Blepharoplasty – How is it done?
Blepharoplasty pronounced as BLEF-uh-roe-plas-tee is a type of surgery that involves removing excess skin, muscle or fat and also repairs droopy eyelids. As a person ages, the eyelids stretch, and the muscles becomes weak in supporting them. As a result, excess fat may accumulate above and below the eyelids, causing sagging eyebrows, droopy upper lids and bags under eyes.
Besides making a person look older, severely sagging skin around the eyes can decrease the side vision or peripheral vision, especially the upper and outer parts of the area of vision. Blepharoplasty can lessen or eliminate the vision problems and make the eyes seem younger and more alert.
To help in deciding whether blepharoplasty is right or not, one must find out what to realistically expect and also explore the advantages and potential risks of blepharoplasty.
Blepharoplasty -Why is it done?
Eyelid surgery is sought by people seeking for anti-aging treatments. Sagging of the skin around the eyes is a natural part of aging, but this surgery may be considered if the effects are bothering. Candidates may also seek out blepharoplasty surgery if they have significant bags under their eyes or if their eyebrows are starting to sag.
For some people, a blepharoplasty goes far away from cosmetic concerns. Some people may complain that their vision is blocked by the skin hanging when looking upwards is blocked by the hanging skin.
To decrease the risk of complications, the candidate must not smoke or have any chronic illnesses that can affect the recovery.
If droopy or sagging eyelids keep the eyes from opening fully or pull down your lower eyelids then blepharoplasty can be considered. Removing surplus tissue from the upper eyelids can improve vision. Upper and lower lid blepharoplasty can make the eyes appear younger and more vigilant.
Blepharoplasty may be an option if someone is having:
- Baggy or droopy upper eyelids
- Excess skin of the upper eyelids which interferes with the peripheral vision
- Excess skin on the lower eyelids
- Bags under the eyes
Blepharoplasty can be undergone at the same time as another surgery, such as a brow lift, face-lift or skin resurfacing.
Insurance coverage on Blepharoplasty may depend on whether the surgery is repairing a condition that impairs vision. The cost will not be covered probably by insurance if you the surgery are conducted only to improve appearance. Lower lid blepharoplasty is mostly always done just for cosmetic reasons.
Blepharoplasty – Risks
Possible risks of eyelid surgery may include:
- Infection and bleeding
- Dry, irritated eyes
- Difficulty in closing eyes or any other eyelid problems
- Noticeable scarring
- Injury to muscles of eye
- Skin discoloration
- follow-up surgery if required
- Temporarily blurred vision or, rarely, loss of eyesight
- General Risks associated with surgery, including reaction to anesthesia and blood clots
The doctor should be consulted for the surgical risks. To understand what’s involved in blepharoplasty and comparing the benefits and risks can help in deciding if this procedure is a good option.
Blepharoplasty – How to prepare
Before arranging for blepharoplasty, an appointment would have to made with a plastic surgeon and an eye specialist (ophthalmologist) or a plastic surgeon who specializes in eye surgeries (oculoplastic surgeon) to discuss:
- Medical history.The surgeon will ask questions about any previous surgeries and past or current conditions, such as dry eyes, glaucoma, allergies, circulatory problems, thyroid problems and diabetes. The doctor will also inquire about the use of medications, vitamins, herbal supplements, alcohol, tobacco and drugs.
- Expectations of patient.A discussion of hopes and motivation for the surgery will help in setting the expectation for a satisfactory outcome. The surgeon will also discuss whether the surgery will go in favor or not
Before the eyelid surgery, following procedures need to be done:
- A physical examination will be conducted by the surgeon which will include, testing the tear production and measuring parts of the eyelids.
- A vision examination will be conducted by the doctor to examine the eyes and test the vision, including peripheral vision. This examination is needed to for an insurance claim.
- The eyes and eyelid will be photographed from different angles. These photos will help with planning the surgery, assessing its prompt and long-term effects and also supporting an insurance claim.
Following will be asked by the doctor:
- Stop taking warfarin (Coumadin, Jantoven), aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others), naproxen (Naprosyn), and any other medication or herbal supplements which increases bleeding. The doctor should be consulted as to how long before surgery the medicines need to stop. Medications approved by your surgeon should only be consumed.
- Quit smoking several weeks prior to the surgery. Smoking can decrease the ability to heal after surgery.
- In case of an outpatient surgery the patient should arrange for a drive. Don’t be alone and should have someone stay over for the first night after returning home from surgery.
Blepharoplasty – What can be expected?
Before the Surgery
Blepharoplasty surgery is mostly conducted in an outpatient setting. Numbing medication is injected into your eyelids by the surgeon and administers intravenous medication to help relax.
During the Surgery
If the surgery is conducted on the upper and lower eyelids, the surgeon usually works on upper lids first. Incision is done along the fold of the eyelid, removes some excess skin, muscle and possibly fat, and then closes the cut.
On the lower lid, the surgeon makes an incision is made just below the lashes in the eye’s natural crease or inside the lower lid. Excess fat, muscle and sagging skin is removed, and the cut is closed.
If the upper eyelid is drooping close to the pupil, the surgeon may do blepharoplasty with a procedure known as ptosis (TOE-sis) that provides additional support to the eyebrow muscle.
After the procedure
After surgery the patient is shifted to the recovery room, where they are monitored for complications. Later the patient may leave to recover at home.
After surgery the patient may temporarily experience:
- Blurred vision from the lubricating ointment applied to the eyes
- Eyes watering
- Sensitivity to light
- Dual vision
- Puffy, numb eyelids
- Swelling and bruising similar to having black eyes
- Pain or discomfort
Following steps need to be taken after the surgery:
- After every hour for about 10 minutes use ice packs on the eyes the night after surgery. The next following day, use ice packs on eyes four to five times throughout the day.
- Clean gently the eyelids and use prescribed the eyedrops or ointments.
- Straining, heavy lifting and swimming to be avoided for a week.
- Strenuous activities, such as aerobics and jogging to be avoided for a week.
- Avoid smoking.
- Keep away from rubbing your eyes.
- If contact lenses are used, don’t put them in for about two weeks after surgery.
- Wear darkly tinted sunglasses to protect the skin of the eyelids from sun and wind.
- For a few days sleep with your head rose higher than your chest for a few days.
- Apply cold compress to reduce swelling.
- After a few days, go to the doctor and remove the stitches, if needed.
- For about a week, avoid medications such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others), naproxen (Naprosyn), and other medications or herbal supplements that may increase bleeding. If needed, use acetaminophen (Tylenol, others) to control pain.
Medical attention needs to be immediately sought if experiencing any of the following:
- Breathing shortness
- Pain in the chest
- Heart rate unusual
- Severe new eye pain
- Vision problems
Blepharoplasty – Outcome
Blepharoplasty is primarily used to serve the common signs of aging that develops around the eyes. If the candidate is concerned about the excessive amounts of skin or sagginess around the eyes, a dermatologist should be consulted about the options. In some cases, the surgery may not be needed.
Many people are satisfied with the results and outcome of blepharoplasty, such as a more rested and youthful aspect and more self-confidence. For some people, outcomes of the surgery may last a lifetime. For others, droopy eyelids may recur.
In about 2 weeks, bruising and swelling generally subside, which may be when feeling comfortable going out in public again. Scars from the surgical incisions may take months to fade. The delicate eyelid skin should be protected from too much sun exposure.
Blepharoplasty – Insurance Cover
Cosmetic surgeries are typically not covered by health insurance companies.
But If the eyelid surgery is being conducted for a medical reason (for instance, because the eyelids are drooping so much that it affecting the vision), and if it is confirmed from a vision test, then the insurance company may cover it. This should check thoroughly before the surgery to know exactly what to pay.
A blepharoplasty is sometimes used in combination with other related procedure to improve the results. Some people with saggy eyebrows being significant might consider for a brow lift. Other people may even undergo a complete facelift to address other cosmetic issues at the same time. The surgeon should be consulted if other procedures would help increase the effects of eyelid surgery.
Preferably, the eyelid surgery is a one-time procedure. However, follow-up surgeries may be needed if the results are not satisfactory, or if the eyelids don’t heal properly the first time around.