Several factors such as aging, sun damage, smoking, stretching and obesity can cause the eyelids to droop and sag as the supporting tissues weaken. This area is often one of the first to deteriorate, as the skin of the eyelid is thinner than the rest of the face. Eyelids that droop or bulge can reduce peripheral vision, making certain normal daily activities, such as driving, more difficult.
Blepharoplasty
Blepharoplasty or eyelid surgery is now the most popular facial plastic surgery procedure after rhinoplasty (nose surgery). The popularity of this procedure reflects the importance of the eyes in perfecting overall appearance. In fact, two-thirds of adults consider the eyes to be the defining feature of the face. If you are unhappy with the appearance of your eyes, you may want to consider blepharoplasty to improve your look and boost your confidence through a safe procedure with minimal downtime.
Functional Blepharoplasty
If the eyelids begin sagging into the field of vision, a functional blepharoplasty, or eyelid surgery, may become necessary. This procedure can be covered by medical insurance if it is visually significant. Dr. Polonski can determine this by checking the peripheral visual field with an instrument called the Humphrey Visual Field (HVF) Analyzer. An upper blepharoplasty will tighten the muscles and tissue as well as remove excess fat and skin from the upper eyelids. This can eliminate the drooping of the skin into the visual field, improving peripheral vision tremendously.
Cosmetic Blepharoplasty
Cosmetic blepharoplasty can be performed on the upper or lower eyelid or both. If no skin needs to be removed, a transconjunctival blepharoplasty can be performed, in which the incision is made inside the lower eyelid and there are no visible scars. This procedure has no effect on vision, but offers a younger, more refreshed look that reflects across the whole face.
Candidates
The best candidates for blepharoplasty are individuals who are in good overall health and who do not smoke or have any serious eye conditions. If you have loose, sagging skin or puffy bags around your eyes, this procedure can help reduce these unwanted effects and leave the eyes looking young and fresh.
It is important for patients to have realistic expectations before undergoing surgery in order to be satisfied with their results. While this procedure can enhance your appearance and may improve self-confidence as a result, it cannot alter your entire appearance or change the structure of your face.
Procedure
The blepharoplasty procedure is performed under local anesthesia with sedation. General anesthesia may be used for anxious or nervous patients. Patients may choose to have this procedure on their upper or lower eyelids, or both. Depending on these choices, the procedure can take anywhere from 45 minutes to 2 hours.
If the upper eyelid is being treated, an incision is made along the natural crease of the eyelid. Once the incision is made, Dr. Polonski may reposition fat deposits, tighten muscles and tissue or remove excess skin in order to leave the eye looking younger and refreshed. For the lower eyelid, an incision is made just below the lash line in order for excess skin to be removed.
After the procedure is performed, the incisions are closed with sutures and usually wrapped in gauze to allow the area to heal.
Recovery
After the blepharoplasty procedure, Dr. Polonski may recommend applying lubricating ointment and cold compresses to help aid the healing process and minimize side effects such as swelling, bruising, irritation or dry eyes. The eyes may be wrapped in gauze after the procedure as well.
Patients can usually return to work within two days, but should avoid exercise and strenuous activities for at least two weeks. Swelling and other side effects usually subside within two weeks after surgery. Dr. Polonski will give you specific instructions on how to care for your eyes after surgery.
Results
Results of a blepharoplasty procedure are visible as swelling and bruising subside and will continue to improve for up to a year after surgery. This procedure is designed to produce long-lasting results. While surgery cannot prevent your eyes from aging, most patients are satisfied with their results and do not seek repeat procedures.
The scars from the blepharoplasty procedure are usually well concealed and will fade with time until they are virtually unnoticeable. The incision is hidden in the crease of the eyelid in an upper blepharoplasty, and just below the lashes in a lower blepharoplasty.