Cosmetic Eyelid Surgery

Mississippi Gulf Coast Board Certified Plastic Surgeon

The eyes are our most intriguing and revealing facial feature, they draw attention and convey expression. Through them, we not only see others but others see us as well. Our interest and how we feel physically or emotionally is reflected in our eyes. Unfortunately hereditary factors and the signs of aging can greatly impact the appearance of our eyes, so that what they reflect is not really how we feel. If you are bothered by upper eyelids with excess, drooping skin that makes you appear sad or angry or by eyes that look tired due to puffiness or bags, cosmetic eyelid surgery may be right for you. In general, eyelid surgery corrects the excess skin, tissue and fat that contribute to puffiness and bags in both the upper and lower eyelids, revealing a more youthful and energetic appearance.

Cosmetic eyelid surgery, technically called blepharoplasty, is a surgical procedure to improve the appearance of the upper eyelids, lower eyelids or both. Specifically, eyelid surgery can treat:

  • Loose or sagging skin that creates folds or hides the natural contour of the upper eyelid
  • Excess skin that hangs down from the upper eyelid, sometimes impairing vision
  • Excess fatty deposits that appear as puffiness in the upper eyelids
  • Bags under the eyes
  • Droopiness of the lower eyelids, showing white below the iris
  • Excess skin and fine wrinkles of the lower eyelid

These conditions typically appear as part of the natural aging process or due to heredity. When they are the result of heredity, individuals as young as their 20’s and 30’s may achieve a marked improvement in the appearance of their eyes through eyelid surgery. Eyelid surgery removes excess skin, eliminates bags, and restores firmness to the area surrounding the eye, making you look more rested and alert. Most commonly, eyelid surgery is performed on adult men and women who have healthy facial tissue and muscles and have realistic goals for improvement of the upper and/or lower eyelids and surrounding area. Good candidates include:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for improvement through eyelid surgery

In addition, the following medical conditions are essential to disclose if you are considering eyelid surgery:

  • Eye disease such as glaucoma, dry eye or a detached retina
  • Thyroid disorders such as Graves’ disease and under or overactive thyroid
  • Cardiovascular disease, high blood pressure or other circulatory disorders or diabetes

The Consultation

A consultation with your plastic surgeon is the first step to learn how eyelid surgery can improve the appearance of your eyelids and the surrounding region. A consultation is designed to fully educate you about eyelid surgery in a non-pressured environment, and will include:

  • A discussion of your goals and an evaluation of your individual case
  • The options available for eye lid surgery
  • The likely outcomes of surgery and any risks or potential complications
  • The course of treatment recommended by your plastic surgeon

Dr. Dees will also answer your questions.

Your surgeon, your choice

Choosing to have cosmetic or reconstructive plastic surgery is an important decision; so is selecting a plastic surgeon. Consider these important guidelines:

  • BOARD CERTIFICATION – Not all physicians who perform plastic surgery or who use the title plastic surgeon are board-certified in plastic surgery.
    • The American Board of Plastic Surgery (ABPS) and The Royal College of Physicians and Surgeons of Canada certify physicians in plastic surgery of the face and entire body. To be certified by either board, a plastic surgeon must:
      • Graduate from an accredited medical school
      • Complete a minimum of five years of surgical training following medical school, including an accredited plastic surgery residency program
      • Pass comprehensive written and oral exams
  • PRIVILEGES – Your surgeon should have operating privileges at an accredited, local hospital for the same procedure you plan to have performed  even if that surgeon suggests your procedure be performed in an accredited office-based surgical facility or at an ambulatory surgery center.

The Evaluation

Overall health and personal outlook can greatly impact the outcome of cosmetic eyelid surgery. These will be carefully evaluated in consultation with your plastic surgeon. The success of your procedure, safety and overall satisfaction require that you:

  • Honestly share your expectations
  • Fully disclose health history, current medications, the use of vitamins, herbal supplements, alcohol, tobacco and drugs
  • Commit to precisely following all of your plastic surgeon’s instructions

My Safety

By making the decision to consult with your plastic surgeon and following all the instructions given, you are taking an important step in helping to assure your safety. Dr. Dees is certified by The American Board of Plastic Surgery. This certification designates surgeons who are specifically trained in plastic surgery of the face and entire body.

Like any cosmetic procedure, eyelid surgery requires an individualized approach. Dr. Dees will evaluate your patient anatomy, the condition you wish to have corrected, what is causing the condition, and your realistic goals for improvement. Eyelid surgery can offer dramatic improvement in the upper and lower eyelids and surrounding regions. This degree of correction of drooping eyelids, puffiness or bags can only be achieved surgically by repositioning muscle, redistributing fat that has settled into contours and, when necessary, by removing excess skin. Skin resurfacing techniques may be recommended to further improve the tone and surface appearance of skin surrounding the eye and, in some cases, as a substitute for excision of minimal excess lower eyelid skin. Where a low positioned brow or crows’ feet at the outer corner of the eyes contribute to the aging appearance of the eyes, a browlift may be more appropriate than or recommended in conjunction with eyelid surgery. In addition, a brow lift can also smooth a lined or furrowed forehead. A midface lift, one that corrects sagging in the cheek region and pronounced nasolabial folds (creases from the nose to the outer corner of the mouth) may be performed through the same incisions as blepharoplasty. A facelift and neck lift may also be performed at the same time as eyelid surgery.

Before beginning the process, Dr. Dees recommends that you research cosmetic eye surgery on the ASPS website to ensure that you completely understand the procedure along with the facts that the surgery delivers different results for each patient. The first step in the process of getting cosmetic eye surgery begins by simply picking up the phone to call Dr. Dees’s office to schedule your free initial cosmetic consultation. During this consultation, you and Dr. Dees will go over the surgical techniques that are best for you. A personalized plan will be agreed upon and photos will be taken. After you have the necessary information and Dr. Dees is comfortable with your knowledge of the cosmetic eye surgery plan, you will return home and spend time reviewing the information in order to decide if the surgery is right for you. If you decide to proceed, call the office to schedule your surgery. Once your surgery is scheduled, it is important to organize your life, job, school, and family. Recovery times vary from patient-to-patient; therefore, it is recommended that you be prepared in advance. Approximately two-to-three days prior to surgery you will have a preoperative office visit. After you are cleared for surgery, Dr. Dees will give you written preoperative instructions, prescriptions, and order an evaluation by the anesthesia department at the surgery center. Lab work may be required. Fees will be paid at this time. On the day of your surgery, you may take a preoperative oral sedation before arriving at the outpatient surgery center. This will require you to have someone drive you to and from the surgery center. Upon your arrival at the center, you will complete any required paperwork, verify all of your information, and give your final consent for the surgery. Before surgery can begin, you will have one final anesthesia evaluation. After you are cleared for surgery, an IV will be started and medication will be given. Once the procedure is complete, the healing process begins, which will vary from patient-to-patient. You will be in recovery for at least two hours. After you are released from the anesthesiologist and given post-operation instructions and a follow-up appointment time, your driver may take you home.

Post-Op

Once your procedure is completed, lubricating ointment and cold compresses may be applied, and in some cases your eyes may be loosely covered with gauze. Before being released, you and an accompanying family member, friend or caregiver will be given specific instructions that may include:

  • How to care for the surgical site
  • Medications to apply or take orally to aid healing and reduce the potential for infection
  • Specific concerns to look for at the surgical site or in overall health
  • When to follow-up with your plastic surgeon

Progress and healing

Initial healing may include some swelling, bruising, irritation or dry eye, and discomfort that can be controlled with medication, cold compresses and ointment. Irritation at the incision sites is also possible. These are all common conditions. Dr. Dees will instruct you to keep your head elevated at all times until initial swelling has subsided and to wear sunglasses to protect your eyes from bright light, sun, and wind. Follow all instructions carefully. This is essential to the success of your outcome. A return to light, normal activity is possible as soon as you feel ready; usually within a few days of surgery. Healing of incisions may take 5 to 10 days at which time any sutures will be removed, if necessary. You will be ready to return to work and normal activity at this time and to resume wearing contact lenses. Cosmetics can camouflage any bruising or redness that remains. Healing will continue for several weeks as swelling continues to dissipate and incision lines improve. Diligent sun protection and consistent use of darkly tinted sunglasses is essential.

Results and outlook

Your final results will appear over time, generally within several weeks. It may take up to a year for incision lines to fully refine. While eyelid surgery can be expected to correct certain conditions permanently, you will continue to age naturally. Life-long sun protection, including the use of sunscreen and sunglasses, will help to maintain your results. The benefits of your surgery should reveal a smooth, firm contour of the upper and/or lower eyelids. What matters most is that the appearance of your eyes matches the way you feel inside; youthful, vital and alert.

This material is provided by the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery. It is not intended to make any representatives or warranties about the outcome of any procedure and is not a substitute for a thorough, in-person consultation with a board-certified plastic surgeon.

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