The most visible signs of facial aging are typically first noticed around the eyes, the most focal point when we relate to one another. “Drooping eyelids” and “bags under the eyes” are common aging complaints that cause a person to look tired, sad, angry or older than they really are. This can affect a person’s self-image and attitude and also how others perceive them. For some individuals, drooping upper eyelids may partially obstruct vision. It’s not uncommon to hear people comment about having to “tilt my head back” to see traffic lights. In those instances insurance companies may help with the cost of the surgery depending on individual policies and an ophthalmology evaluation to document the visual field obstruction. Dr. Parva will be happy to assist you with a complete evaluation to determine your options. Eyelid surgery can help restore the alert, refreshed and youthful appearance of the eyes of years gone by.
What is Eyelid Surgery (Blepharoplasty)?
Eyelid surgery addresses two components that add to the aged appearance:
- Excess, loose skin of the upper and lower eyelids
- Fat that herniates “bulges” out and contributes to the puffiness of the eyelids.
The upper and lower eyelids are evaluated together, yet they must be considered separately units in deciding what procedures are best for each individual situation. Additionally, it is critical to consider the position of the brow. For women, the eye brows generally arcs above the boney ridge above the eye. Men tolerate a slightly lower position with the eye brow at the boney ridge. If there has been significant descent of the brow, simply removing eyelid skin will not be sufficient to improve the appearance. A brow lift in conjunction with eyelid surgery may provide the optimal results. If the eye brow is at a good position, then the upper eyelids alone can be reduced, or lifted. With a low brow, then a brow lift should be considered.
When considering the lower eyelids, fat is often a problem and is seen as “bulging,” or fat pads that are seen below the eye. Both skin and fat should be reduced in these situations.
Who is a Good Candidate?
- Someone with loose skin of the upper eyelid drooping over the lids
- Excess skin and tiny wrinkles in the lower eyelid
- Persistent bags and dark circles under the eyes even when well rested
- Partially obstructed vision, especially when gazing upward
- Family history of eyelid surgery to treat excess skin
- A healthy individual
- Realistic goals and expectations
“I know that true beauty is measured by the heart but thank you so much for making me feel “pretty” on the outside.”
The Eyelid (Blepharoplasty) Procedure:
Pre-operative planning will determine the surgical plan. If the brow position is low, then a brow lift is planned. The upper eyelids are marked in the pre-operative holding area, as is the lower eyelids as indicated. Dr. Parva, board certified plastic surgeon, takes great care to mark a conservative skin removal. The consequences of removing too much skin are significant if the eyes cannot close completely.
When the skin is incised and removed, any excess fat is also carefully reduced. The lower eyelids generally have more fat protrusion that must be thinned. The upper eyelids are then closed with a single running suture under the skin. For the lower eyelids, individual sutures are placed. Corneal protectors are shields placed over the cornea during surgery that protect the eye from scratches and damage. At the completion of the surgery, the corneal protectors are removed and the head is elevated and cool sponges are placed over the closed eyes.
Recovery and Healing:
- Care is taken to avoid any strenuous activity or lifting for the first 2 weeks.
- Limit eye strain, such as reading, computer work and TV for the first 1 to 2 weeks.
- Use eye ointment prescribed by Dr. Parva for 1 to 2 weeks to prevent potential dryness while sleeping.
- Bruising may take 2 or more weeks to resolve. Head elevation and massage are helpful.
- The head must be kept elevated for 1 to 2 weeks.
- Cool compresses, or frozen bags of peas, are effective in reducing swelling and pain.
Loss of the excess skin and the “bags” under the eyes is seen immediately.
Two to 3 months before long term results are seen.
Enjoy the direct eye-to-eye contact as people focus on your vibrant, beautiful eyes.