Blepharoplasty

Blepharoplasty is surgery performed by Dr. Beers of Peninsula Laser Eye Medical Group in our state-of-the-art surgery center in Mountain View.  This procedure  involves repairing droopy eyelids by removing excess skin, muscle and fat.  As we age, our eyelids stretch, and the muscles supporting them weaken. As a result, excess fat may gather above and below the eyelids, causing sagging eyebrows, drooping upper lids and bags under your eyes. Besides making us look older, severely sagging skin around the eyes can impair the peripheral or side vision. Blepharoplasty can reduce or eliminate such impaired vision.  Some insurance companies will cover the removal of excessive eyelid skin if the excessive skin is interfering with activities such as reading and/or driving.

Why Eyelid Surgery

You might consider blepharoplasty if drooping or sagging eyelids keep your eyes from opening completely or pull your lower eyelids down. Removing excess tissue from your upper eyelids, lower eyelids or both can improve vision and make your eyes appear younger and more alert.

Blepharoplasty may be an option if you have:

  • Baggy or puffy upper eyelids
  • Excess skin of the upper eyelid that interferes with your vision
  • Droopy lower eyelids, which may cause white to show below the iris (colored part of the eye)
  • Excess skin on lower eyelids
  • Bags under your eyes

Surgery Risks

As with any surgery, blepharoplasty carries some risks, such as infection or reaction to anesthesia. Temporary numbness of the eyelid skin and bruising for a week or two is common.  Fortunately, any complication from eyelid surgery is rare and patients are quite pleased with their improved peripheral vision and cosmetic appearance following eyelid surgery.

Talk to Dr. Beers about how these risks may apply to you. Understanding what’s involved in blepharoplasty and weighing the benefits and risks can help you decide if this procedure is a good option for you.

Preparing for Blepharoplasty

Before scheduling blepharoplasty with Dr. Beers, you need to discuss with him whether the procedure is likely to work well for you. This meeting generally includes:

  • Your medical history. Dr. Beers asks questions about your medical conditions. Detailed questions may address dry eye, eye-related allergies and other eye problems. Advise him if you have circulatory problems, thyroid problems, diabetes or other serious medical conditions. He will also ask about your current medications, including over-the-counter medications and anti-coagulants.
  • A physical examination. Your surgeon conducts a physical examination including measuring the eyelid height and lid margin position.  An honest discussion about reasonable expectations will help set the stage for a satisfactory outcome. Be prepared to talk about your motivation for seeking blepharoplasty and what you hope the results will be. Dr. Beers can tell you whether your expectations are in line with usual results.  Dr. Beers is very careful not to remove excessive skin to avoid the complication of not being able to close the eye fully.  Not being able to close the eye fully can lead to dry eye symptoms.

Before blepharoplasty, you’ll be asked to:

  • Stop taking aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve), and any other medication or herbal supplement associated with increased bleeding. It’s best not to use these medications and supplements for two weeks before and after surgery.
  • Quit smoking. Smoking can impair your ability to heal after surgery.
  • Arrange for someone to drive you to and from surgery if you’re having outpatient surgery. Plan to have someone stay with you for the first night after returning home from surgery.

Surgery Expectations

Blepharoplasty is done in our office with local anesthesia. We give you an oral valium to help you relax and then Dr. Beers injects numbing medication into your eyelids for anesthesia.  An incision is made along the natural fold of the upper eyelid. Then excess skin and some muscle and fat beneath the skin are removed. The incision is closed with tiny stitches that leave a nearly invisible scar.

Blepharoplasty usually takes less than two hours, depending on the amount and location of tissue being removed. You need a friend or family member to take you home where you should rest for the remainder of the day.  We will see you the day following the surgery for a brief visit.

After blepharoplasty an antibiotic ointment will be applied to your incisions nightly. Your incisions will be red and visible at first, and your eyelids may be puffy and feel numb for several days. Swelling and bruising, similar to having “black eyes,” will likely last a week or more. Ice packs or cold compresses applied to your eyes can help reduce swelling.

Pain is usually minimal. You may be given a pain reliever, such as acetaminophen (Tylenol, others), for mild discomfort, but remember to avoid aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve), and any other medications that may increase bleeding.

Stitches are removed five days after the procedure.

Take the following precautions for a week after the surgery, unless advised otherwise by Dr. Beers:

  • Avoid straining, heavy lifting and swimming.
  • Avoid strenuous activities, such as aerobics and jogging.
  • Follow your post operative instructions regarding cleansing your eyelids and the use of eyedrops or ointments.

Results

Scars from the incisions are minimal but may take six months or longer to completely fade. Take care to protect your delicate eyelid skin from too much sun exposure during this time.

Many people express satisfaction with the results of blepharoplasty, such as a more rested and youthful appearance and more self-confidence. For some people, results of surgery may last a lifetime, but for others, eyelid drooping eventually may recur.


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