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Shu Cosmetic Surgery offers eyelid surgery, technically known as blepharoplasty. The surgery is designed to improve the appearance and/or function of the eyelids and has become one of the most sought-after facial plastic surgery procedures.

Blepharoplasty corrects drooping upper lids and puffy bags below the eyes by removing fat and excess skin and muscle from the upper and lower eyelids, making you look younger and fresher. In addition, this procedure can add an upper eyelid crease to Asian eyes and can be done alone or in conjunction with other facial surgery procedures, such as a mini facelift or mini brow-lift. Blepharoplasty, however, does not remove crow’s feet or other wrinkles, eliminate dark circles under the eyes, or lift sagging eyebrows.

For upper eyelid surgery, excess skin and fat are removed through a tiny incision hidden within the natural fold of the eyelid. Because the incision follows the natural contour of the eyelid, it will be well camouflaged after healing.

For lower lid surgery, the incision is typically hidden below the lower lashes. Through this incision, excess skin, muscle and fat are removed or redistributed. Other adjustments such as canthopexy (eyelid tightening) may be done to correct special problems, such as muscle laxity.

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Planning for Surgery

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.

The Surgery

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.

Possible Complications

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.

What is blepharoplasty?

Blepharoplasty is a surgery that rejuvenates puffy, sagging or tired looking eyes by removing excess fat, skin and muscle from the upper and lower eyelids. It may be performed for cosmetic reasons or to improve sight by lifting droopy eyelids out of the patient’s field of vision. Patients usually opt for this procedure due to reasons involving aging or inherited traits. At Rejuvelaser, Dr. Shu performs the procedure with local anesthesia in a procedure that lasts 1-2 hours.

Who is a good candidate for eyelid surgery?

Any one or combination of the following conditions may indicate that you are a good candidate for eyelid surgery:

  • excess skin obscuring the natural fold of the upper eyelids
  • loose skin hanging down from the upper eyelids, perhaps impairing vision
  • a puffy appearance to the upper eyelids, making the eyes look tired
  • excess skin and fine wrinkles of the lower eyelids
  • bags and dark circles under the eyes

Aesthetic eyelid surgery can usually correct these problems, although other treatments may also need to be considered.

How can I learn more about the surgery risks?

Significant complications from aesthetic eyelid surgery are rare, but risks and potential complications should be discussed with your surgeon. Potential complications include hematoma (an accumulation of blood under the skin that may require removal), infection, and reactions to anesthesia. Following the surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. There is a possibility of a temporary decrease in sensation of the eyelid skin or impaired eyelid function that can usually be corrected with additional surgery.

You can help minimize certain risks by following the advice and instructions of your surgeon, both before and after your eyelid surgery.

What can I expect on the day of my surgery?

Your eyelid surgery will be performed at Rejuvelaser Clinic. Medications may be administered for your comfort during the surgical procedure. When surgery is completed, there is very little downtime. Your vision will be blurry due to the ointment used to soothe and protect the eye during surgery and from the post-surgery swelling. Occasionally, intravenous conscious sedation is used for patients undergoing eyelid surgery. For your safety, your heart, blood pressure, pulse and the amount of oxygen circulating in your blood will be closely monitored.

How will I look and feel after the surgery?

Recovery time varies greatly among patients. The first evening after surgery, you should rest with your head elevated and apply cold compresses to the eyelids. You may take acetaminophen for pain but not Aspirin or anti-inflammatory medications.

Initially, you may feel a “tight” sensation around the eyes and some mild discomfort that can be controlled with oral medication. During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising, which could persist anywhere between one or several weeks. Bruising typically disappears within seven to ten days. Within the first week, you can use makeup (on the cheek area only, until sutures are removed) to hide discoloration. Stitches are usually removed within a week of surgery.

Your vision may continue to be somewhat blurry for a few days. Your eyes may be temporarily sensitive to light and could also tear up or feel dry. Some surgeons recommend eye drops to help relieve burning or itching.

When can I resume my normal activities?

Patients can typically return to normal activities within ten days, although straining, bending, and lifting should be avoided in the first few days after surgery. Although you might feel like going back to work just a few days after surgery, your vision may still be slightly blurry. You should not wear contact lenses for 1-2 weeks.