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Information, costs, and side effects
Basic
procedures and techniques
Anesthesia: General, local or sedation
Location: Hospital, surgical center or office
Surgery time: 1-3 hours
During the operation, the surgeon makes incisions above and below
the eye tissue. These incisions follow the natural folds of the
eye and allow the surgeon to separate the underlying fatty tissue
and muscle. The surgeon then removes the fat and excises the sagging
skin and muscle.
Upper Eyelid Blepharoplasty
Incisions are made in the natural skin crease of the upper eyelid.
Excess skin and fatty tissue is removed and the muscles and orbital
septum may be tightened to correct droopy eyelids. The incisions
are closed.
Lower Eyelid Blepharoplasty
Lower eyelid surgery removes fat deposits and tightens loose skin.
Incisions are made along the lower lash line and extends a little
beyond the eye. Excess fat, muscle and skin are excised and the
incision is closed. If your lower eyelids are loose, you may also
require a lid tightening procedure. This results in more swelling
and a longer recovery.
If you have fat pockets below your eyes, and do not have loose skin,
your surgeon may recommend a transconjunctival blepharoplasty.
Transconjunctival blepharoplasty
Transconjunctival blepharoplasty does not tighten the skin, it simply
removes excess fat. The incision is made inside your lower eyelid,
leaving no visible scar. Excess fat and muscle are removed and the
incision is closed.
The
average cost of eyelid surgery
Eyelid Surgery Cost Range: $1,500-$7,000
Average Total Cost
Upper and Lower Lids: $4,000
Surgeons fee: $2,500
Anesthesiologist: $700
Facility fee: $800
Lower Lids: $2,400
Surgeons fee: $1,600
Anesthesiologist: $400
Facility fee: $500
Upper Lids: $2,100
Surgeons fee: $1,200
Anesthesiologist: $400
Facility fee: $500
Initial
consultation
At the initial visit, your doctor will likely ask you to describe
in detail what you would like improved. Be specific about what you
would like done. If your surgeon fully understands your expectations,
they'll be able to determine whether your goals are realistic.
Your surgeon will assess your brow position as well as the extent
of excess skin, skin laxity and fat deposits to determine the technique
that will have the best results.
If you have high blood pressure, glaucoma, a detached retina or
dry eyes, you should also be evaluated by an ophthalmologist to
evaluate possible surgical difficulties.
Tell your doctor if you have any conditions such as:
- cardiovascular disease
- diabetes
- dry eyes
- hypertension or other circulatory disorders
- thyroid problems such as hypothyroidism
These conditions increase your risk for complications. You'll want
to discuss your medical history thoroughly with your physician before
you choose to undergo surgery.
Source: www.plasticsurgery.org
Recovery
Pain Level: Mild discomfort. 0-3 days of pain medication;
may not require medication
Swelling and bruising: skin removal only: 3-5 days;
skin & fat removal: 1-2 weeks
Stitches: if used, removed in 2 -5 days; no bandages
Work: Return after 5 days with makeup; After 2-3
weeks without makeup
Exercise: Wait 2-3 weeks
Sun protection: Six months with SPF 15 or higher
Final result: Seen after 1-2 months
Contact lenses may be worn in 1-2 weeks (glasses can be worn immediately)
Eye makeup can be work after 7 days
For faster recovery:
- Sleep with your head elevated for the first few days after surgery
- Place ice compresses on your eyes for 1-3 days
- Avoid activities that dry the eyes (reading, watching television,
wearing contacts, and using a computer)
- Avoid excessive blinking, which leads to increased swelling
- Wear sunglasses to protect your eyes from wind and sun irritation
- Avoid any activity that increases blood flow to the eyes (bending,
lifting, crying and exercise)
- Don't drink alcohol (can cause fluid retention and delay recovery)
Initial recovery takes anywhere from two weeks to one month, and the
complete healing process takes up to six months as scars fade to thin
white lines.
After surgery your eyes may feel tight, with minor discomfort that
lasts for a day or two. Your eyes will be swollen and bruised. Your
head will be kept elevated and cold compresses applied to reduce
swelling and bruising. Your blood pressure will be monitored to
avoid bleeding complications. Your eyes will be lubricated, which
may blur your vision.
The incisions may be red and bumpy initially and will gradually
flatten and fade. The swelling and bruising should disappear within
1-2 weeks depending on the extent of your surgery. During recovery,
your eyes may be sensitive to light and your vision may be blurry
the first few days. Your eyes may also experience, burning, itching,
tearing or dryness. Your doctor will likely dispense eyedrops to
alleviate any discomfort.
Wear sunglasses home. At home, keep your head elevated and take
it easy. Apply light ice packs (try frozen peas in a plastic bag)
over your eyes continuously for the first 48 hours.
The eyelids may become swollen and stuck together. If this occurs,
clean the eyelashes carefully with warm water on a Q-tip. Some oozing
from the incision lines and crusting along the eyelashes is normal.
However, if you have increased bleeding or decreased vision, call
your physician immediately.
Be sure to follow your doctor's advice carefully and go to all post-op
visits.
Dr. Mark Gorney, a board-certified plastic surgeon in Napa, CA,
wrote an article in the Aesthetic Surgery Journal that contained
important information about preventing vision loss in the early
post-operative period:
"In a survey of 5 consecutive cases of blindness after blepharoplasty,
it was discovered that the only factor all patients had in common
was that they were discharged very shortly after the termination
of outpatient surgery. On arrival at home, all 5 patients did something
to generate a sudden rise in blood pressure at the time of maximal
reactive hyperemia as the epinephrine in the local anesthetic wore
off, such as a constipated bowel movement, sudden coughing fit,
or bending over and reaching down to tie a shoelace. It is imperative
that all patients undergoing outpatient surgery involving undermining
of heavily vascularized tissues be warned in writing not to perform
any maneuvers that will generate a sudden rise in blood pressure.
It is strongly recommended that no patient be discharged from an
outpatient surgical facility until at least 3 hours after the last
epinephrine-containing local injection and until there is evidence
that all local anesthetic effects have worn off."
Risks
and complications
Complications of eyelid surgery, while rare, can cause prolonged
healing, change in or loss of vision, unpleasant-appearing and painful
scars, the inconvenience and cost of further surgery, and the possibility
of requiring eye drops or ointment, temporarily or permanenetly.
Blindness: The risk of permanent blindness is
less than 1 out of 10,000. Vision loss is usually related to bleeding
following eyelid fat removal.
Blurred vision: This is a temporary condition
that occurs in less than 1% of surgeries.
Corneal abrasion
This condition is temporary and is easily treated by patching the
eye for 1-3 days.
Double vision: This condition is temporary and
occurs in less than 1% of surgeries.
Difficulty closing eyes: This condition is usually
temporary in rare cases. In rare cases, corrective surgery is required.
Dry eye syndrome: Dry eye syndrome is potentially
dangerous. In rare cases it leads to damage to the cornea of the
eye and vision loss.
Inability to close eyes: This condition is usually
temporary. In rare cases, corrective surgery is required.
Milia: Tiny skin cysts can form on the scar line.
This is normally temporary, but in some cases requires surgical
removal.
Retrobulbar hematoma: A rare complication in which
a pocket of blood forms behind the eyeball.
Scars
Surgical scars are permanent. However, the incisions are
placed so that they are not normally noticeable except on very close
observation. The scars run in the natural contours of the skin below
the eye and in the upper eyelid. If only fat is removed, the incision
may be inside the lower eyelid along the lower lash line, which
is completely hidden. The scars should be almost invisible in 2
weeks.
For more information, view eyelid
surgery before and after photos.
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