View Before and After Pictures
Information
After Surgery
Preventing Vision Loss
Risks and Complications
Eyelid surgery will remove excess fat, muscle and skin from the upper and lower eyelids. It improves drooping lids and puffy eyes. It does not correct wrinkles, dark circles, sagging eyebrows. These problems may be corrected through other procedures, such as a brow lift or skin resurfacing techniques.
In some cases only upper lid surgery is performed and sometimes only lower lid surgery. Upper and lower procedures can also be performed at the same time.
During the operation, the surgeon making incisions above and below the eye tissue. These incisions follow the natural folds of the eye and allow the surgeon to separate the underlying fatty tissue and muscle. The surgeon then removes the fat and excises the sagging skin and muscle.
Upper Eyelid Surgery
Incisions are made in the natural skin crease of the upper eyelid. Excess skin and fatty tissue is removed and the muscles and orbital septum may be tightened to correct droopy eyelids. The incisions are closed.
Lower Eyelid Surgery
Lower eyelid surgery removes fat deposits and tightens loose skin. Incisions are made along the lower lash line and extends a little beyond the eye. Excess fat, muscle and skin are excised and the incision is closed. If your lower eyelids are loose, you may also require a lid tightening procedure. This results in more swelling and a longer recovery.
If you have fat pockets belowe your eyes, and do not have loose skin, your surgeon may recommend a transconjunctival blepharoplasty.
Transconjunctival Eyelid Surgery
Transconjunctival eyelid surgery does not tighten the skin, it simply removes excess fat. The incision is made inside your lower eyelid, leaving no visible scar. Excess fat and muscle are removed and the incision is closed.
After surgery, you will feel mild to moderate discomfort and will likely have swelling and bruising (3-5 days if only skin is removed; 1-2 weeks if skin and fat is removed). You should be able to return to work within a week with the use of makeup and within a month without makeup.
Your final results will seen after 1-2 months.
Your eyes may feel tight, with minor discomfort that lasts for a day or two. Your eyes will be swollen and bruised. Your head will be kept elevated and cold compresses applied to reduce swelling and bruising. Your blood pressure will be monitored to avoid bleeding complications. Your eyes will be lubricated, which may blur your vision.
The incisions may be red and bumpy initially and will gradually flatten and fade. The swelling and bruising should disappear within 1-2 weeks depending on the extent of your surgery. During recovery, your eyes may be sensitive to light and your vision may be blurry the first few days. Your eyes may also experience, burning, itching, tearing or dryness. Your doctor will likely dispense eyedrops to alleviate any discomfort.
Wear sunglasses home. At home, keep your head elevated and take it easy. Apply light ice packs (try frozen peas in a plastic bag) over your eyes continuously for the first 48 hours.
The eyelids may become swollen and stuck together. If this occurs, clean the eyelashes carefully with warm water on a Q-tip. Some oozing from the incision lines and crusting along the eyelashes is normal. However, if you have increased bleeding or decreased vision, call your physician immediately.
Be sure to follow your doctor's advice carefully and go to all post-op visits.
Recovery takes anywhere from two weeks to one month, and the complete healing process takes up to six months as scars fade to thin white lines.
Dr. Mark Gorney, a board-certified plastic surgeon in Napa, CA, wrote an article in the Aesthetic Surgery Journal that contained important information about preventing vision loss in the early post-operative period:
"In a survey of 5 consecutive cases of blindness after blepharoplasty, it was discovered that the only factor all patients had in common was that they were discharged very shortly after the termination of outpatient surgery. On arrival at home, all 5 patients did something to generate a sudden rise in blood pressure at the time of maximal reactive hyperemia as the epinephrine in the local anesthetic wore off, such as a constipated bowel movement, sudden coughing fit, or bending over and reaching down to tie a shoelace. It is imperative that all patients undergoing outpatient surgery involving undermining of heavily vascularized tissues be warned in writing not to perform any maneuvers that will generate a sudden rise in blood pressure. It is strongly recommended that no patient be discharged from an outpatient surgical facility until at least 3 hours after the last epinephrine-containing local injection and until there is evidence that all local anesthetic effects have worn off."
Source: Gorney M. Ten years' experience in aesthetic surgery malpractice claims Aesth Surg J March/April 2001;21:569-571
Complications of eyelid surgery, while rare, can cause prolonged healing, change in or loss of vision, unpleasant-appearing and painful scars, the inconvenience and cost of further surgery, and the possibility of requiring eye drops or ointment, temporarily or permanenetly.
Possible complications: (not an exhaustive list)
Abnormal lid position, Abnormal scarring, Abnormal skin color, Anesthesia reaction, Bleeding, Blindness, Blurred vision, Burning, Corneal abrasion, Double vision, Decreased sensation in eyelid, Difficulty closing eyes, Dry eye syndrome, Excessive tearing, Gritty sensation in eye, Inability to close eyes, Milia, Reactions to medications, Retrobulbar hematoma, Slow healing, Stinging, Visible scarring
Blindness
The risk of permanent blindness is less than 1 out of 10,000. Vision loss is usually related to bleeding following eyelid fat removal.
Blurred vision
This is a temporary condition that occurs in less than 1% of surgeries.
Corneal abrasion
This condition is temporary and is easily treated by patching the eye for 1-3 days.
Double vision
This condition is temporary and occurs in less than 1% of surgeries.
Difficulty closing eyes
This condition is usually temporary in rare cases. In rare cases, corrective surgery is required.
Dry eye syndrome
Dry eye syndrome is potentially dangerous. In rare cases it leads to damage to the cornea of the eye and vision loss.
Inability to close eyes
This condition is usually temporary. In rare cases, corrective surgery is required.
Milia
Tiny skin cysts can form on the scar line. This is normally temporary, but in some cases requires surgical removal.
Retrobulbar hematoma
A rare complication in which a pocket of blood forms behind the eyeball.
