questions about which procedure is right for you.
The Surgery
Local anesthesia is given around the eyes. An intravenous line is started so that sedation may also be given. During the procedure you will be awake but comfortable and relaxed. General anesthesia is rarely used.
This procedure is performed on an outpatient basis at our surgical center. It is important to arrange for care after the surgery. Someone must drive you home and be available to care for you for the first 24 hours.
Complications are unlikely when performed by a surgeon with experience in blepharoplasty. These include: bleeding and swelling, delayed wound healing, infection, drooping of eye upper or lower eyelid, asymmetry, double vision and dry eyes.
Recovery: What to Expect
The area surrounding the eyes will remain swollen in the days following the surgery. It should begin to subside after the first day. Some vision blurring is normal.
The stitches will be removed in 4-5 days. Swelling and bruising will persist for about 10 days, but you can begin wearing makeup to help conceal these concerns. You may expect to resume normal activity within a week to 10 days, and start enjoying your new look within approximately 10-14 days. It may take about 6 months for the scars to lose their redness.
Wrinkling will recur later in life, however it is unlikely that the “bags” will recur because the fat has been removed. Deeper wrinkles around the outer eye extended onto the temple are not greatly affected by the eyelid lift. These areas may be treated with laser resurfacing.