What Is Eyelid Surgery?
If you have impaired vision as a result of excess skin hanging down from your upper eyelids or your eyes look tired, puffed up and aged, you may need eyelid surgery. Eyelid surgery or blepharoplasty is a procedure which can be performed on your upper eyelids, lower eyelids, or both, to resolve a number of concerning underlying issues.
Blepharoplasty may be performed as a standalone procedure, or as part of a combination of procedures, to help rejuvenate the overall appearance of a patient
The Procedure
General anesthesia is commonly used during a blepharoplasty procedure, although local anesthesia or intravenous sedation may be desirable in some instances.
For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood. Your surgeon will follow the surgical plan discussed with you before surgery.
Based on a preoperative evaluation of factors such as your underlying facial muscle structure, bone structure, and the symmetry of your eyebrows, your surgeon will decide how much skin, muscle, and/or fat he needs to remove to achieve the best results.
Your surgeon will make precise markings to indicate where excess tissues will be removed in your upper eyelids and/or in your lower eyelids:
Upper eyelid surgery: Your surgeon will mark the natural lines and creases of your lids and keep your scars as hidden as possible along these natural folds. Through the incision he or she will remove excess skin, muscle, and fat. Fine sutures will be used to close the incisions, thereby minimizing scar visibility.
Lower eyelid surgery: There are a number of options for performing lower eyelid surgery:
The traditional approach places the incision just below the eyelashes, trimming and/or repositioning excess skin and fat, and tightening the lower eyelid muscle.
The transconjunctival approach is effective in improving lower eyelid bags and puffiness. During this procedure, your surgeon places the incision inside the eyelid. Your surgeon can remove excess fat through a transconjunctival incision, but not excess skin.
Sometimes fat may be redistributed in the lower lids to eliminate puffiness or bulges. Your surgeon may also make other adjustments to correct specific problems such as muscle laxity.
Your surgeon will then remove tissue through these incisions using surgical instruments, including scalpels, surgical scissors, radiofrequency cutting devices, and, sometimes, cutting lasers.
Less tissue is removed in patients with dry eyes to avoid exposing more of the eye to the air, which can cause symptoms to worsen.
Your surgeon will then apply sutures to smooth and reconfigure areas around the eyebrows and eyelids. Sutures are invisible to the eye and are commonly self-dissolving. In most cases, there is virtually no detectable scar.
The procedure normally takes between 120 - 180 minutes.
Am I a candidate for surgery?
You are a candidate for Eyelid Surgery if:
If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
Advantages of Surgery:
Disadvantages of Eyelid Surgery
Preparation for Surgery
Prior To Your Arrival
Before traveling to Cyprus, as part of your surgery preparation you will complete a detailed specific questionnaire and will submit a recent Chest X-Ray and photographic images of the problem areas which you wish to have treated.
Initial Consultation: Once the images have been received by us, we will schedule a consultation with your chosen surgeon, via Skype or telephone. This will allow you to ask any questions regarding the procedure and will also allow your chosen surgeon to assess your condition and determine your eligibility for your chosen procedure.
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your chosen surgeon will evaluate you as a candidate for surgery and clarify what Eyelid surgery can do for you. Understanding your goals and medical condition, both alternative and additional treatment options may be considered. You should be prepared to discuss your complete medical history. This will include information about:
Your treatment plan
Based on your goals, physical characteristics, and the surgeon’s training and experience, your surgeon will share recommendations and information with you, at this point including:
In advance of your procedure, your surgeon will ask you to:
Ten days prior to your arrival in Cyprus, you will receive all the necessary pre operative instructions, to prepare yourself both physically and mentally for your chosen cosmetic procedure.
Before your departure to come to Cyprus your records will be reviewed thoroughly by our surgeon. This includes Chest X-ray and a complete medical and surgical history.
Getting your house ready before your surgery
It is also important to get your house ready for after you come home from the hospital. At first it will be harder for you to move around, so arrange your furniture and household items ahead of time to make it easier for you during your rehabilitation.
Remove all your throw rugs or anything on the floor that may cause you to trip.
Move phone and electrical cords close to the walls.
Move necessary personal items you need to reach to shelves and tables that are above your waist level.
Preparation for the hospital
Here are a few things to keep in mind as you pack and prepare for the hospital and recuperation:
Getting dressed in the morning helps you feel better, so be sure to bring some comfortable clothing to the hospital:
Upon Arrival
After traveling to Cyprus, a new set of blood tests, E.C.G and chest X-ray will be taken as well as an in person physical examination.
The surgeon and anesthetist will meet with you and go through your medical and surgical plan.
During this consultation, your surgeon will discuss your surgical procedure and answer any further questions. Your plastic surgeon will proceed to examine measure and photograph your face for your medical record.
Day before surgery
Your doctor or nurse will give you more instructions based on the type of prep.
You should not eat or drink anything after midnight the evening before your surgery.
Morning of surgery
Bring all your medicines, if any in their original containers with you to the hospital.
You will meet with the anesthesiologist. This doctor will talk to you about general anesthesia. This is a controlled sleep while the surgery is being done so you will not feel any pain or remember the surgery. You will have an IV or intravenous line put in to give you fluid and medicine during your surgery.
Your plastic surgeon shall consult with you once again and shall make any markings he needs on your brow/ face, indicating the incision marks for the proposed procedure.
Recovery after surgery
When you wake up after your surgery, you will be in the recovery room, where you will continue to be closely monitored. You will stay there until you are awake and your pain is under control. Most patients return to their room after a couple of hours.
After blepharoplasty, a lubricating ointment will be applied to your eyes to protect them and prevent dryness. The ointment may cause temporary blurred vision.
Hospital discharge and home instructions
Your diet is slowly increased from ice chips to liquids to solid foods as your intestines start functioning.
Before leaving the hospital, our surgeon and staff will help you adjust to recovery in every way possible. You will receive specific instructions and precautions from your surgeon and nursing staff and they will show you safe techniques of simple activities like getting in and out of bed, bathing, going to the bathroom, managing steps at home and getting in and out of a car.
You will be able to leave the hospital when you are:
For the first couple of days following surgery, expect to treat the incisions with ointment to keep them lubricated and place cold compresses on the eyes to reduce swelling. You will be advised to use eye drops to keep the eyes from drying.
Most people are able to go home the day after their surgery; however recovery time after the procedure and the length of your hospital stay depend on your overall health and the type of procedure performed.
Life After Surgery
These guidelines give you an overview of what you may expect as part of your care after you leave the hospital. Be sure to follow your doctor’s discharge instructions if they are different from what is listed here. This will include information about wearing compression garments, taking an antibiotic if prescribed and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
You may experience excessive tearing, light sensitivity, and double vision just after the surgery. 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. Significant bruising typically occurs, but will resolve within two weeks. Your surgeon will probably instruct you to apply ice packs or cold compresses to your eyes to help reduce swelling.
Sleep with your head raised higher than your chest. Use regular pillows, wedge pillows, or sleep on a recliner and help minimize swelling and bruising by keeping your head elevated as much as possible during the first few days of recovery.
You may notice that your eyes tire easily for the first several weeks of the recovery period. Take frequent naps and void activities that may dry the eyes, including reading, watching television, wearing contacts, and using a computer.
For the first two weeks after your surgery, wear dark sunglasses to protect the eyes from irritation caused by sun and wind.
Your plastic surgeon will remove the stitches between two and seven days after your eyelid surgery.
You may wash your hair gently twenty-four hours after your surgery. Do not use the usual heat-type hair dryer; use the cap type or use the cool setting on the blow dryer. You may shower or bathe the day after surgery, but do not let the spray directly strike your face. It is permissible to get your suture lines wet, however.
You may be able to return to work within 2 weeks and to full activity within a few weeks, but you must avoid heavy lifting or straining during this time.
Your Activity
It is fairly common to feel weak and tired immediately after discharge from the hospital. The body needs time to recover from the stress of surgery.
Walking is permitted and encouraged beginning the same day of surgery. At home, start short, daily walks and gradually increase the distance you walk.
Going up and down stairs is permitted. Initially, have someone assist you.
You may lift light objects (less than 10lbs.) after your discharge. This may be increased gradually after 2 weeks. If lifting an object causes discomfort, you should discontinue the activity. This restriction helps prevent hernias at the sites of your incisions.
Driving is not permitted for 2 weeks after surgery or your first follow-up visit with your surgeon. If you are taking prescription pain medications or narcotics, DO NOT DRIVE.
Sexual intercourse may be resumed as your comfort level permits.
People with sedentary jobs have returned to work as early as 2 weeks postoperatively. A physically demanding job may require 4 weeks before returning to work. This may be determined by you and your employer. Some people have residual fatigue several weeks after surgery.
Do not go swimming, diving, water skiing, or participate in strenuous athletic activity for at least one month after surgery.
Your bowel habits
You may have different bowel habits after your surgery. Loose stools are common for the first week or two after surgery. If you have watery diarrhea, call your surgeon. This may be a sign of a bowel infection. Severe constipation should be avoided. See the section below on medicines for constipation.
Your diet
There are generally no dietary restrictions following cosmetic surgery. Avoid foods that cause diarrhea or digestive discomfort. You will eventually be able to resume your regular diet. A dietary supplement or drink can be used.
Medications
Your medicines: Take the medicines you were taking before surgery, unless your surgeon has made a change.
Your surgeon will order a prescription pain medicine for you after surgery. As your pain lessens, over the counter pain medicines such as acetaminophen or ibuprofen can be used. They can also be used instead of your prescription for mild pain.
Prescription pain medicines can cause constipation. Your doctor may order a stool softener to prevent this. You should be back to your normal bowel routine in about 2 weeks. If the stool softener does not work, take Milk of Magnesia. If you still are not getting relief, call your surgeon.
Call your surgeon right away if you have:
Long-term
Removal of hooding and upper eyelid skin is a procedure that is performed only once and as aging continues; your brow can drop or descend, causing excess skin to reappear on the upper eyelid. In this case the solution is a brow lift, not a second upper blepharoplasty.
Lower blepharoplasty is usually performed to remove eye bags and puffiness around the eyes, and it too should only need to be performed once.
How Long Will the Results Last?
You can expect the earliest result from surgery to be evident after 2 months. Your eyelid surgery results should be long-term and you should be enjoying a long- lasting youthful appearance.
Follow-Up
Follow-up after surgery is extremely important and our surgeons at Salus are committed to providing all the post surgical care you need. For safety, as well as the most beautiful and healthy outcome, whenever you notice any unexpected changes do not hesitate to contact your surgeon. In order to identify and treat any complications as they may arise, close, lifetime follow-up is essential.