Eyelid Surgery

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Eyelid Surgery
Your eyes are one of your most expressive facial features, but are they expressing sadness or fatigue rather than your inner vitality? Are your eyes making you look older than you feel? The aging process, heredity, skin type and environmental factors, such as sun damage, can cause the eyelids to sag and droop or become puffy and heavy, making you appear sad, tired or older than you feel. Eyelid surgery, also known as blepharoplasty, may be performed on the upper eyelids, the lower eyelids, or both. Depending on your specific needs, your surgeon may also suggest a brow lift to improve your upper eyelids.

Upper

Introduction
Your eyes are one of your most expressive facial features, but are they expressing sadness or fatigue rather than your inner vitality? Are your eyes making you look older than you feel? The aging process, heredity, skin type and environmental factors, such as sun damage, can cause the eyelids to sag and droop or become puffy and heavy, making you appear sad, tired or older than you feel. Eyelid surgery, also known as blepharoplasty, may be performed on the upper eyelids, the lower eyelids, or both. br/> Depending on your specific needs, your surgeon may also suggest a brow lift to improve your upper eyelids. This animation describes upper eyelid blepharoplasty, which can reduce the appearance of heavy and sagging upper eyelids.

What Causes Eyelids to Change?
layer of muscle is located just beneath the eyelid skin and is separated from fatty tissue by a thin tissue membrane, called the orbital septum. Muscle layers and the orbital septum weaken and sag with age, and fat deposits shift in response to weakened muscles, causing puffiness and drooping. In addition, changes occur in the skin itself. The collagen and elastin that provide support to the skin, break down over time, causing the skin to lose elasticity and become lax. Additionally, eyebrows may droop with age, causing the upper eyelids to sag.

How Upper Eyelid Surgery Works
Upper eyelid blepharoplasty typically involves removing or redistributing fat deposits, as well as removing excess skin and muscle to improve the contour of the upper eyes.







Preparation
The blepharoplasty procedure will most likely be performed under local anesthesia with sedation, in which the eyelids and surrounding areas are numb and you are relaxed but may not be asleep. Alternatively, you may be given general anesthesia, which causes you to sleep during the procedure. Incision guidelines may be drawn to ensure that the incisions follow the natural contours of the upper eyelid and the resulting scars will be as inconspicuous as possible.

Procedure
Your surgeon will make an incision in the fold of the upper eyelid and carefully remove a predetermined amount of excess skin.

In some instances a small strip of muscle will be removed as well. In order to gain access to the fat deposits, a small incision will be made in the orbital septum and your surgeon will reposition or remove a portion of the fat, which reduces the puffy appearance. To conclude the procedure, the incisions will be closed with absorbable or non-absorbable sutures and a lubricating ointment and small bandages may be applied to your eyelids.

Recovery and Results
You may experience some pain, bruising, and swelling after the procedure, and your physician will likely recommend cold compresses or pain medication to help make you as comfortable as possible.

You should avoid strenuous activity, such as heavy lifting or exercise, as recommended by your doctor, to allow your body sufficient time to heal. If absorbable sutures were used, they do not need to be removed and will dissolve on their own.

Any non-absorbable sutures are typically removed in about a week, and you will begin to notice an improvement in the bruising around your eyes. Upper eyelid surgery will not stop your eyes from aging, but the results are usually very long-lasting and will brighten your eyes to the rested, youthful appearance you desire.


Lower

Introduction
Are your eyes still one of the most striking features on your face? Do they convey your actual emotions and inner vitality, or do they make you appear fatigued, sad, or older than you feel? Eyelid surgery, also known as blepharoplasty, may be performed on the upper eyelids, the lower eyelids, or both. This animation describes lower eyelid blepharoplasty, which reduces the appearance of puffiness and bags underneath the eyes.

What Causes Eyelids to Change?
The skin on your lower eyelid is very thin, especially toward the center of your eye. A layer of muscle is located just beneath the eyelid skin and is separated from the fat by a thin tissue membrane, called the orbital septum. Muscle layers and the orbital septum weaken and sag with age and fat deposits shift in response to weakened tissues, causing puffiness and bags under the eyes. In addition, changes occur in the skin itself. The collagen and elastin that provide support to the skin break down over time, causing the skin to lose elasticity and become lax.


Procedure Variations

There are two variations of the procedure for removing or repositioning fat deposits from beneath the eyes: outside and inside lower eyelid surgery. For those who have excess skin beneath the eyes, the outside lower eyelift, also called transcutaneous lower blepharoplasty, is appropriate. This variation is performed with incisions on the outside of the lower eyelid and removes excess skin and sometimes muscle tissue in addition to fat deposits beneath the eyes. An inside lower eyelid lift, also called transconjunctival blepharoplasty, involves a single incision inside the eyelid in the thin membrane that lines the inside of the eyelid, called the conjunctiva. This procedure is appropriate for patients with fatty deposits and little or no excess skin in the lower eyelids.

Preparation
Lower eyelid surgery is most commonly performed under general anesthesia, which causes you to sleep during the procedure. Alternatively, you may be given local anesthesia with sedation, in which the eyelids and surrounding areas are numb and you are relaxed but may not be asleep. Protective, plastic shields, similar to contact lenses, may be applied to your eyes.



Outside Lower Eyelid Procedure
During an outside lower eyelid procedure, incision guidelines may be drawn just beneath the eyelashes of the lower eyelid to ensure that the resulting scar will be as inconspicuous as possible. Your surgeon will make an incision and expose the underlying muscle. Another small incision will be made in the muscle layer and the skin and muscle will be separated from the underlying orbital septum. Your surgeon will carefully open the orbital septum to expose the three orbital fat deposits of the lower eyelid. These fat deposits will be removed or repositioned to reduce puffiness under the eyes. Finally, excess skin and, if needed, small portions of muscle are removed from the outer eyelid to eliminate bags under the eyes, and the incisions are closed with either absorbable or non-absorbable sutures.

Inside Lower Eyelid Procedure
The inside lower eyelid procedure consists of an incision inside the lining of the lower eyelid. Your surgeon will gently pull the lower eyelid away from the eye and make a small incision in the conjunctiva, exposing the three orbital fat deposits. Each fat deposit will be removed to reduce puffiness under the eyes. Your surgeon may choose to close the incision with sutures, but sutures may not always be necessary.


Recovery and Results
You can expect to experience some pain, bruising, and swelling after the procedure, and your physician will likely recommend cold compresses or pain medication to help make you as comfortable as possible. You should avoid strenuous activity, such as heavy lifting or exercise, as recommended by your doctor, to allow your body sufficient time to heal. If absorbable sutures were used, they do not need to be removed and will dissolve on their own. Any non-absorbable sutures are typically removed in five to seven days, and you will begin to notice an improvement in the bruising around your eyes in seven to ten days. Lower eyelid surgery will not stop your eyes from aging, but will reduce puffiness and bags from beneath your eyes. The results are usually very long-lasting and will brighten your eyes to the rested, youthful appearance you desire.