Rejuvenation of the appearance around your eyes
The first signs of aging occur around the eyes. This is also the first place people look when talking to someone. Gravity and age cause the eyelid skin to droop, hood, and wrinkle. The smooth upper eyelid skin begins to disappear. Fat around the eyelids also changes. Excess fat can herniate forward from behind the eyes giving the appearance of bags. In others, the fat may shrink with age giving a hollowed appearance.
The position and health of the upper cheek will greatly influence the appearance of the lower eyelids. With age, upper cheek skin and fat begin to shrink and drop. Dark circles may develop under the lower eyelids as the cheek starts to drop with gravity. The result is a tiered and old appearance.
With eyelid surgery, known as blepharoplasty surgery, Dr. Anzarut can improve the appearance of drooping eyelids, bags around the eyes, and loss of fat. Related procedures can address the circles and drooping of the cheek. This leads to a more rested and youthful look.
Is Eyelid Surgery for me?
If you feel your eyelids are heavy or leave you with tired appearance you may be a good candidate for a blepharoplasty procedure. A consultation with Dr. Anzarut may be the best way to know. Dr. Anzarut will discusses what to expect before, during, and after the surgery.
Your safety is Dr. Anzarut’s primary concern. If you are in good physical health and do not have any medical conditions that would complicate recovery or increase the risk of surgery, you may be a candidate for eyelid surgery. Bleeding disorders, problems with dry eyes, uncontrolled hypertension, or LASIX surgery in the past 6 months may exclude you from having blepharoplasty.
In some patients drooping upper eyelids may be caused by loose skin on the forehead (brow ptosis) or stretched eyelid muscles (upper eyelid ptosis). This will be assessed during the consultation process. Dr. Anzarut can treat these conditions with either a brow ptosis or an eyelid ptosis procedure, if needed.
Contact Dr. Anzarut if you have any questions regarding your suitability for eyelid surgery. During your consultation, Dr. Anzarut will discuss your options and recommend a course of treatment. Dr. Anzarut is also able to perform remote consultations.
About the procedure
Upper eyelid surgery (Upper eyelid blepharoplasty)
Dr. Anzarut will use a marking pen and calipers to mark the incisions and areas of fat excess or fat loss. Local anesthesia, freezing, is applied. Medicated eye drops are provided to reduce post-operative swelling. Some patients prefer an oral medication to help them relax during the procedure. If you think you may prefer this, let Dr. Anzarut know. To ensure the freezing has had its maximal effect your procedure will begin approximately 25 minutes after freezing.
Dr. Anzarut performs his skin incision at the level of the skin fold of the eyelids. This is usually 8 to 10 mm above the eyelashes. Excess skin, muscle and fat are removed as needed. In some patients fat is add to an area of fat loss and hollowing. If the eyelid muscles require repair, ptosis surgery, this completed. The skin incision is then stitched closed with non-dissolving sutures. Dr. Anzarut avoids dissolving on the skin because they create more scarring. The procedure takes 15 to 30 minutes and should be pain free.
Lower eyelid surgery (Lower eyelid blepharoplasty)
Similar to upper eyelid surgery, Dr. Anzarut will use a marking pen and calipers to mark the incisions, areas of fat excess, and areas of fat loss. Local anesthesia, freezing, is applied. Medicated eye drops are provided to reduce post-operative swelling. If you prefer, the procedure can also be performed with sedation or with general anesthesia (asleep). To ensure the freezing has had its maximal effect your procedure will begin 20 minutes after freezing.
If the addition of fat is required to treat hollowing, this is done first. Next, an incision is made on the inside of the eyelid or on the outside of the eyelid just below the eyelashes. Excess fat under the eyes is either removed or repositioned. If necessary, excess skin is removed and the upper check is lifted (midface lift). A stitch is placed to support the eyelid in order to avoid lower eyelid drooping. This is called a canthopexy. In some cases Dr. Anzarut will place a temporary suture between upper and lower eyelids. This is called a Frost stich. A lower lid blepharoplasty procedure takes one to two hours depending on the complexity of the individual case.
Recovery from Eyelid Surgery
The key to a fast and painless recovery is to minimize swelling and bruising. Dr. Anzarut takes special measures to shorten your recovery. If you have fat (fat grafting) added you will have significantly more swelling and bruising. It is important to follow the pre and post-procedure instructions.
2 WEEKS BEFORE SURGERY
Before surgery you will be provided with a list of foods and medications to avoid (LINK). On the day of the procedure ensure you fill your prescriptions and bring them to the office with you. You may also benefit from ensuring you have ice packs ready for your journey home and the following 48 hours. You should have a pair of comfortable sunglasses to use during the week after the procedure. You should arrange a recliner or multiple pillows to allow you to sleep with your head up for the first two nights after surgery. Finally, you will need to arrange a ride to bring you home after the procedure.
THE DAY OF YOUR PROCEDURE
At the time of the procedure, medications are used to reduce bruising and swelling. After surgery it is very important to ice the area. Icing is done 15 minutes on and 15 minutes off for the first 48 hours, while awake. Ice is applied indirectly with a cloth placed between the ice and the skin. Your head is kept elevated for the next 48 hours to help reduce swelling. This means you will benefit by sleeping with your head up. This can be done by sleeping in a lazy boy chair or with multiple pillows. Avoid any heavy lifting or straining for the first 3 weeks after surgery. This may increase the risk of bleeding.
THE FIRST WEEK AFTER SURGERY
The first week after surgery your eyelids may not close as tightly. To avoid problems with dry eyes Dr. Anzarut will advise you on the use of medications to keep the eyes clean and lubricated. You will use an ointment at night and liquid drops during the day. Your stiches are removed by Dr. Anzarut 5 to 7 days after surgery.
AFTER THE FIRST WEEK
After the first week the swelling and bruising will have subsided. You can start to use makeup. At this point you can slowly resume normal activities. Heavy lifting or straining should still be avoided for 3 weeks. You can shower, however you should avoid swimming for 3 weeks.
Talk to Dr. Anzarut if you have any questions or concerns about the recovery period.
It may take several months for the final results to appear. With an upper eyelid blepharoplasty, most of the swelling and bruising is gone by the second week. With lower eyelid blepharoplasty, the recovery period is more variable. It depends on the complexity of the procedure required. The results of eyelid surgery last a long time, however the aging process does continue. It is important to take care of the area as it heals and sun protection will help maintain your results. Note that it may not always be possible to obtain optimal results with one procedure, and another operation may be required in a few cases. This is more common in patients requiring the addition or fat (fat grafting).
Risks of Eyelid Surgery
Blepharoplasty, like all surgery, carries some risk. Complications are not common and usually minor when surgery is performed by a certified plastic surgeon (LINK).
Don’t be afraid to ask Dr. Anzarut any questions you may have about the procedure or recovery process.
Some of the possible side effects of Eyelid Surgery include temporary dry eyes, temporary difficulty closing the eyes, temporary sensitivity to bright light. Rarely patients can develop a cyst along the incision line. This can easily be removed under local anesthesia. Infection is very rare.
Lower eyelid surgery carries the additional risk of lower eyelid droop (ectropion). During lower eyelid surgery Dr. Anzarut places a special stitch (canthopexy) to avoid this problem. Dr. Anzarut has published his research on the importance of this stitch in cosmetic lower eyelid blepharoplasty. It was published in the most highly regarded plastic surgery journal (the Journal of Plastic and Reconstructive Surgery). This work is one of the most highly quoted research papers on the topic of lower eyelid blepharoplasty.
You can reduce the risks of complications by ensuring your surgeon is a certified plastic surgeon and by following your surgeon’s instructions closely after surgery.
The cost of any procedure may include surgeon fees, facility costs, anesthesia costs, medications, and fees for medical tests. Purely cosmetic surgery is not usually covered by the medical services plan. However, some patients may qualify for financing plans. (LINK)
Cost of Upper Eyelid Surgery (Upper Blepharoplasty)
If the excess skin and hooding of the upper eyelids is so severe that it blocks your peripheral vision the costs of surgery may be covered by the medical services plan (MSP). If damage or weakness of the eyelid muscles is the cause of your eyelid drooping (ptosis), the costs of surgery may be covered by the medical services plan (MSP).
If you decide to pay privately for upper eyelid blepharoplasty the cost may be close to $1,200.
Cost of Lower Eyelid Surgery (Lower Blepharoplasty)
If the drooping of the lower lid leads to significant deformed or the tearing function of the eyes is impaired, the costs of surgery may be covered by the medical services plan (MSP).
If you decide to pay privately for lower eyelid blepharoplasty the cost may ranges from $2,500 to $4,000.