Cosmetic eyelid surgery for the correction of drooping eyelids (ptosis) and/or baggy eyelids (blepharochalasis) does not hurt!  Not before, during or following the procedure.  That may seem hard to believe and I must agree that unless I had witnessed this phenomenon numerous times, I would not believe it either.   

Preoperative photos are taken and a plan for surgery is discussed with the patient. Firstly, during the procedure the patient is given an intravenous sedation and once asleep the eyelids are anesthetized with Novacaine and adrenaline.  When I say “asleep” I mean local sedation which wears off in several minutes unless it is repeated.  Some patients are awake enough to maintain a conversation, others prefer to “not know anything.”  Any level of sedation is possible.   The adrenaline is added to the Novacaine to shrink the blood vessels of the skin and thus reduce bleeding.

During the procedure the excess skin is removed.  I prefer to accomplish this with a radio frequency generator transfering the energy to a cutting needle.  Some refer to this as “radio-surgery.”  The incision is precise and bleeding is minimal, all leading to a rapidly healing wound with little to no scarring.  Once the skin has been removed, the underlying fat is excised, this eliminates the baggy appearance.  In general, woman require that all the fat be removed as this allows for a smooth contoured upper eyelid which makes the application of mascara and eye shadow much easier.

Lower eyelid surgery requires attention to detail.  The contour of the lower eyelid line is important as is the bagginess of the lid.  The baggy lids are due to the migration of fat from behind the eyeball to a more forward position.  The sagging lower eyelid line may be due to a weakening of the structures supporting the lid.  A fine line incision is made below the eyelashes and the fat is exposed and excised.  Now that the lid is dropping back to the position that it should assume, the extra skin is removed.  The wounds are stitched with a fine synthetic  material (Prolene) which is removed in one week.

I discharge patients on the day of surgery with instructions to use ice compresses and return to the office in 24 hours.  We never offer pain medication as there is no need for any.  On the first day the wound is cleaned and folks are asked to return in a week.  They are to use ice for the next few days and at the same time they can be up and around; driving, desk work, etc is O.K. 

Bruising from the surgery is related to the amount of bruising that folks normally experience.  To minimize the bruising I ask patients to discontinue aspirin and anticoagulants well in advance of the day of surgery.  If your medical condition does not allow for the discontinuance of these medications, you are not a candidate for eyelid surgery.

In many instances, I am able to get patients qualified with their health insurance company  (including Medicare and Medicaid), to pay for the surgery for the upper eyelids; lower eyelid surgery is usually considered cosmetic and not paid. There are some exceptions in the case of drooping lower eyelids causing tearing (ectropion).

Call the office, come in and let’s talk about your specific situation.

Scientists are beginning to unlock the mystery of aging.  In 1900 average life expectancy was 47 years.  We are now pushing the average toward 80 years.  But there is far more to just racking up the years, in my view it is about quality of life; we want to live well for as long as we can.  I see myself as dying at 94 while standing on the bow of my fishing skiff wrestling a 110 pound tarpon. 

Part of feeling well is looking good.  As we age, it takes an extra effort to accomplish that goal.  Gravity is at work, body fat is relocating, collagen (the scaffold supporting our skin) is degenerating and our genetic predisposition begins to play out.  If you are in your forties, just look at the quality of the skin of your parents and get a glimpse into your future.  All of these factors  have an effect on the appearance of our face.   Perhaps the most important feature of the face is the eyelid area.  Upon meeting a person, this is the first region that is considered and we are programmed to make numerous decisions about that person at the instant of “the first encounter.”  By creating small alterations in the appearance of the eye area, one can send a whole new set of information at the moment of the encounter. 

62 year old prior to upper eyelid surgery

Following surgery

The only thing that was done in this case was to create a lid crease by removing skin.  You have a more youthful appearance and you notice the sparkle in the eye.  The key to surgical success is to do the minimum necessary to create the desired effect.

This procedure, known as blepharoplasty or cosmetic eyelid surgery is a 20 minute outpatient procedure which we do in our adjacent ambulatory surgery center.  It is done with local intravenous anesthesia from which the patient awakes immediately and leaves the operating room under their own power.  For reasons that remain unclear to me, there is no pain  following the surgery.  Folks can be up and about on the next day provided that they make an effort to apply ice to the surgical area.  The issue of bruising always comes up.  If you tend to bruise then expect that with the surgery, otherwise localized swelling is the norm.  The sutures are removed in one week. 

In many instances, health insurance companies including Medicare and Medicaid provide full coverage for this surgery.  When a patient meets the criteria, we take photographs preoperatively and submit them for review by the insurance companies.  Many people are surprised to learn that they are covered.

Age alone is not a factor; your state of health and your motivation to look as good as you can are the driving forces.  Call the office and I will meet personally with you and review your candidacy for blepharoplasty.