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If you are considering an eyelid lift in Southern California including Beverly Hills, Santa Monica and Long Beach from a Board Certified Female Plastic Surgeon continue reading ...

One of the first signs of early aging is bagginess or puffiness around the eyes, often associated with wrinkling of the eyelid skin. Blepharoplasty is designed to correct this condition and to restore the youthful, alert appearance of your eyes. This condition may be present in the upper eyelids, lower eyelids or both. It also may be associated with looseness of the skin of the eyebrows or temple region.

Normally, everyone has a small amount of fat around the eyeball. If the quantity of fat increases, or the local tissues stretch and weaken, the fat begins to bulge, producing "bags". Occasionally this bulging is seen in young patients and is an inherited family trait and not a result of aging. The laxity and wrinkling of eyelid skin may be seen alone or in conjunction with excess fat. These changes have a striking effect on one's appearance. An attractive face with these early signs of aging can affect a patient's self image, attitude and sense of well.


What is a blepharoplasty? Blepharoplasty is an operation designed to remove sagging skin and muscle from the eyelids, and to remove "bags" by trimming away excess fat bulges. In some cases the upper or lower lids can be treated alone. If indicated, all four lids may be treated at the same time. At times, a forehead lift and/or a face lift is done along with the eyelid surgery. Excess drooping of the eyebrows and corners of the upper eyelids may require a forehead lift to correct the area.

Where are the incisions? The incision in the upper lid usually lies in the lid crease. The incision in the lower lid lies just below the eyelashes and parallel to the lid edge. Both incisions may extend for a short distance beyond the eyelids, toward the temple. In certain cases, lower lid incisions may be made inside the lid.(transconjuctival incision). Excellent healing is characteristic of the eyelid skin, and once the wounds are mature, they usually become quite inconspicuous. The outer part of the incision - the part extending toward the temple - is the slowest to mature, and is sometimes noticeably pink for some months after the operation. The stitches are removed in 3-7 days after surgery.

What kind of anesthesia is used? A local anesthetic is used. The patient also receives sedation so that the operation will be a relaxed and comfortable experience. A general anesthetic may be indicated in some cases.

How fast is recovery? Swelling, discoloration, and bruising is to be expected. It is not unusual to have some difficulty seeing during the first day or two after surgery because of the swelling. Patients vary a great deal in their recovery rate, but usually can resume normal light activity or work 3-4 days after surgery using dark glasses and make-up to camouflage the swelling and discoloration. The patient will usually be presentable without dark glasses in 10 days. A small amount of residual swelling persists for many weeks but gradually disappears.

Will the bags and wrinkles come back? Sagging skin or wrinkles may recur as the years go by, but it is unusual for "bags" to recur. The operation can be repeated as necessary. "Crows feet" (skin wrinkling at the corner of the eye near the temple) is not greatly affected by this procedure; they may be helped with an ancillary procedure such as a dermabrasion or chemical peel.

Where is the operation done? The operation is usually done in a surgicenter as an outpatient. A friend or relative should be available to take you home and stay with you for at least the first 24 hours after surgery. Some patients may be done in a hospital operating room if other medical conditions are present.

Will insurance pay for eyelid surgery? Patients who have functional or visual problems caused by excessive upper eyelid skin may have coverage by their insurance policy. This usually requires documentation by an opthalmologist regarding the medical necessity of surgery.

What are the risks of surgery?

1. GENERAL RISKS of surgery can include infection, pain, delayed wound healing, blood clots, hematoma (a collection of blood inside the body), bleeding, reactions to drugs or anesthetics.

2 . BLEEDING: When blood collects beneath the skin it causes excessive discoloration. Sometimes lumps that last many months may occur. If blood collection is discovered, it is usually removed by taking out a few stitches and squeezing the clot out, or inserting a needle and aspirating it. If bleeding continues, it is sometimes necessary to return to the operating room to stitch the bleeding vessels. If excessive bleeding occurs into the deep tissues around the optic nerve to the eye, emergent surgery is required to treat this problem which can result , very rarely in blindness. This is an extremely rare complication. This risk is increased in people who take aspirin or who bruise easily. Let your doctor know if this is the case. Do not use aspirin or aspirin-containing products for two weeks before and two weeks after surgery. (See list of medications that may increase bleeding.)

3. INFECTION: Infection in facial surgery is uncommon but can occur. This is a rare complication, but when it occurs, antibiotic treatment and additional hospitalization may be needed. Some scarring may result. There is an increased risk toward skin loss.

4. DROOPING OF THE UPPER EYELID (PTOSIS) : In patients who have lax skin of the upper eyelid (particularly older patients), it is not uncommon for the tendon which opens the upper4 eyelid to be thin and worn and be on the verge of splitting, something which can happen spontaneously. The movements of the surgical instruments can cause the weak area to split. The result is a drooping eyelid if the split is not repaired. Such areas are identified and repaired in the course of the blepharoplasty. Because of the thinness and stretchiness of the tissue, exact repair can be difficult and under-correction or over-correction can occur. When this happens, we adjust the tendon stitches in another brief procedure under local anesthesia.

5. DROOPING OF THE LOWER EYELID (ECTROPION): Occasionally, patients have loose supporting tissues and tend to droop for a while in the post-operative period. With taping and massage this usually goes back to normal. Rarely, an extra operation is needed to tighten up the supporting tissues, or to add skin to the lid. If very lax supporting tissues are noted on the pre-operative examination, a lid tightening procedure can be done at the same time as the blepharoplasty. In most cases, this drooping is temporary.

6. DOUBLE VISION: It is not uncommon to have some double vision for a few hours after surgery due to the local anesthesia, or during the next few days due to swelling. There have been reports in medical journals of remote cases of persistent double vision, nerve or muscle injury or scarring.

7. ASYMMETRY: Every effort is made to make both sides match, but the eyelids are not normally symmetrical to start with, so complete symmetry is never achieved. Sometimes more asymmetry than normal is noted early in the post-operative period. This almost always improves greatly as the wounds mature.

8. DRY EYE SYNDROME: Even though the tear glands are not directly involved in this operation, tear secretion will sometimes diminish after the surgery. This can cause dryness, itchiness and soreness of the eyes. Lacri-Lube ointment is used at night and artificial tears are used during the day to lubricate the eye during this period. This is usually a temporary state that gradually improves, although it has been known to be permanent, necessitating the use of artificial tears indefinitely.

9. PAIN: Generally facial operations have surprising little pain, however, pain is very subjective. On occasion a patient will experience tightness, swelling and discomfort for a prolonged period of time. Scars may remain sensitive for months.

10. SCARS: Every operation creates some type of scar. Incisions are planned to hide and minimize visible scarring. Scars, however, are not predictable and occasional patients will develop scars which are widened, thickened, raised, more red or generally more visible than we would like (hypertrophic or keloid). Normally, scars go through a maturation process which takes months. This includes an expected period of thickness, redness and firmness during the first 4-6 month, though it takes a year for a scar to mature.

11. NUMBNESS: Parts of the face, forehead, and eyes may feel numb for weeks or months after surgery; this is normal and expected. On occasion, loss of sensation may be prolonged or permanent.

12. DEPRESSION: Some patients may experience an emotional let-down after cosmetic surgery. This may be related to the normal chemical changes after extensive surgery, or overly high expectations. It is usually self limited and does not require treatment.

13. ALTERNATIVES: Other procedures which may improve an aging face but are less extensive include chemical peels, collagen or fat injections and liposuction.

14. PHOTOGRAPHY: Photographing, filming or videotaping of the treatment or procedure for educational or diagnostic use is a standard and required part of patient care.

15. NO GUARANTEE: The practice of medicine and surgery is not an exact science. Although good results are expected, there cannot be any guarantee, nor warranty, expressed or implied, by anyone as to the results that may be obtained.

16. COMPLICATIONS AND ADDITIONAL SURGERY: Any of these problems or disorders noted above may require additional surgery or hospitalization. If this occurs, there will be additional costs for surgical fees, supplies, anesthesia, etc. depending upon the required operation.

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Breast - augmentation  |  lift/reduction  |  reconstruction
Face - blepharoplasty  |  facelift  |  rhinoplasty  |  other facial procedures
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Dr Mary Powers
2888 Long Beach Blvd
Long Beach, CA 90806