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Facial Surgery :: Blepharoplasty
Blepharoplasty
Understanding Blepharoplasty
Blepharoplasty is a procedure to remove fat - usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids puffy bags below your eyes - features that make you look older and more tired than you feel and may even interfere with your vision. However, it won't remove crow's feet or other wrinkles, eliminate dark circles under your eyes, or lift sagging eyebrows. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift.

Blepharoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your idea, or cause other people to treat you differently. Before you decide to have surgery think carefully about your expectations and discuss them with your surgeon.

Is blepharoplasty for you?
The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.

A few medical conditions make blepharoplasty more risky. They include thyroid problems, dry eye, high blood pressure or other circulatory disorders, cardiovascular disease and diabetes. A detracted retina is also a reason for caution. You must discuss all of these with your personal specialist to determine whether blepharoplasty is an option for you to consider.

Your surgeon might recommend some other facial surgery procedures in conjunction with blepharoplasty to increase the success of the surgery.

Making the decision
Whether blepharoplasty is required for functional or cosmetic reasons your choice of a facial plastic surgeon is very important. The patient must ensure that he/she follows all the instructions of the surgeon.

The initial consultation with your surgeon is very important. The surgeon will need your complete medical history and he will also need to know if you have any allergies; if you are taking any vitamins, medications, and if you smoke. In this consultation, your surgeon will test your vision and assess your tear production. You should also provide any relevant information from your ophthalmologist or the record of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along. It is important to be open and honest with your surgeon which will establish the basis for a successful outcome.

You should carefully discuss your goals and expectations for this surgery with your surgeon. You will need to discuss whether to do all four eyelids or just the upper or lower ones, whether skin as well as fat will be removed and whether any additional procedures are appropriate. Don't hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.

Once a decision has been made by both you and your surgeon or he will explain the techniques and anesthesia that will be used. The surgeon will explain the type of facility where the surgery will be performed, the risks and the costs involved.

Understanding the surgery
Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.

In a typical procedure, the surgeons makes incisions following the natural lines of your eyelids, in the creases of your upper lids and just below the lashes in the lower lids. The incisions may extend into the crow's feet or laugh lines at the outer corners of your eyes. Working through this incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.

If you have a pocket of fat beneath your lower eyelids but don't 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.

After the surgery?
After surgery, your surgeon will probably lubricate your eyes with ointment and apply tiny sterile bandages. Your surgeon will instruct you to keep your head elevated for seven days, and to use cold compresses to reduce swelling and bruising. Your eyelids may feel tight and sore as the anesthesia wears off, but the discomfort can be controlled by the medication prescribed by your surgeon.

For a week and a half following blepharoplasty you will have to clean your eyes. Many doctors recommend eyedrops, since your eyelids may feel dry at first and your eye may burn or itch. For the first few weeks you may also experience excessive tearing, sensitivity to light and temporary changes in your eyesight, such as blurring and double vision. Your surgeon will follow your progress very closely for the first week or two. The stitches will be removed two days to a week after surgery. Once they're out, the swelling and discouloration around your eyes will gradually subside, and you'll start to feel and look much better. Self-absorbing stitches will dissolve on their own. You should be able to read and watch television after two to three days. However, you won't be able to wear contact lenses for about two weeks and even then they may feel uncomfortable for a while. Most people feel ready to go back to work in a week to 10 days. You may be sensitive to sunlight, wind and other irritants for several weeks so you should wear sunglasses and a special sunblock made for eyelids when you go out.

Your surgeon will probably tell you to keep your activities to a minimum for three to five days and to avoid strenuous activities for about three weeks.

Insurance does not generally cover surgery that is done purely for cosmetic reasons. Surgery to correct or improve vision or surgery for eye deformity or injury may be reimbursable in whole or part. The patient must check with the insurance company to find out the degree of coverage.

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