Eyelid Surgery (Blepharoplasty)

"I look years younger with my droopy, baggy eyelids removed."

"I love having a place to put eye shadow again."

"No one asks me any more if I'm tired. They just say I look great."

Eyelid surgery (technically called "blepharoplasty") is a procedure to remove fat - usually along with excess skin and muscle - from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes - features that make you look older and more tired than you feel, and may even interfere with your vision. A brief word about fat removal. Some patients need fat removed. Many have the fat repositioned. Some do not have any fat removed. Each patient's operative plan is unique. An over resection of fat (older technique) done routinely produces a gaunt older look routinely.

Many of our patients choose a forehead lift at the same time, to lift sagging eyebrows. Others combine eyelid surgery with facial laser resurfacing to help smooth and rejuvenate the skin. Of course eyelid surgery is frequently done in conjunction with facelift surgery.

Blepharoplasty can enhance your appearance and your self-confidence. The best candidates for eyelid surgery are men and women 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.

Before you decide to have this surgery, consult with a board-certified plastic surgeon who is well trained and experienced in his specialty, plastic surgery. Discuss your goals and expectations and look at before and after photos to help you make an informed choice. You'll need to discuss whether to do all four eyelids or just the upper or lower ones, whether skin as well as fat will be removed, and whether any additional procedures are appropriate. Our computerized video imaging allows you to preview the new you before surgery.

Eyelid surgery is performed on an outpatient basis in our AAAASF accredited surgical suite. The procedure is short - from 30 to 90 minutes - and the recovery time is quick. Within a few days, you'll be able to read or watch television. Most people feel ready to go out in public (and back to work) in a week to 10 days.

On younger patients, we are often able to perform what is called "no-scar eyelid surgery," or "transconjuctival blepharoplasty." If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, we make an incision inside your lower eyelid, leaving no visible scar.

Even when we remove fat, we use a laser to seal the blood vessels, so no stitches are needed. With laser-assisted blepharoplasty, there is less bleeding, less swelling and bruising, and faster healing.

For all patients, the positive results of eyelid surgery - a more alert and youthful look - should last for years.

Am I a good candidate for eyelid surgery?

Any one or combination of the following conditions may indicate that you may be considered a good candidate for eyelid surgery:

• Excess skin obscuring the natural fold of the upper eyelids
• Loose skin hanging down from the upper eyelids, perhaps impairing vision
• A puffy appearance to the upper eyelids, making the eyes look tired
• Excess skin and fine, "crepe paper type" wrinkles of the lower eyelids
• Bags and dark circles under the eyes
• Lower eyelid droopiness

Results of Your Eyelid Surgery

Aesthetic eyelid surgery has the effect of making you look more rested, refreshed and alert. Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months usually becoming barely visible. The results of aesthetic eyelid surgery are usually long-lasting, but they may be affected by heredity and lifestyle factors.

Removal of fat from your eyelids, which is usually the cause of puffiness and bags, is permanent, and these conditions generally will not recur. The skin continues to age, however, and skin laxity along with the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows which mimics a recurrence of drooping upper eyelids. If this happens, correction may require a forehead lift or a secondary eyelid procedure.

Even though the aging process continues, patients are usually happy with their appearance for many years following eyelid surgery. Some patients find that they want to make additional improvements at a later time.

Your Personal Consultation

How will I be evaluated for aesthetic eyelid surgery?

During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved. This will help Dr. Moliver understand your expectations and determine whether they can realistically be achieved.

You should come to the consultation prepared to discuss your medical history including previous surgeries, past and present medical conditions and current medications. It is important for you to provide complete information. High blood pressure, thyroid problems, diabetes, etc. should be reviewed as these medical conditions may increase some risks associated with eyelid surgery.

We will want to know if you have allergies, especially if they affect your eyes.

It will be necessary for your surgeon to know if you were ever told by an ophthalmologist that you have a condition called "dry eye" or if you have any other problems with your eyes.

Upper Eyelids

For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it usually is inconspicuous.

Lower Eyelids

For lower eyelid surgery, often an incision is hidden just below the lower lashes. Through this incision, excess skin, muscle and fat are removed, or fat may be redistributed to eliminate puffiness or bulges. Other adjustments to correct special problems such as muscle laxity may be performed. As in upper eyelid surgery, placement of the incision in natural crease lines allows for the scar to usually heal in an inconspicuous fashion. In some cases, you and your surgeon may decide that the best approach for removing excess fat is through an incision placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. A laser may sometimes be used in conjunction with this method to tighten the lower eyelid skin.

Understanding Risks

Fortunately, significant complications from aesthetic eyelid surgery are infrequent. Every year, many thousands of people undergo eyelid surgery successfully, without experiencing any major problem.

The risks in most surgeries are similar. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection, changes in sensation, scarring, allergic reactions, damage to underlying structures, need for revisions, unsatisfactory results possibly necessitating additional procedures and medical risks. Following the surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. There is a possibility of impaired eyelid function that sometimes may need to be corrected by additional surgery.

You can help minimize certain risks by following the advice and instructions you are provided both before and after your eyelid surgery.

The Day of Eyelid Surgery

Your eyelid surgery will be performed in our fully accredited AAAASF facility. Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing eyelid surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your vision will be blurry as a result of ointment used to soothe and protect the eye during surgery as well as from the swelling that is a normal aftermath of eyelid procedures. There should be surprisingly little discomfort, however, from the surgery. You will be permitted to go home after a short period of observation.

Eyelid Surgery Recovery

It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

The first few days after surgery, you should rest quietly with your head elevated. You will be instructed to apply cold compresses to your eyelids. Remember, you must not take aspirin or certain anti-inflammatory medications. Initially, you may feel a "tight" sensation around the eyes and some mild discomfort that can be controlled with oral medication. During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. Some patients find that mild swelling persist for several weeks, while others may see swelling resolve in as little as one week. Bruising typically disappears within 7 to 10 days. Within the first week or so, you will be permitted to use makeup, if desired, to conceal any discoloration. Stitches are usually removed within a week of surgery.

Your vision may continue to be somewhat blurry for a few days or longer. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. You may want to wear dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation.

Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within 10 days or less. Although you might feel like going back to work just a few days after surgery, your vision may still be slightly blurry which could make reading or other paperwork more difficult.

How much will eyelid surgery cost?

Cost is always a consideration in elective surgery. Please see our Payment Options page under About Us.

We always present our plastic surgery consultation patients with a "fee quote." This fee includes:

• Surgeon's professional fee
• Facility fee
• Anesthesia fee

It does not include any laboratory tests, preoperative examinations, garments or postoperative prescriptions.

Maintaining a Relationship with Your Plastic Surgeon

You will return to our office for follow-up care at prescribed intervals, at which time your progress will be evaluated.

Please remember that our relationship with you does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact us.

Complimentary Consultation

For more information about our facial surgery procedures near Houston, go back to the top and follow the links. When you are ready to talk with Dr. Moliver in person, you can request a complimentary consultation online or call 281.282.9555 to schedule your visit.

Please see the facelift portion of our Photo Gallery, since many of our facelift patients have also had forehead lifts and eyelid surgery.

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