Blepharoplasty surgery is most often performed under local anesthesia. Sedation or general anesthesia may be utilized in appropriately selected patients. Experience and expertise are required to execute the procedure. First, the blepharoplasty incision is measured and marked. Subsequently variable amounts of skin, soft tissue and fat are removed to achieve a pleasing and youthful appearance of the eyelid and to improve the visual field. After the desired amount of excision is accomplished skin incisions are closed with sutures.
The best way to learn what blepharoplasty accomplishes, and therefore what an individual patient might expect, is by examining preoperative and postoperative photographs of blepharoplasty patients . Some doctors offer computer imaging and others don’t. Those who are in favor of imaging find that it helps to precisely plan the operation and it is greatly appreciated by the patients. Those who dislike imaging are worried about raising unrealistic expectations. Compared to other procedures, such as rhinoplasty, computer imaging is relatively less reliable for upper eyelid blepharoplasty.
Remember that the result will almost always differ somewhat from the computer generated outcome, regardless of the surgeon’s expertise.
Blepharoplasty can be performed for aesthetic or functional purposes (impairment of vision). Your surgeon will ask you about your past medical history, including medications you are taking, allergies, smoking habits, previous surgery and more. At least 2 weeks prior to the surgery, any patients who are taking aspirin or warfarin sodium (coumadin) are instructed to discontinue these medications. Patients may also be instructed to cease smoking for a given period before and after the procedure.
Your surgeon may also question you about any dryness or watering of your eyes you may have, he/she may ask for some extra tests to eliminate any problems with your tear functions.
Your physician will talk about the various options of correcting your upper eyelids. Added procedures that may be performed in combination with an upper eyelid blepharoplasty are discussed. These include injection of the “crows feet” wrinkles with botulinum toxine or application of fillers to smoothen lines. If drooping of the eyelids is present, this should be taken into consideration and an eyebrow lift may be recommended. Laser treatments and chemical peels of other facial areas may also be performed during an upper eyelid blepharoplasty procedure.
Your surgeon will also talk to you about the risks, benefits and possible complications of an upper eyelid blepharoplasty procedure. Your surgeon will also talk to you about results, realistic expectations, and what the limitations of the procedure are.
You can typically get up and walk around the evening of the surgery or the following morning. You should be prepared for moderate swelling and bruising of the skin. The degree of swelling and bruising differs markedly from patient to patient. Either way the swelling and the bruising both subside within 1-4 weeks, after which time it is typically hardly notable that you just underwent surgery.
A bandage is usually not needed after the surgery. Some surgeons prefer to use small strips to cover the incision site. Following the completion of the procedure, ointment may be applied over theincisions for approximately 1 week. Artificial tear drops can be prescribed to prevent the dryness at early postoperative period. Ice packs are applied over the operated area for 24 to 48 hours.
Non-absorbableskin sutures are removed 5 to 7 days, Absorbable sutures dissolve within 1-3 weeks. Both types of sutures have advantages and draw backs and your surgeon should explain to you which suture material she / he recommends.
Generally speaking the recovery period after upper eyelid blepharoplasty is usually short and you may start doing your daily routines as soon as the following day. The swelling and ecchymosis vary among patients, but rarely last longer than 3 weeks and almost never limits patient mobility.
Your surgeon may ask you to refrain from applying make-up for a certain time after the surgery.
Failure to meet the patient’s expectations, residual excess skin, asymmetry or scarring may necessitate additional treatment or a secondary operation.
Overcorrection may cause upper eyelid retraction which may result in the inability to close the eye. Topical lubricants and massage may be helpful for managing mild situtations. Injectable steroids can be used. Severe cases may require a secondary operation.
Eversion of the eyelids inwards or outwards is a rare complication and may also require a secondary procedure for correction.Very rarely double vision may occur due to injury of eye muscles.
Rhinoplasty is a demanding procedure. You should be aware that it will take 1-2 years for your nose to heal completely and take its final form. If after surgery there is a deformity or asymmetry of your nose your surgeon will advise you to wait 6-12 months for complete healing to occur.
If there are still asymmetries or deformities after this period, you should discuss the available options with your surgeon. Ageing also involves the nose and some long-term changes may be observed in your nose as you grow older.