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Blepharoplasty is surgical modification of the eyelid. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery.
Blepharoplasty is often done as an elective surgery for cosmetic reasons. Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid "bags" and reduce the wrinkling of skin. Asian blepharoplasty or double eyelid surgery is a special type of blepharoplasty that creates a crease in the upper eyelid.
How Should I Prepare for Eyelid Surgery ?
You will need to have another person drive you home after your surgery. You should also have someone stay with you the night of the procedure.
Expect and plan to stay home from work and limit your activities for several days after surgery to give your eyelids a chance heal. Some patients experience dry eyes after surgery, but the condition rarely lasts more than two weeks. If you have dry eyes lasting more than two weeks, contact your doctor.
At home, you should have the following items readily accessible : -
Ice cubes
Ice pack or you can use freezer bags filled with ice, frozen corn or peas.
Small gauze pads
Bowl (for water)
Eye drops or artificial tears (ask your doctor to recommend the proper type to meet your particular needs)
Clean washcloths and towels
Over-the-counter painkillers (which your doctor can recommend)
How Is The Operation Done ?
Marking of excess skin and fat bulges is done in a standing position. The surgery can be done under local or general anesthesia and the incision is made in the natural crease of the lid. The excess skin is removed and the fat excised or relocated and the incision closed by sutures. This leaves a very thin scar in the area which fades over time.
Surgery on the lower lid depends on the preoperative condition. Bulging fat from lower lid without excess skin is treated by a transconjunctival blepharoplasty (Scar less and stitch less). Excess skin and muscle require excision of the same and will leave a scar very close to the edge of the lid. Some time there may be too much laxity of the lid exposing the conjunctiva and causing tearing which may require tightening of the lid in the horizontal direction at the corner of the eye called canthoplasty.
How Is the Procedure Performed ?
Blepharoplasty usually takes about two hours if both upper and lower eyelids are done together. Your doctor will most likely use local anesthesia (a painkiller injected around the eye) with oral sedation.
If you are having the procedure completed at a hospital or surgical center, you will most likely receive intravenous sedation.
If you're having all four eyelids done, the surgeon will probably work on the upper lids first. The surgeon will usually make incisions following the natural lines of your eyelids. Through these incisions, he or she will separate the skin from the underlying tissue and remove the excess fat, skin and muscle. The incisions are then closed with very small sutures. There will be sutures in both upper lids that will remain for three to six days. The lower lids may or may not require sutures depending upon the technique used.
Surgery on the lower eyelids may be done using one of several techniques. The transconjunctival technique is performed by making an incision inside the eyelid. No incision is visible following surgery. Through the incision, fat may be removed to correct baggy lower eyelids. Then, fine lines in the skin can be softened using a C02 or erbium laser.
Risk of Operation
Due to scar contraction, rarely there is pulling of lid downwards called ectropion. Dryness of eyes and visible scarring are rare.
Side effects
Temporary discomfort in vision and the itching of the eyes can take place. The light sensitivity remains or few days. The temporary dryness of the eyes remains for few days; you should consult your surgeon before and after the Blepharoplasty surgery.
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