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The first step of the process is to thoroughly plan the surgery by reviewing your medical history and examining your eyes with your surgeon. High blood pressure, thyroid problems or diabetes are examples of conditions that can increase risks during surgery; Medications such as Coumadin and Aspirin can also increase risks. Be sure to inform your surgeon if you have any allergies or conditions such as “dry eyes” or any other problems or disease you may have. Bring a list of your current medications, including prescription, over-the-counter and vitamins. In addition, bring all records from recent eye examinations, as well as glasses or contacts if applicable.
When planning, you and your surgeon must carefully discuss the goals and expectations for this surgery. Your surgeon will also explain the steps done throughout the procedure and the risks and costs involved.
Preparing for Surgery
It is very important that you follow all directions given to you by your nurse, as they are crucial in helping your surgery go more smoothly. Instructions can involve how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Be sure to arrange for someone to drive you home after the surgery who can help you with anything you need.
Blepharoplasty is typically performed under local anesthesia and oral or occasionally intravenous sedatives. You will be awake but relaxed and insensitive to pain. However, you may feel some tugging or occasional discomfort.
The surgery typically takes between 1-2 hours, depending on the extent of the procedure. In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids, such as in the creases of your upper lids, or just below the lashes in the lower lids; the incisions may extend into the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from the underlying fatty tissue and muscle, removing excess fat if necessary and trimming any sagging skin and muscle. The incisions are then closed with tiny sutures.
If you have a pocket of fat beneath your lower eyelids, but do not need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.
Complications are very rare, but can occur. Minor complications include double or blurred vision for a few days, temporary swelling at the corner of the eyelids, and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out, which can be removed easily with a fine needle.
Following surgery, some patients experience difficulty when trying to close their eyes when sleeping; this can usually be corrected with surgery. Another rare complication is ectropion, a pulling-down of the lower lids. In both cases, further surgery may be required. A very rare complication that can occur the evening after surgery is a bleed behind the eye, which is very painful and could cause vision loss if left untreated.
The Best Candidates
Blepharoplasty can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal look or cause others to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Patients are typically at least 35 years old, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age. Those who experience thyroid problems, such as hypothyroidism and Graves’ disease, “dry eye” or lack of sufficient tears, diabetes, high blood pressure, or other circulatory disorders may experience complications with the surgery.