Blepharoplasty (Eyelid Surgery)

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Over time, eyelids tend to sag, which can cause a number of problems with both aesthetics and function. Droopy eyelids above the eye and puffy or stretched lids below tend to give the face a tired appearance. If the upper eyelids fall enough, they can even reduce the patient’s field of vision. Eyelid surgery corrects problems with the eyelids by removing excess skin and tightening and resurfacing the remainder.

One of the biggest advances in eyelid surgery (blepharoplasty) has been the incorporation of the laser into the procedure. A skin resurfacing laser, called the Ultra Pulse Co2, can be used both for upper and lower blepharoplasty, and to improve the skin around the eyes. The laser is often used in a focused beam on the outside of the upper eyelids to make incisions to remove skin. It allows Maryland blepharoplasty surgeon, Dr. Mark Richards, to work with precision and cleanliness, because the laser seals blood vessels as it cuts. There is little bleeding or scarring. The laser can also be used to remove any fat that may be causing puffiness. Then, by adjusting the beam, the same machine can be used to tighten the skin around the eyes through skin resurfacing. By using the laser, eyelid surgery operation time and residual bruising are reduced.

Learn More About This Procedure

View our online video library to watch Dr. Richards describe his techniques.

Video Library

The eyelid surgery experts at Ageless Impressions Plastic Surgery Institute are more than happy to answer any further questions you have regarding blepharoplasty. Our staff can also help you set up an appointment for an eyelid surgery consultation today.

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Being a Candidate for Upper Eyelid Surgery

Common problems that are likely to be corrected by upper blepharoplasty include:

  • Extra skin in the upper eyelids that causes them to feel heavy
  • Disappearance of the upper eyelid crease
  • Tired or sad appearance
  • Obstructed vision from eyelid skin
  • Wrinkles around the eyes

Upper Eyelid Surgery

Eyelid surgery involves very fine incisions that follow the natural contours of the eye in order to minimize the appearance of scars afterwards. For work on the upper eyelid, the incision is placed in the crease between the eyebrow and the lid itself, while the incision for the lower lid runs just beneath the row of eyelashes below the eye. At Dr. Mark Richards’ practice, a specially designed laser is the tool of choice for this procedure. The laser offers several advantages when working with the eyelids: it puts less stress on the delicate skin, it cuts very accurately, and it minimizes bleeding and bruising by sealing severed blood vessels as it goes. Once the incisions have been made, the lids are separated from the underlying muscle and excess skin and fat are removed, and the cuts are sewn back together. The laser is then adjusted to project a less intense beam and serves to rejuvenate the remaining skin with brief applications of its light.

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Being a Candidate for Lower Eyelid Surgery

Common problems that are likely to be addressed by lower blepharoplasty include:

  • Puffy bags in the lower lids
  • Looseness of lower lids
  • Wrinkled skin of the lower lids
  • Hollows under the lower eyelids

Not all persons with these features may be suitable for blepharoplasty. Patients should be physically healthy, psychologically stable, and realistic in their expectations. In addition, certain skin characteristics – texture, coloration, thickness, exposure to sun, potential for scarring, and others – should be evaluated before laser eyelid surgery is recommended. A qualified blepharoplasty specialist can advise patients further. By contacting Mark E. Richards, M.D. at the Ageless Impressions Plastic Surgery Institute, you can see if eyelid surgery is right for you.

Lower Eyelid Surgery

Lower eyelid surgery can be performed at an outpatient facility and is usually in the form of one of three approaches:

  • Laser resurfacing of the lower eyelid skin to tighten and shrink the outside of the lower eyelid.
  • A laser incision inside the lower eyelid to expose the fat pads and trim them. This can be combined with laser resurfacing of the outer eyelid skin as well.
  • An external incision just below the eyelashes that extends out into the smile lines. This is done for more extensive problems that require several things fixed in the lower eyelid. This approach can be used to transfer bulging fat of the lower lids into the hollows of the upper cheek, benefiting both areas!

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Risks Particular to Blepharoplasty

Certain conditions may be problematic to blepharoplasty. These include insufficient tear production, a detached retina, thyroid problems, high blood pressure, and diabetes. Allergies, some supplements, and smoking may also affect the procedure, so it is important to discuss these with Maryland blepharoplasty surgeon, Dr. Richards.

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Preparing for Blepharoplasty

A blepharoplasty surgeon typically issues instructions on how to prepare for eyelid surgery. These will include habits in eating, drinking, smoking, and taking vitamins or medications. Of particular concern are aspirin, ibuprofen and Vitamin E, which should be avoided for two weeks prior to eyelid surgery. They make recovery more difficult because they exacerbate bleeding and bruising.

It is usually best to purchase products like cold compresses and eye drops that may help in recovering from blepharoplasty surgery. If the patient takes prescription medications, it is usually best to purchase them ahead of time so that he or she can continue them with minimal interruption. If the patient is having laser skin resurfacing performed in conjunction with blepharoplasty, the eyelid surgeon may recommend certain topical skin products to prepare the skin.

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Post Eyelid Surgery

Immediately following eyelid surgery, Dr. Richards usually applies lubricating and antibiotic ointments to the eyelids. As the anesthesia begins to wear off, the eyelids may begin to feel slightly sore. Mild pain medication is usually prescribed.

Elevating the head for a few days, in combination with the use of cold compresses, reduces swelling and bruising, though some of each is normal. The sutures are usually removed within three to five days of eyelid surgery, after which swelling and discoloration will dramatically subside.

The patient is instructed on cleaning the eyes. Eye drops are usually recommended to overcome the itching and dryness that may accompany blepharoplasty. Other temporary effects may include proliferative tearing, sensitivity to light, or blurry vision.

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Returning to Normal After Blepharoplasty

Two or three days after eyelid surgery, the patient should be able to read or watch television. Most people feel perfectly comfortable going out in public within five to seven days. However, the eyes may still feel sensitive to light and may be easily irritated. The eyelids may also be particularly vulnerable to the effects of the sun for a while. It usually takes two weeks before patients are allowed to wear contacts or makeup. Most blepharoplasty surgeons recommend avoiding strenuous activities and salty foods for a few weeks, to prevent fluid buildup around the eyes.

Within a few months, the scars have usually faded almost completely and the full effects of the eyelid surgery are realized.
If you are interested in eyelid surgery, contact Ageless Impressions Plastic Surgery Institute today to find out more about your eyelid surgery options.

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Frequently Asked Questions About Eyelid Surgery

Q: How much will blepharoplasty change the shape of my eyes?
A: Blepharoplasty is only designed to restore the shape of the eyelids to their natural state. There are other procedures that are designed to alter the shape of the eyes. Initial change in eye shape may occur due to swelling, but will resolve over time.

Q: Can my vision be harmed by eyelid surgery?
A: When blepharoplasty is performed by a qualified plastic surgeon, the risk of damage to the patient’s vision is very minimal. A protective shield is placed over the eyes while the laser is being used. Careful attention to the eyelid surgeon’s instructions can minimize the risk even further. Ageless Impressions Plastic Surgery strives for eyelid surgery perfection and a full recovery of each of our blepharoplasty patients.

Q: How noticeable are the incisions from eyelid surgery?

A: After healing is complete, the scars are usually unnoticeable. The skin of the eyelids heal particularly well.

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Schedule Your Consultation

To set up a consultation for eyelid surgery, please contact us today. If you would like to get a closer look at the procedure, take a moment to visit our video gallery and view our Before and After photos.