What Is Blepharoplasty?
Every year, 100,000 men and women choose cosmetic eyelid surgery to improve the way they look. Why? The eyes are the first place people look at us. They are also the first place to show aging. People considering eyelid enhancement want to improve:
- Droopy, puffy eyelids
- Sagging skin that weighs on the eyelashes
- Bags under the eyes
- A tired appearance
These problems can make you look older and droopy eyelids can sometimes impair vision. Eyelid surgery improves these issues so that you look less worn and tired. The surgery, called blepharoplasty, can be performed on the upper eyelids, the lower eyelids or both together.
Blepharoplasty contours the fat and muscle, removing excess skin from the upper and lower eyelids. Other options include ptosis repair, and repair of malpositioned eyelids from previous surgery, trauma, or aging.
Candidates for Blepharoplasty
Physically and emotionally healthy men and women are the best candidates for eyelid surgery. Generally speaking, individuals come to see a facial cosmetic surgeon after the age of 35, when they begin to notice changes due to aging. Depending on family characteristics and your lifestyle, you may want to see us sooner.
Anyone who’s over 18, in good overall health, and willing to have a reasonable expectations is a good candidate for blepharoplasty. Individuals who have certain medical conditions may be candidates for surgery but may need special attention due to the extra complexity of those conditions and increased risks involved. Such conditions would be:
- Thyroid Eye Disease (Graves’ Disease)
- Chronic severe dry eye
- High blood pressure, heart disease, and diabetes
- Chronic use of anticoagulants such as warfarin and clopidogrel
Eyelid surgery can do wonders for your appearance and can greatly boost your self-confidence! But, eyelid surgery is not a magic answer to the bad feelings you may have about yourself. People may not treat you differently after your surgery. That is why it is so important to have realistic expectations about the outcome and to speak frankly to Dr. Fante & Dr. Goecks to make sure all your questions are answered. You need to have a complete understanding of the procedure and the changes you will go through post-surgery.
Eyelid Surgery Benefits
Eyelid surgery may improve but does not completely correct the problems mentioned above. Blepharoplasty can remove bags under the eyes and correct droopiness and puffiness of the eyelids. Dark circles under the eyes can be due to under-eye bags, which will be improved when the bags are removed. Blepharoplasty cannot always remove the general darkness of skin color under the eyes.
In addition, some people have eyelid surgery to correct inherited characteristics. For example, many Asian women have surgery to create a “double eyelid” or well-defined upper crease.
Eyelid surgery doesn’t completely solve the problem of crow’s feet and is not appropriate for lifting sagging eyebrows. It won’t eliminate those dark ‘bags’ or circles under your eyes. When desired, blepharoplasty and other forms of eyelid surgery can be performed along within a facelift, cheek lift, brow lift, or other therapies to improve those problems for maximum results.
Individual needs vary widely. Dr. Fante or Dr. Goecks can best answer most questions you may have about eyelid surgery during your initial consultation.
Eyelid Surgery Before & After
Preparing for Your Eyelid Surgery
As with all facial plastic surgery, good health and realistic expectations are desirable.
- A complete medical history will be taken. Be sure to tell Dr. Fante or Dr. Goecks if you have any allergies.
- Your vision will be tested and tear production assessed.
- During your consultation with Dr. Fante or Dr. Goecks, you will decide whether all four eyelids should be done, or just the upper lids, or just the lower lids. You’ll have a chance to discuss other options as appropriate for your face and your goals.
- Dr. Fante & Dr. Goecks will explain the techniques they will use, and the anesthesia, and the risks involved.
- Dr. Fante, Dr. Goecks, and their staff will give you guidelines on eating and drinking, as well as smoking, and any vitamins, herbs, and medications you should take or avoid.
The Blepharoplasty Procedure
In general, the blepharoplasty procedure will last between 30 and 90 minutes, using local anesthetic combined with some form of sedative. Depending on your exact situation, Dr. Fante & Dr. Goecks can appropriately perform surgery in our office or in an ambulatory surgery center.
There are many procedures to choose from. Dr. Fante or Dr. Goecks will customize your procedure for your unique face. Some of the possibilities are:
- Removing puffiness from upper and/or lower eyelids (prolapsed fat that accumulates with age)
- Removing excess skin from upper eyelids (that droops, sometimes interfering with vision)
- Correcting weakness of eyelid muscles and tendons
- Smoothing the area below the eyes (with laser resurfacing, Botox, or surgical removal of skin)
Dr. Fante & Dr. Goecks use a laser for many procedures. When an incision must be made, they’re always very tiny, and strategically placed so that they heal to near invisibility. The incisions by Dr. Fante or Dr. Goecks will follow the natural creases of your upper eyelids and the natural line just below your lower eyelashes. The doctor closes the incisions with very small stitches, which he will remove in a week or so.
Upper & Lower Eyelid Blepharoplasty
Risks of Eyelid Surgery
Harm to the eyes is extremely uncommon after Blepharoplasty. You may find in the first weeks after the surgery that your eyes:
- May tear up more than usual
- Be more light-sensitive
- Have some trouble focusing, especially if your upper eyelids were very droopy beforehand
- Feel a bit itchy or burning
Revision Eyelid Surgery
If you have had eyelid surgery in the past and are not happy with the results, Dr. Fante & Dr. Goecks may be able to perform revision eyelid surgery depending on how long it has been since the previous procedure. To see the full results of a blepharoplasty procedure, it is always advised to wait a few months for full healing to take place and for swelling to diminish. If you have given time and are still not happy with the results, schedule a consultation with our office to explore your options for an eyelid revision procedure.
Every case is different, so it is important for Dr. Fante & Dr. Goecks to evaluate each patient in order to determine if they are a candidate for revision surgery. If the original surgery resulted in overcorrection, meaning too much tissue was removed, the remaining skin may need to be redistributed to provide better results. If undercorrection is the problem, meaning not enough tissue was removed, another standard blepharoplasty procedure may be performed.
Cost of Upper Blepharoplasty
At your consultation, once we know the particulars of your surgery and insurance, we will strive to give you an estimate of the costs of your out of pocket costs. Please understand that if you are planning to file your surgery with insurance, it is entirely your responsibility to ensure that we are in network for your plan and that if referrals are required for your plan from your PCP, it is up to you to get them to our office. Your procedure will be billed under your medical insurance (not your vision insurance).
As far as your financial responsibility is concerned, this is dependent upon your specific plan, whether or not you have met your deductible, and your co-insurance (if any). We will take care of getting prior-authorization and pre-determination completed before your operation whenever possible.
Can Blepharoplasty Be Combined with Any Other Procedures?
For your most refreshed, most youthful appearance, Dr. Fante or Dr. Goecks might also advise undergoing other procedures in addition to eyelid surgery. The choice will always be yours, but Dr. Fanteor and Dr. Goecks might recommend:
- Botox, fillers, and/or microfat transfer to finish off your best appearance
- Forehead lift to improve a drooping brow and smooth the forehead
- Skin resurfacing to improve the fine lines in the eye area
- Endoscopic midface or cheek lift to efface the intensity of dark circles and improve the contours of the cheeks
- Proper treatment for any issues that might affect the health of your eyes
Upper eyelid surgery is often done in conjunction with a brow lift, which mildly raises the eyebrows, to give the eyes a more open, rested look. Lower eyelid surgery is often performed together with an endoscopic mid face lift. Another common combination is for people to have cosmetic surgery on both the eyes and the neck at the same time.
Eyelid Surgery Patient Testimonial
Will Eyelid Surgery Affect my Vision?
Only temporarily, if at all. You may find in the first weeks after the surgery that your eyes:
- May tear up more than usual
- Be more light-sensitive
- Have some trouble focusing
- Feel a bit itchy or burning
Blepharoplasty is sometimes done on Asian eyes for a different reason than it’s done on Occidental eyes. For Occidental eyes, the surgery is usually to correct droopiness caused by age. This is sometimes also the reason for eyelid surgery on Asians.
For Asians who have a “single” eyelid, it’s also often done to soften or westernize the look of the eyes, and is often called “double eyelid surgery”. A “double eyelid” has skin visible between the eyelashes and the skin fold – a place where many women like to wear makeup.
There’s also a thing called the epicanthal fold, a piece of tissue which drapes over the inner part of the eye. In most Occidentals, it’s barely visible, whereas in most Asians, it’s quite evident.
When it’s adjusted surgically, a new crease forms which gives the eyes a different look, and also causes the eyelashes to turn upwards, instead of being pushed downwards by that epicanthal fold.
Will I Have Any Scars After My Blepharoplasty?
All incisions leave scars. These incisions are very tiny and are strategically inside existing creases. The resulting scars will be virtually invisible or alternatively are hidden completely inside the eyelid. When rarely needed, there are cosmetics that will camouflage these little scars very well.
What to Expect After Blepharoplasty
After your blepharoplasty, you can go home, but you’ll need someone to drive you.
- There’ll be antibiotic ointment temporarily blurring your vision
- You’ll have a prescription for an oral pain reliever
- Dr. Fante or Dr. Goecks will give you written instructions for self-care
- There’ll be some swelling and bruising which you can minimize with an ice pack. Herbal and homeopathic medicines can sometimes also help with bruising. Dr. Fante or Dr. Goecks will give you information on which ones to consider.
- Dr. Fante & Dr. Goecks will remove your sutures after about a week
After a week or so you’ll be able to return to work, exercise, and normal routines. Some bruising may persist into the second week after surgery. Since we live in the Rocky Mountain climate, you will probably want to use artificial tears for a little while to offset the dry air.
If you are a contact lens wearer, you won’t be able to wear them for at least two weeks. Within two or three days of the surgery, you’ll be able to use a computer, watch television, and read comfortably. It may be 7-10 days or so before you feel comfortable to face the public and go back to work. Most people are “back to normal” by two weeks after surgery. Healing will continue and isn’t really complete until a year or more after surgery (scars can continue to improve throughout your life). Once Dr. Fante or Dr. Goecks have given you the go-ahead, you will be able to wear makeup to hide any bruising you still have. In the interests of helping it fully subside, avoid smoking and drinking excessive alcohol.
Make-up Camouflage for Post Surgery Bruising
Recovery From Eyelid Surgery
Dr. Fante & Dr. Goecks will ask you to restrict your activities for about one-week post-surgery, and in particular to avoid vigorous activities for about three weeks. We recommend walking and other light activity. You would not want to increase your blood pressure and cause bleeding during this time by serious running or lifting. Patience will be the key to successful healing and your best new look after full recovery.
You can speed your healing time by taking rest seriously. Prop yourself up in bed with pillows and watch TV, do social media, or read to pass the time. Let yourself doze off as much as you want, so long as you stay on your back. A comfortable recliner is great for this, too.
If you notice extra sensitivity to wind, sun, or other bright lights, avoid them, or wear good sunglasses. Dr. Fante & Dr. Goecks will give you some special sunblock for the eyelids if needed.
Do not worry if the little scars remain pink for several months afterward. They will eventually become no more than a thin whitish line in the eyelid crease. It will only be visible when you close your eyes. They’ll be more than offset by the refreshed and youthful look your face will have. With good post-op self-care, you can expect to enjoy the new, younger you for many years to come.
Have a Driver Ready Post-Surgery
You will not need a driver for most office appointments. However, virtually all surgeries performed in the office, surgery center, or hospital will be accomplished under sedation, and you will not be able to operate a vehicle afterwards. Please plan to have a driver for those occasions.
Schedule a Consultation
You’ll be very happy with your new look. Insurance may even cover your reconstructive eyelid surgery! Dr. Fante & Dr. Goecks are always available to answer questions and provide support. If you think blepharoplasty is right for you, call (303) 839-1616 to schedule a consultation today!