Blepharoplasty, also known as eyelid surgery, is a common procedure that has been gaining a lot of momentum in the past few years. This is likely fueled by the fact that many patients note their first signs of aging around the eyes. The average eye blinks about 28,000 times per day which makes it an area of repetitive motion which likely contributes to many of the changes we note with aging. In the upper lid we typically tend to notice excess skin and a build up of fat in the portion of the eyelid closest to the root of the nose. In the lower eyelid there is often a build up of excess fat primarily and sometimes excess skin. In addition, a harsh transition between the lower eyelid and the cheek dan form that we refer to as a tear trough deformity. This leads to a more tired appearance and therefore the goal for lower eyelid blepharoplasty is to create a smooth transition between the cheek and lower eyelid. The lower lid blepharoplasty is typically performed using general anesthesia at our surgical facility while upper eyelid blepharoplasty is one of the few procedures that can be performed under local anesthesia directly in the clinic. Incisions are generally very well concealed in both the upper and lower eyelid due to the great healing properties of your eyelid skin. It is also important to remember that the different areas of the face, such as the eyes, cheeks, and neck will all eventually age together and should “match” each other. It is, therefore, typically advisable to surgically correct more than one area of the face for a natural look that maintains “facial harmony”. Since most of our interactions begins with making eye contact, rejuvenation of the eyes play an important role in turning back the clock and getting the refreshed but natural look most are hoping to achieve. Learn more about both procedures and get answers to some of the most common questions below:
Fast Facts Eyelids (Blepharoplasty)
+ Length Of Surgery
< 1 hour.
If done by itself, local anesthesia. IV sedation and general anesthesia are also possible.
+ Length Of Surgery
Typically general anesthesia or IV sedation.
+ Length Of Stay
Done alone or with other eyelid work it is an outpatient procedure. If performed in conjunction with a facelift, a single overnight stay is highly recommended.
The Surgery Center at UCLA is the only place in Los Angeles that allows you to have your surgery followed by a monitored overnight stay with a registered nurse (R.N.) in the same facility.Not to mention, that UCLA’s world class hospital ranked “Best in the West” according to the U.S. News and World Report for the last 2 decades (add link?), is next door in the rare event of an emergency.
This allows for a safer surgical experience which is one of the main reasons Dr. Jason is proud to be on faculty at UCLA.
Generally mild discomfort. Up and about the same day. Stitching to be removed by 7 days. Swelling and bruising mostly gone by two weeks. Makeup can be worn after 1 week. Avoid excuser or any significant increase in your heart rate for two weeks. You can start exercises that do not require leaning over or significant movement/motion of the head and neck at 3-4 weeks. Return to full activity and return to full activity/exercise at 2-3 months.
Minimal to no scarring, well concealed in the natural creases of the eyelid.
+ Risks/Possible Complications
Serious complications, while possible, are unlikely. Some potential complications can be avoided by carefully following your surgeon’s instructions.
In addition to the usual risks associated with anesthesia, other risks include:
– Headaches: not uncommon but most common limited to the first 1-2 weeks
– Hematoma: Is a collection of blood beneath the skin and can be treated without compromising result.
– Infections are very rare.
– Visual changes are very rare
– Excessive tearing
– Temprary of eye dryness.
Before & After Eyelids (Blepharoplasty) Photos
1) I am only 45 years old, can I be a good candidate for eyelid surgery (blepharoplasty)?
As the saying goes, “age is but a number” and facial aging is no different. There are many factors involved with how your face ages, both your genetics and environmental exposures play a crucial role. Many patients notice their first signs aging around their eyes. Therefore, there is no particular age that one should wait before considering a blepharoplasty. The procedure is effective for anyone who feels as though they have excess fullness and/or skin laxity around their eyes. We blink 30,000 times per day, which contributes to why we notice changes around the eye with aging before ay other area. This repetitive motion creates excess skin around the eye from its constant use but can also cause excess fat that deposits in the eyelids, causing a fullness that are often referred to as “bags.”
2) What should I ask during my consultation to find the right doctor for me?
You should look at the doctors before and after photos critically and decide whether you like their sense of aesthetic. Cosmetic surgery is an art and therefore you want to find a doctor that matches your taste so to speak.
3) What kind of eyelid surgery (blepharoplasty) is best? What are the different types of eyelid surgery (blepharoplasty)?
For the upper eyelid, an incision along the upper eyelid crease is made to conceal the scar and remove and excess skin or fat. If a crease is not present, which can be common among asian patients, than a crease can be created, when desired. Now for the lower eyelid, an individualized approach is taken typically to address any or all of the following three components: 1) excess skin, 2) excess fat (eyelid bags), 3) a harsh transition between the lower eye lid and cheek that we refer to aa the “tear-trough.” Scarring is generally very well concealed with all the above techniques. Each of the approaches have advantages and disadvantages. During your consultation with Dr Jason, he will go over which technique best suits your particular needs.
4) How long will the effects of eyelid surgery (blepharoplasty) last?
Just as with any rejuvenation procedure, we cannot prevent ongoing aging but we can set the clock back many years! With that said, the eyelid surgery seems to be one of the more resilient procedures we perform. It is very rare for patients to request a repeat eyelid surgery procedure in less than 20 years.
5) I have been considering additional procedures (rhinoplasty, fillers, breast augmentation, etc.). Can I have multiple procedures done at the same time?
It is possible to have multiple procedures done at the same time. For instance, including a facelift and/or eyelid procedure (blepharoplasty) with a browlift is very common. However, it is important to keep the planned operating time to less than 6-8 hours in order to optimize your safety. Increased operative times have been shown to increase the risk for complications such as infections and risk for deep vein clots that can lead to pulmonary emboli.
6) How can I control swelling after eyelid surgery (blepharoplasty)?
Swelling is normal following surgery. Some measures to reduce the amount of swelling include: a) Try to keep your head above the level of your heart at all times for the first 2 weeks. Dr Jason recommends a large wedge that elevates your back and your head. b) Use cooling measures such ice water soaked gauze or ice water in a ziplock for the first 48-72 hours. Your skin should just feel cool to the touch. Avoid anything completely frozen such as gel packs as this can cause damage to your skin. c) Avoid activities that involve bending over or straining. You should also minimize your salt intake as much as possible after surgery. Ideally you should ingest no more than 1-2 grams per day for the first 3 months after surgery. All of these measures combined will help minimize the amount of swelling you encounter following surgery.
7) How long will it take to heal (aka when will I be ready for a special engagement)?
One of the benefits of eyelid surgery is that the scars are hidden by your scalp and/or hairline. Therefore, at about 2-3 weeks the swelling and bruising has resolved and most patients will feel comfortable with attending special engagements.
8) When can I start working out again after eyelid surgery?
For the first 2-3 weeks following surgery, you want to avoid straining (lifting anything more than 5 lbs), or getting your heart rate/blood pressure up as this can lead to bleeding. After 2-3 weeks you should avoid mechanical forces that will stress or put tension on your healing incisions for 3 months. This means you should avoid high impact activities that lead to excessive movement of your head and neck, such a running. If you feel up for it, after 2-3 weeks, Dr Jason Roostaeian recommends starting with the seated stationary bicycle which is low impact and minimizes movement of your head and neck. Listen to what your body is telling you at all times, for instance stop the workout if you experience any new discomfort in your eyelid area. Remember, getting plenty of rest and reducing your overall activity will give you time to heal and speed up your recovery!
9) When can I go back to work after eyelid surgery (blepharoplasty)?
It really depends on what you do for work. If you have a desk job you can typically return to work after 1 week. If your profession is more physically demanding, Dr. Jason recommends to wait at least 2-3 weeks before returning to work. Remember, you do not want to strain or lift anything that weighs more than five pounds for the first 2-3 weeks.
If you are considering facial rejuvenation, please come in for a consultation with Dr Jason.
At the consultation Dr Jason will listen closely to what you are looking for and what you are trying achieve. He can also make recommendations as to what you may or may not want to consider in terms of ancillary procedures. You will also have the opportunity to thoroughly review his earlier work and see whether the results of his facelifts are what you are looking for.
Recommended Shopping List:
Button-up pajamas – to avoid pulling any clothes over your scalp and face after surgery.
Refresh Eyedrops – to keep eyes moist while healing.
Zip Lock bags to put ice water and keep eyelid area cool for swelling..
Foods with Very Low Salt- you want to really minimize salt, ideally to less than 1-2 grams per day, as this will help reduce your swelling. You want to maintain the low salt diet for at least 6 weeks and ideally for 3-6 months.
Eyelid Surgery Pre-Operative Do’s and Dont’s:
Avoid smoking cigarettes, wearing a nicotine patch or using nicotine gum three weeks prior and three weeks after surgery. All nicotine products inhibits circulation and slows your healing process.
TWO WEEKS BEFORE SURGERY
+ Do not take aspirin or any aspirin products. These medications cause bleeding which can lead to
complications. You may only use Tylenol.
+ If you are using Retin-A, discontinue use two weeks prior to surgery date. Do not recieve a dermabrasion, chemical peel, or laser, within five days prior to your surgery date.
+ Do not take Vitamin E (it will cause you to bleed).
+ Make arrangements for someone to drive you home after the doctor sees you the day following surgery.
+ It is extremely important that we are informed about any medications or supplements that you are currently taking such as diet pills, mega doses of vitamins, prescriptions for depression, etc., Dr.Roostaeian and your anesthesiologist need to know every medication that is in your system.
Eyelid surgery- THE DAY BEFORE + THE DAY OF SURGERY
+ Shampoo your hair and body with an antiseptic soap the night before surgery. We prefer you to use Hibiclens (sold at most drug stores) to wash your hair, face, and body (avoid the eyes) the night before and/or morning of surgery.
+ Do not eat or drink anything (not even water) after midnight. The morning of surgery you may take your regular medications such as blood pressure, heart, thyroid, etc. with a small sip of water.
+ Leave all your jewelry at home, including any body (pierced) jewelry. Do not wear contact lenses- not even extended wear. Remove all makeup. Do not apply lotion or creams. Bring a robe, gown (one that will slip easily over your head or one that buttons up the front) and slippers.
+ DO NOT “WORKOUT” THE DAY BEFORE OR THE MORNING OF SURGERY. This will dehydrate your body and you will not be able to replenish it with water.
Eyelid (Blepharoplasty) – What to Expect after surgery:
+ Keep your head elevated 30-45 degrees for at least a week to minimize swelling. Also, do not bend over. It’s important to keep your head above your heart.
+ Clean incisions (face, eyes, and/or neck) very gently with half strength witch hazel (use tap water to dilute). Q-Tips will work perfectly to remove crusts from suture lines.
+ Keep animals away from your incisions. Do not allow animals to sleep in your bed for 4 weeks.
+ During the first week post surgery have a soft, very low-salt diet, no chewing and minimal amount of fluids.
+ During week two up to 3 months, maintain a low-salt diet with minimal fluids.
+ Do not consume aspirin or ibuprofen products within 2 weeks post surgery.
+ No nicotine products within 4 weeks post surgery.
+ Be very gentle when caring for your hair for 4 weeks. No brushing, pulling, or rubbing on the hair around the sutures. Do not use any heat (curlers, curling iron, blow dryers, etc.) on your hair as your scalp and face can be burned very easily.
+ No extreme temperatures on your eyelid area such as heating pads or ice packs. Your nerve endings and blood supply in some areas have been temporarily disturbed and you can easily burn or freeze.
+ Be careful when pulling clothing over your head.
+ Avoid the direct sun or tanning spa for at least 12 weeks
following surgery as fresh scars will permanently pigment (turn brown)!