Eyelid Surgery (Blepharoplasty)

MiddleagedOften, the eyes are the first facial feature noticed when meeting a new person. The eyes provide us with a powerful means of expression, allowing us to communicate a wealth of emotion and feeling. The ageing eyelids can convey a tired, sad, or stressed appearance. Eyelid surgery, otherwise known as blepharoplasty, can rejuvenate the areas around the eyes, reverse common signs of the natural aging process, and provide a rested, more youthful look. In addition to improving aesthetics, blepharoplasties can also address certain functional problems of the eyelids. Dr. Neil Zemmel have the experience and skills to revitalize your appearance while customizing each eyelid surgery procedure in order to achieve your individual aesthetic goals. In addition to the cosmetic benefits, our patients at Richmond Aesthetic Surgery often report feeling an increased sense of self-esteem after their blepharoplasty procedure. Patients often combine eyelid surgery with one of our other facial procedures for a more complete rejuvenation.

Eyelid Aging

Changes in eyelid appearance are one of the earliest signs of facial aging that typically begin in the late thirties and then progress over time. Some of these changes include:

  • Fine wrinkling of upper and lower eyelid skin
  • Bulging of eyelid fat pads
  • Development of deepening grooves of the lower lids adjacent to the nose (tear troughs)
  • Development of loosening of eyelid skin.
  • Loss of eyelid tone or “snap”, resulting in drooping of the lower eyelid and increased show of the soft tissues that are normally hidden by the eyelid. The net result of these changes is a sad or tired appearance of the eyelids. The on-going bulging of lower eyelid fat and skin can contribute to chronic swelling, that often worsens as the day progresses.

Blepharoplasty Consultation

Ideal candidates for eyelid surgery include healthy men and women who have heavy, drooping eyelids, excessive wrinkling, or bags and swollen areas around the eyes. During your initial consultation, you will have the opportunity to convey your eyelid concerns and the outcomes you hope to achieve. You will undergo a comprehensive review of your medical history, including any underlying ophthalmologic conditions, such as dry eyes or glaucoma. Patients who suffer from these conditions may not be eligible for eyelid surgery or may require the need for additional precautions to minimize issues postoperatively. After a thorough examination of your eyelids, their supporting structures, and brows, Dr. Zemmel will provide a customized surgical plan to address your eyelid concerns. A successful blepharoplasty treatment relies on each patient maintaining realistic surgical expectations as well as clear doctor-patient communication with our plastic surgeon. Smoking can compromise blepharoplasty results, so Dr. Zemmel recommends that all patients are non-smokers or cease smoking well before surgery.

If Dr. Zemmel determines you to be a good candidate for blepharoplasty after the initial consultation, he will provide detailed pre-operative instructions in preparation for your surgery.

In some cases, the weight of excess upper eyelid skin and fat causes changes in an individual’s visual fields. In these cases, upper eyelid blepharoplasties may be covered by certain insurance plans. To determine whether you may qualify for insurance coverage, you may be referred to an eye care professional who performs the specific tests necessary to determine the extent to which your eyelids affect your vision.

About Blepharoplasty Surgery

Blepharoplasties are surgical procedures that correct age-related aesthetic and functional abnormalities of the eyelids. The goals of the procedures are a more youthful, yet natural appearance to the eyelids. Because the of role that the eyes play in our personal interactions, surgical rejuvenation of the eyelids can convey an overall more youthful appearance to the entire face. However, blepharoplasties are frequently combined with other facial rejuvenation procedures to provide a more holistic treatment of facial aging.

Upper Eyelid Surgery

upperblephUpper eyelid blepharoplasties remove excess loose skin of the upper eyelid. As a result,the overall eyelid tone tightens and wrinkles and fine lines diminish in appearance. During this procedure, an incision is designed that is hidden in one of the eyelid creases. The amount of skin to be excised is measured so that enough excess tissue is removed to achieve a more youthful appearance. Once extra skin and some of the muscle immediately deep to the eyelid skin is removed, some of the pockets of bulging eyelid fat can be thinned or removed. The fat is removed progressively to avoid hollowing out the eyelid area, resulting in an overdone look. The incision is then closed with sutures that are typically removed approximately one week after surgery.

Lower Eyelid Surgery

lowerblephLower eyelid blepharoplasties are intricate procedures that correct a number of age-related deformities of the lower lids. In most cases, an incision is made immediately below the margin of the eyelashes. A flap of skin and muscle is elevated to expose the structure that holds the fat pockets of the lower orbit in place. Frequently, this structure is released to expose the fat pockets. These fat pockets can be used to fill in areas of the cheek that have lost youthful volume, in particular the tear trough areas. Excess fat that is not used is then removed. The skin and muscle flap can be used as a sling that is suspended at the outer corner of the eyelid to correct laxity in the structural support of the eyelid. Occasionally, tightening of the tendon that supports the eyelid is necessary to correct structual laxity. The sling of skin and muscle not only provides improvement of lower eyelid appearance and tone, but conveys a mini cheek lift for an overall more youthful appearance. Any excess skin and muscle is then removed, and the incisions are closed with sutures that fall out by themselves over time.

Your Eyelid Surgery Procedure

All eyelid surgeries are performed at either Bon Secours St. Francis Hospital’s Ambulatory Surgical Center or at Henrico Doctor’s Hospital Forest Campus by Richmond Aesthetic Surgery’s board-certified plastic surgeon. Blepharoplasty is considered an outpatient procedure, and patients are typically put under deep sedation or general anesthesia. It is not uncommon for blepharoplasties to be performed with other facial rejuvenation procedures. The surgery can take approximately 2 ½ hours to perform upper and lower lid blepharoplasties depending on the procedural goals you discuss during your consultation.

Your Eyelid Surgery Recovery

Patients should expect some moderate swelling after eyelid surgery, and our plastic surgeon often recommends eye drops to lubricate the eye during this time. To expedite the healing process, you should keep your head elevated as often as possible. A cool compress can also be used to further reduce any swelling. Any post-operative pain can be easily managed with oral medication. Within 2-3 days, most blepharoplasty patients return to their normal daily activities, though some patients prefer to wait about a week before returning to work while their bodies continue to heal. Sutures are typically removed 5-7 days after surgery. After 6-12 weeks, depending on the speed of your body’s natural healing process, you can begin to fully enjoy your new youthful and revitalized appearance. In most cases, after approximately 3 months the incisions are largely imperceptable.

To learn more about blepharoplasty, or to schedule a consultation, please contact us today.

Turn back the hands of time and renew your youthful appearance.

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