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Cosmetic surgery for your eyes can lift your spirits and improve your appearance. Dr. McBride performs cosmetic eyelid surgery to correct problems associated with sun damage and aging. If your wrinkled, puffy eyelids make you look tired or older than you feel, or if your eyebrows are heavy and low over your eyes and make you look serious or angry, you will benefit from an eyelid lift to remove excess skin and/or a browlift to elevate the brows and lift the upper eyelid skin. The sagging skin in your upper eye lids can add years to your apparent age and even impair your vision.
Why Eyes Look Old and Tired
The lower eye lids get loose and stretch due to aging, and from elastic tissue damage caused by sun exposure. Bags under the eyes are caused by fat around the eyeball that pushes out on these loose lower lids. The eye lids stretch from the pressure of the fat and a bulge forms in the lid. As sunlight or room light shines down from above, a shadow is formed under the bulge. This dark shadow creates a tired, old look. The lower lids may also have loose, wrinkled skin as a result of heredity or sun damage. The wrinkles also make the lids look old and tired. When the two problems occur together, the lids look even worse. Most of the wrinkles around the eyes are etched into the skin and cannot be removed by a blepharoplasty procedure alone. Some additional skin wrinkle treatment, such as FotoFacial, laser resurfacing, chemical peel, or home skin care with tretinoin (Retin A) may need to be considered.
Low or droopy brows may make it impossible to obtain a significant improvement of upper eyelid appearance without first raising the brows with a brow lift. The blepharoplasty procedure by itself (without a brow lift) does not improve droopy eyebrows. In fact, removing excess upper eyelid skin in someone with low brows may cause the brows to droop further. Please see the section on Brow Lift to get more information about raising low brows.
Eyelid surgery is usually performed under intravenous sedation or a light general anesthetic. For upper eyelid rejuvenation, Dr. McBride uses radiosurgery to make tiny incisions along the natural lines of the upper eyelid. Excess skin, and occasionally protruding fat and excess muscle, is removed using a special laser which prevents almost all bruising. The lid is closed with dissolving sutures to minimize discomfort. The stitches are hidden in the natural crease when the eye is open. Mild swelling develops in the first few days, but bruising is usually minimal.
To remove protruding fat from the lower eyelid, Dr. McBride makes a fine incision inside the lower lid with a laser. The laser is used to remove the excess fat from the lid without any bleeding. There is usually no bruising after fat removal. The laser prevents almost all bleeding and bruising and results in less swelling than traditional techniques.
Loose skin may be removed from the lower lid at the same time. A fine incision is made just below the lower eyelashes. The loose skin is separated from the deeper tissues and the excess skin is removed. The laser is used to reduce bruising to a minimum. The muscle of the lower lid is not cut, thus speeding recovery. Dissolving sutures are used to close the incision. There is usually noticeable bruising of the lower lid when skin is removed, but not when just fat is removed. The skin heals extremely well in the lower lid, so a noticeable scar line almost never occurs.
RecoveryMost patients are back to their normal routines within a few days, although complete recovery may take a few weeks. Swelling, bruising and mild discomfort are part of the recovery process, and can usually be alleviated with cold compresses and appropriate medication.
Makeup may be applied to cover any bruising that may occur in the lower lid. Carefully avoid the suture line. Makeup applied to the suture line before the sutures are removed may permanently discolor the skin. Makeup should not be applied to the upper lid or lower lid suture line until two days after suture removal. Our esthetician will assist you with makeup application to help hide any bruising, and will give you guidance regarding skin care as you heal and thereafter.
Strenuous activity should be limited for a week after surgery to help prevent additional swelling that may occur if you raise your blood pressure substantially. All other activities can be undertaken as your bruises subside and you feel comfortable with your appearance.