Surgical Procedure:

For traditional lower lid blepharoplasty; an incision is made just beneath the lash line. Excess fat, muscle and skin are removed.Fine sutures are used to close the incision. Permanent stitches will be removed 3-5 days after the procedure. If you have a pocket of fat beneath your lower eyelids, but do not need to have any loose skin removed, your surgeon may recommend a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with fatty lower eyelids. Transconjunctival blepharoplasty does not tighten the skin but reduces the puffiness in the lower eyelid region.

Pre Operative Care:

Inform us about any allergies, any serious medical condition(s), and all medications you are taking ( both prescription and non-prescription )

Hospital Admission:

This depends on your preferences as well as your surgeon's. Upper eyelid blepharoplasty can be performed on an out patient basis, in the hospital, or in an ambulatory surgical suite under either general or local anesthesia.

Anesthetic: General or Local Anesthesia.

Post - operative Care:

The first evening after surgery, you should rest quietly with your head elevated. It will help to apply cold compresses to your eyelids. (Avoid any compress heavier than one ounce. A Ziploc bag with a few frozen peas works well.) Your blood pressure should be monitored to avoid bleeding complications that can affect vision. And, although you can be up almost immediately, you should limit your activities.

For the first week, you will need to avoid activities that dry the eyes, including reading, watching television, wearing contacts, and using a computer. Also avoid excessive blinking, which leads to increased swelling. You should also wear dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation. The eyes may tire easily for several weeks; frequent naps are helpful.

For the first three or four weeks, you should avoid any activity that increases blood flow to the eyes, including bending, lifting, crying and sports. Your surgeon will let you know when you are ready for exercise. Also avoid drinking alcohol, which can lead to fluid retention and delayed recovery.

Results:

This surgery will make eyes look brighter, larger, and more rested by removing loose skin, stretched muscle, and excess fat. In some people this procedure will improve vision by removing the excessive skin of the upper eyelids which can hang down and interfere with peripheral vision. Eyes will look more youthful.

The surgery of lower lids should smooth out bulges, take away fat bags from under the eyes, and make the skin snugger. You will look rested, and people will see your face instead of focusing on your unsightly lower lids. The results tend to be long lasting. It is most common to have this surgery between ages 38 and 50.

Recovery:

At first the incisions will probably be red and somewhat bumpy. Eventually, the resulting scar should become flat and inconspicuous. Your sutures (stitches) will be removed sometime within the first week.

The swelling and discoloration around your eyes will gradually subside, and you will start to look and feel better each day. Swelling and bruising varies considerably from person to person. Bruising typically disappears within seven to ten days. Within the first week you will be permitted to use makeup, if desired, to conceal any discoloration.

Your vision may continue to be somewhat blurry for a few days or longer. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. You may receive eyedrops to help relieve any burning or itching.

Risks and Complications:

• Lagging of the eyelid is the abnormal position of the lower eyelid after surgery because of poor function of eyelid before surgery. This can be reduced by excercise eyelid muscle before surgery.
• Retrobulbar hematoma - (bleeding behind the eye) - rare, but can be serious. Symptoms include loss of vision.
• Temporary problems with excessive tearing.
• Decreased sensation in the eyelid.
• Dry eyes - dryness, burning, stinging, gritty sensation in your eye(s).
• Prominence or firmness of the scars.
• Blurred vision asymmetry in healing or scarring.
• Milia or whiteheads where the sutures emanate from the skin.
• Difficulty closing eyes completely; in rare cases, this condition may be permanent.

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