Eyelid Surgery
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Eyelid surgery can help achieve the most rewarding improvement in your facial appearance. Excess skin, bulges, or puffiness around the eyelids can make you look older, tired, angry, or sad. Your personality is viewed through your eyes. Because people look at your eyes when they look at you, aging in this area has the most detrimental effect on your appearance. Therefore, rejuvenation of the eyelid region often provides the most dramatic improvement in your look. At the Center for Cosmetic Surgery in Golden, Colorado, Dr. Wolfe and Dr. Vath invite you to visit for a consultation to discuss how blepharoplasty can benefit you.
By removing excess skin on the upper eyelids, dramatic benefits can be seen giving you a less tired, more youthful look. This is often performed in conjunction with a brow lift in order to elevate the outer brow back to a more youthful position which also helps clear the skin off of the upper eyelid. When the upper eyelid is visible, the eyes appear more "open" and you appear more attractive, young, and vibrant.
The lower eyelids can also cause an aged, tired look. This can be due to excess lower lid skin, wrinkles, and/or fatty bags. Lower eyelid skin can be tucked to decrease skin excess and wrinkles. The bags or bulges under the eyes can be reduced by removing some of the protruding fat that causes the problem.
Am I a good candidate for a blepharoplasty?
A blepharoplasty is an appropriate and rewarding surgery for healthy people who do not smoke and wish to rejuvenate their facial appearance. Excellent candidates for a blepharoplasty are those who want to decrease lax eyelid skin or reduce fatty bulges around the eyes, but do not have siginificantly dry eyes. It is important that anyone considering a blepharoplasty understands the reasonable expectations achievable by the surgery. A personal consultation with Dr. Wolfe or Dr. Vath at the Center for Cosmetic Surgery in Golden, Colorado can provide you with a thorough understanding of what a blepharoplasty can do for you.
What causes the excess skin on the upper eyelid and what should I do about it?
Whenever upper eyelid rejuvenation is a patient's desire, two separate but related factors must be considered in the proper diagnosis and treatment of the situation. First, the position of the eyebrow plays an important role in the upper lid appearance. As the brow falls, usually at the outer portion creating "lateral brow hooding", the skin on the upper lid tends to crowd and bunch up. Second, excess upper lid skin can be a function of aging and decreased eyelid skin elasticity.
How can I tell how much of my upper lid problem is due to brow descent?
You can determine for yourself the degree to which brow descent is contributing to your upper eyelid skin excess. Look straight into the mirror without your chin up or down, but in a neutral position. Then, manually lift the outer brow slightly to reduce the lateral hooding but not too much so as to over-glamorize your appearance. Don't lift the inner brow as this causes a surprised look. Once your brow is in the ideal position, notice how much more upper lid is visible and how much less excess skin exists within the lid. If this improves your look considerably, then a brow lift is an important component to your upper lid rejuvenation. At the Center for Cosmetic Surgery, Dr. Wolfe and Dr. Vath most often perform a mini brow lift that requires minimal scarring and recovery, but does a wonderful job of elevating the brow off of the eyelid. If your manual manipulation helps minimally, perhaps an upper blepharoplasty alone will suffice to dramatically clean up your upper lids.
What does the brow have to do with the upper eyelid?
As the outer eyebrow drops with age and loss of skin elasticity, it can cause crowding of the upper eyelid skin. Often, a mini brow lift is an essential step to rejuvenating the upper lid and must be considered whenever upper eyelid aesthetics are discussed.
What are the risk factors for having problems after a blepharoplasty?
There are many risk factors associated with having a problem after a blepharoplasty. None of these are absolute contraindications to having a blepharoplasty but must be considered when discussing the risks and appropriateness of surgery. Dry eyes prior to a blepharoplasty can be worsened after surgery. A loose lower eyelid (not eyelid skin) that does not snap back after pulled away from the eyeball increases the risks of lower eyelid surgery. Scleral show (visible white eyeball between the lower lid and the color of the eyeball when looking straight forward) increases the risk of lower blepharoplasty. Bulging eyeballs (proptosis or exopthalmos) increases the risks associated with eyelid surgery. During your consult, a full examination will be performed and any risk factors will be discussed in order to help you determine what's best for you.
What procedure is most commonly performed with an upper blepharoplasty?
A mini temporal brow lift is the most common procedure performed with an upper blepahroplasty. The two procedure work hand-in-hand to achieve the best possible rejuvenation of the upper lids.
What causes bags under the eyes?
Bags under the eyes become visible when the fat compartments around the eyeball become relaxed allowing the fat to bulge out.
How is an upper blepharoplasty performed?
If upper eyelid surgery is performed in conjunction with a brow lift, the brow lift is performed first in order to get the brow to the appropriate position. This will clear some of the excess eyelid skin. Then, the remainder of the upper lid skin excess is determined. An ellipse of this skin is excised so that there is less redundancy after the skin edges are sutured together. Caution is exercised so as not to remove too much skin so that you can comfortably close your eyes after surgery.
What is the scarring like after an upper blepharoplasty?
The final scar is left hidden in the upper lid sulcus and extends out to the side of the lid within a natural skin crease. The scar is incredibly inconspicuous and fades from pink to white over several months. Most patients find that they are comfortable going out in public within a couple of weeks of surgery.
How is a lower blepharoplasty performed?
Depending upon your goals and anatomic needs, there are several variations of lower eyelid surgeries that may be appropriate for you. When there is some loose, excess, or wrinkled lower lid skin, Dr. Wolfe and Dr. Vath often favor performing a "pinch" blepharoplasty. This procedure entails removing an ellipse of lower eyelid skin with minimal tissue disruption in order to modestly tighten the eyelid and minimize the risks of surgery. If lower eyelid bulges are your problem, a transconjunctival blepharoplasty can be performed where some of the fat around the eyeball is removed through the inside of the eyelid. Often, people complain of both lower lid skin laxity and fatty bulges. In these situations, both a pinch and transconjunctival blepharoplasty can be performed.
What is the scarring like from a lower blepharoplasty?
The pinch blepharoplasty leaves an inconspicuous scar directly beneath the eyelashes. The scar fades from pink to white over several months but is hardly visible to anyone within a couple of weeks. A transconjunctival blepharoplasty does not leave any scarring on the skin because the procedure is performed through the inside of the lid.
What is a "pinch" blepharoplasty?
A pinch blepharoplasty is a lower eyelid procedure designed to reduce excess, lax, or wrinkled lower eyelid skin. This procedure minimizes tissue disruption within the lid. Therefore, it reduces the risks associated with lower eyelid surgery. The procedure is not designed to completely flatten or tighten the lower lid but to improve lid aesthetics by decreasing the laxity and wrinkling. At the Center for Cosmetic Surgery, Dr. Wolfe and Dr. Vath believe that the risks of aggressive lower eyelid surgery including lower eyelid malposition and a fake, tight look justify a conservative approach to this area of the face. The pinch blepharoplasty will provide a modest, natural improvement while minimizing risks to the smallest level.
What is a transconjunctival blepharoplasty?
A transconjunctival blepharoplasty is a procedure designed to reduce lower eyelid fatty bulges by removing some of the fat around the lower eyeball. This is performed via the inside of the eyelid through the conjunctiva and is extremely safe as this is the most direct approach to the fat pad compartments. This procedure is very effective in reducing the "bags" under your eyes while minimizing the risks of surgery by avoiding disruption of most of the eyelid. A transconjunctival blepharoplasty is often performed in conjunction with a pinch blepahroplasty when lax skin and fatty bags are both present.
Is there a lot of bruising after a blepharoplasty?
Because eyelid skin is very thin, bruising is likely after a blepharoplasty procedure. However, bruising does not correlate with pain and most patients have very little discomfort after eyelid surgery. Usually, bruising is minimal by 1 to 2 weeks and most patients feel comfortable being seen at this point.
Will I have an "operated" or "fake" look?
At the Center for Cosmetic Surgery, the goal of a blepharoplasty is to rejuvenate, not change your face. A blepharoplasty will take years off of your face and give you a more pleasant, awake look without overdoing it so no one will know you had surgery. You will look natural, not "operated" upon or "pulled" so that you simply appear and feel younger and less tired.
Is a blepharoplasty commonly performed with other procedures?
Yes. Eyelid surgery is very commonly performed at the same time as a mini temporal brow lift and a mini facelift in order to achieve a complete facial rejuvenation.
Will smoking affect my recovery?
Smoking adversely affects wound healing. The small vessels that supply blood to the tissues shrink up and prevent the necessary nutrients for healing to get to the wound. The incidence of having a wound complication such as an open wound or skin death is much higher in smokers. Furthermore, the rate of wound infection is also significantly increased in smokers for the same reason of limited blood flow. Because of this, a patient must stop smoking for a minimum of two weeks prior to surgery to decrease the risk of these complications.
Where is the surgery performed?
Eyelid surgery is most commonly performed in an office operating room setting or sometimes at the Denver West Surgery Center in Golden, Colorado, depending upon your anesthetic and post-operative needs. The Denver West Surgery Center is an accredited outpatient facility which provides an extremely safe surgical environment. Tenured board-certified anesthesiologists with hospital privileges provide anesthetic care.
What kind of anesthesia is used?
Either general anesthesia or IV sedation, depending upon your situation, is used to achieve sedation and pain control during a blepharoplasty. You will be asleep either way, and awaken comfortably in the recovery room. General anesthesia and IV sedation are extremely safe in healthy patients undergoing cosmetic surgery.
What is the recovery period?
After a blepharoplasty, you may recover comfortably at home or in a facility with nursing care. There will be some swelling and bruising which will peak at 3 to 5 days after surgery and then gradually subside over the following days to weeks. Generally, patients do not have much discomfort and are off of pain medication within a few days of surgery. Non-exertional work activity is permissible after a week. You must avoid straining, lifting, bending over, and any strenuous activity for a couple of weeks. At 3 weeks, low-impact exercise is permissible followed by unrestricted activity after 6 weeks.
The Center for Cosmetic Surgery has two offices conveniently located in the Denver metropolitan area. One is located just outside of Denver in lovely Golden, Colorado immediately off of I-70 and the other is located downtown in Cherry Creek, Denver. Please schedule a free personal consultation to learn what an eyelid lift can do for you. Simply call 1.877.255.2600 or request your free consultation online.
