Sagging skin and puffy fat deposits on your upper or lower eyelids may give you tired, old or sad appearance
It is not unusual for the first manifestations of aging to occur around the eyes. Frequently women in their late thirties or early forties begin to notice extra skin on their upper lids that interferes with the natural lid contour. I’ve even had patients in their 20’s with baggy lower lids that are hereditary. These changes can create a tired or sad appearance, or simply make you look old. Eyelid Rejuvenation surgery (blepharoplasty) can make you look younger, brighter and more rested. As a general rule, aging changes in the upper lid are primarily related to excess skin, while in the lower lid, the primary problem is usually bulging fat.Upper eyelid blepharoplasty is much simpler than lower eyelid surgery. It is done under local anesthesia, meaning you don’t have to be put to sleep. It generally involves removal of a redundant fold of skin, a narrow strip of muscle and a small amount of fat. This gives the eye a cleaner, more youthful and more open look. Upper eyelid blepharoplasty is a quick outpatient procedure that takes about thirty minutes.
Recovery is generally rapid and uneventful. Most patients can return to work in two or three days, but it may be seven to ten days before the bruising and swelling is completely resolved. Elevating the head of the bed (or sleeping on pillows or in a recliner), and applying iced gauze (or frozen peas) to the lids for the first 48 – 72 hrs helps to minimize the swelling and bruising. Sometimes normal post-operative swelling and stiffness of the eyelid temporarily prevents complete closure of the eye and a narrow slit-like opening remains even at night when you are sleeping. I have all patients apply a bland lubricating ointment (such as Lacrilube or GenTeal gel) directly into the eye at bedtime for the first 7 – 10 days to prevent dryness and scratchiness of the eyes until the swelling resolves and the normal suppleness of the lid returns.
It is very important to be off of any blood thinning medication before eyelid rejuvenation surgery. This includes over the counter medications such as aspirin, advil, aleve, motrin, BC powders, vitamin E, fish oil, flaxseed oil, etc. Failure to do so can result in bleeding that can lead to serious eye problems. If you suffer from chronic dry eyes because of a tear film problem and use artificial tears by day and lubricating ointment at night, you may not be a candidate for upper eyelid blepharoplasty as it could exacerbate your dry eye symptoms.
In contrast to upper eyelid blepharoplasty, lower eyelid blepharoplasty is much more involved. Aging changes in the lower lid usually result from some combination of bulging fat, baggy skin, saggy muscles and laxity of the tendons that attach the lid to the bone. The surgical approach varies, depending on the specific anatomic problem. Most of the patients in my practice have all four of the issues mentioned above. Moreover, the bulging fat creates a crescent shaped shadow resulting in a dark circle under the nasal half of the lid known as a tear trough deformity. A typical lower lid blepharoplasty in these patients involves an incision just underneath the lash line with careful separation of the skin, muscle and fat layers. A small amount of fat is removed, but most of it is used to fill in and improve the tear trough deformity. The muscle is lifted and tightened, excess skin is removed and the entire lid is tightened and supported by re-attaching its tendon to the bone. The procedure is delicate, technically demanding and takes considerably longer than an upper lid blepharoplasty so I prefer to use general anesthesia for these cases.
Recovery from lower lid blepharoplasty is similar to that for the upper lid, but generally takes longer, usually 2 – 3 weeks for the swelling and bruising to resolve completely. Occasionally it takes longer than this for lower lid muscle tone to return to normal, or for persistent swelling of the inner lining of the lower lid to resolve completely. This swelling of the inside of the upper lid – known as chemosis – can hold the lid a few millimeters away from the eyeball, cause excessive watering of the eye and require prolonged use of steroid drops for resolution. Fortunately, it doesn’t happen in everyone and it always resolves. Most patients heal uneventfully, are back at work in 7 – 10 days, and can return to full activity – including strenuous exercise – in three weeks.
Dr. Mickel did an amazing job! I am so pleased with the results! I’m so happy he is in Monroe! I highly recommended him to anyone who wants eyelid work done. He did the best job EVER!
Seeing is believing. Click the link above to view a selection of Eyelid Rejuvenation Before and After Photos from patients who have allowed us to share their before and after photos on our web site. If you choose Mickel Plastic Surgery, we will select additional before and after images from our large selection of plastic surgery patient photos for you to study as you consider your options. We hope you enjoy this opportunity to see the possibilities of Eyelid Rejuvenation surgery in Monroe, LA.