Dr. McMahan, thank you for my new eyelids. I can’t believe how easy it was! My hoods and bags have miraculously disappeared. At my high school reunion I looked 20 years younger than everyone else. (OK, the Fraxel laser helped as well) My only regret is that I didn’t have it done years ago.
~ Mary, Columbus
"The eyes tell it all." Make-up, scarves and turtlenecks can only hide so much. Often, it is the eyes that expose someone's age before other parts of the face and neck do so. Fortunately eyelid surgery (blepharoplasty) can be one of the quickest and easiest cosmetic procedures to recover from for facial rejuvenation.
Many procedures in plastic surgery have become more complicated over time. Upper eyelid surgery has actually been simplified. In the past, along with removing excess upper lid skin and possibly bulging fat, a strip of redundant muscle (orbicularis oculi) was removed. Most experienced plastic surgeons now leave the muscle alone to avoid a 'hollowed out' appearance making the procedure a little shorter, less painful and easier to recover from as there is typically less bruising.
While a considerable amount of skin is removed from the upper lids with an upper blepharoplasty, minimal skin is typically removed form the lower eyelids to avoid eyelid margin malposition. An incision is made below the lash line and slightly out to the side along a natural crease and the fat pockets are exposed down to the cheekbone as it approaches the lower orbital rim. Excess fat is removed or re-positioned as needed to eliminate or reduce bulges (bags) or dark circles ('tear through deformities').
There is usually minimal pain with eyelid surgery. Although a prescription for pain pills is provided, most patients find that narcotics are unnecessary except for one or two doses to eliminate the 'stinging' that sometimes exists after the local anesthetic wears off. Head elevation and ice packs immediately after surgery also helps with the discomfort.
Isolated eyelid procedures are generally performed in our office operating room in Columbus, Ohio under just local anesthetic injections with or without oral medication for mild sedation. When combined with a facelift or other procedure, the surgery is typically done at the Upper Arlington Surgery Center under I.V. sedation or general anesthesia provided by an Anesthesiologist or Nurse Anesthetist from Midwest Physician Anesthesia.
How long it takes to recover form eyelid surgery depends on a number of factors and mostly has to do with how long it takes for the bruising to go away. Those with high blood pressure tend to have more bruising and it is important to keep your pressure under good control after surgery. The better you take it easy, keep your head elevated, use ice packs and strictly adhere to our list of medications to avoid for two weeks before surgery, the less bruising tends to be present and the shorter your recovery is.
Obviously, it is not uncommon to combine cosmetic procedures to reduce recovery time and cost. Eyelid rejuvenation is commonly done in the same setting as other facial procedures to reduce the signs of aging. A facelift, neck lift or brow lift are the most frequent surgeries to be done at the same time of a blepharoplasty; however, breast lifts, implants, rhinoplasty or ear pinning surgery can also be done at the same time.