Blepharoplasty (Eyelids/Eyelid Lift)

Generally speaking, the eyes are the focal point of a beautiful face. During the normal aging process, the eyes may be the first region noticeably affected. This is due to the development of saggy unsupported fatty tissue which gives the eyes a bulging and unattractive appearance (puffy eyes). The upper or lower eyelids can be affected either alone or both sets simultaneously. These unfavorable features can be reversed with blepharoplasty and, once performed successfully, is relatively uncomplicated for the patient.

A careful examination in the office is critical in order to decide with the patient, which particular technique of the eyelid lift procedure is most appropriate. Blepharoplasty is one of the most successful procedures for rejuvenating the area around the eyes and it can enhance a youthful glow of one’s face. The recovery time for eyelid lift surgery is approximately one week and blepharoplasty is safely performed in an outpatient setting. For more information about, please read on below.

About Blepharoplasty

Blepharoplasty Eyelid Surgery
Originating from the Greek word Blepharon for eyelid, blepharoplasty or eyelid lift is a surgical procedure designed to enhance your eyelids and bring a more youthful, bright, and awake appearance to your eyes. During the cosmetic blepharoplasty, precise amounts of fat and skin are repositioned and removed for improved eyelid symmetry, definition and sculpture. The goal of a blepharoplasty is a natural improved look. The cosmetic eyelid lift may address the upper eyelids, the lower eyelids, or both, along with tightening of involved muscle structures.

Initial Consultation

During your visit, Dr. Fechner will thoroughly examine your face with its special characteristics as it pertains to aesthetics and function. In particular, he will focus on the region around the eyes. Important aspects to consider are the position of your eyebrows, extent of extra eyelid skin and fat, quality of lower eyelid skin and support of the lower eyelids themselves.

If the support structures of the lower eyelids are not adequate, a lid tightening procedure (a.k.a. canthoplasty or canthopexy) may be necessary. Also, existing eye conditions such as dry eyes and interference of the eyelids with your visual fields are of importance.

Eyelid lifts can be performed as separate procedures or in combination with other cosmetic facial procedures such as browlifts (either as part of the blepharoplasty or as a separate procedure), facelifts or skin resurfacing.

Before your procedure, you will receive specific and important instructions on how to best prepare for your procedure, what to expect and how to care for your eyelids afterwards.

Candidacy for a Cosmetic Eyelid Lift

The eyes represent the most prominent facial feature that every casual observer focuses on first. Also called the “window to one’s soul”, our impression of a person will be heavily influenced by the appearance of the eye region. It is the eyes themselves, the eyelids and their lashes, the brows and the animation of the eye region that suggests a person’s emotions and personality. Genetic family traits, age and harmful sun exposure all contribute to loss of eye tissue elasticity. This in turn leads to wrinkles, puffiness or “bags”, “festoons” of skin and dark circles around the eyes. These changes may cause alterations in our expression with an aged, tired or angry look.

With decreased spring of supporting eyelid tissues and descent of the midface, normal fat of the eye socket becomes visible and bothersome. Often, the upper eyelid crease becomes obscured by protruding skin and fat. In turn, eye make-up rarely is useful anymore. In patients with large amounts of excess upper eyelid skin, the eyelashes may become barely visible leading to an occasional visual impairment. Therefore, good candidates for blepharoplasty are women or men who have any one or more of the above mentioned characteristic.

Eyelid surgery will usually significantly improve these problems. Sometimes, additional treatments and procedures may be available for further enhancement. For example, sagging of the eyebrows may contribute to or worsen the appearance of loose upper eyelid skin and a browlift may be possible. Fine lines, wrinkles and crow’s feet can be improved by a skin resurfacing procedure such as a chemical peel.

About The Procedure

Blepharoplasty Eyelid ReconstructionDr. Fechner performs eyelid lifts routinely as an outpatient procedure in the office. Usually, relaxing medication is administered beforehand to help the patient be comfortable. Alternatively, the procedure can be performed under intravenous sedation (twilight sleep), usually only if the eyelid lift is combined with other facial cosmetic procedures. Dr. Fechner prefers to avoid general anesthesia (find out more about anesthesia).

Initially, Dr. Fechner will mark exactly the location of the planned incisions and measure precisely the amount of skin removal. In order to maximize cosmetic healing, Dr. Fechner places the incisions in the most inconspicuous location. After the eyelid skin has been numbed, skin, muscle and fat will be removed, lifted and repositioned for the most pleasing and natural eyelid appearance. Using these accurate procedures, bleeding is minimal even before little capillaries have been sealed leading to limited subsequent bruising and swelling. All incisions are then vigilantly closed with tiny sutures.

Excess fat in the lower eyelid may be removed through a small incision right underneath the eyelashes. One advantage is the ability for Dr. Fechner to remove some skin for a smoother, less wrinkly appearance. Most patients can benefit from a conservative reduction of extra skin in this region. Alternatively, the incision can be placed through the inside lining of the eye in rare cases where extra skin is not a concern. The Blepharoplasty procedure takes from one to two hours, depending upon the extent of the areas to be treated.

Blepharoplasty with An Internal Browlift

In some patients, a brow position that is too low contributes to the overall droopy appearance of the eyelids. In addition to the various browlift (LINK) techniques, Dr. Fechner performs a brow-release that can be achieved through the standard blepharoplasty incision. The patient’s candidacy for this advanced internal browlift can only be determined through a thorough examination during the consultation.

Advanced Techniques

In some patients, Dr. Fechner applies advanced blepharoplasty techniques, where the lower eyelid fat is not removed but repositioned in order to fill the under-eye depression that is responsible for the hollow appearance and dark eye circles. Dr. Fechner will discuss with you if the eyelid lift with fat repositioning is right for you.

Lower Eyelid Canthopexy and Canthoplasty

These procedures are sometimes performed in conjunction with a traditional lower eyelid lift. Canthoplastic techniques are useful to maintain support of the lower eyelids so that no droopiness occurs. If such droopiness pre-exists, canthoplasty may be used to correct and improve such a condition. It is usually reserved for patients with excessive laxity of the lower eyelid.

Eyelid Resurfacing (i.e., Chemical Peel etc.)

Eyelid resurfacing is a non-surgical procedure designed to improve the skin appearance around the eyes. It may be helpful to improve fine lines and wrinkles as well as sun and age spots. Dr. Fechner will discuss with you in detail if this procedure would be right for your specific concerns.

Risks of Blepharoplasty

Complications from cosmetic eyelid procedures are infrequent and most patients are pleased with the results. Possible but unlikely complications include: bleeding and swelling, delayed wound healing, infection, drooping of the upper or lower eyelid, asymmetry, double vision, dryness or irritation of the eyes and possibly further procedures. Dr. Fechner will discuss with you his experience as it pertains to blepharoplasty.

Recovery after Blepharoplasty

Already during and at the completion of the procedure, cold compresses will be applied to the eyelids. The patient will continue these measures for the first few days in order to further minimize bruising and swelling. The area surrounding the eyes may remain puffy and slightly discolored for a few days following the surgery. You should keep your head elevated above the level of the heart at all times for the first few days. There will be minimal or no pain after blepharoplasty, although you will be given pain medication prescriptions for use if needed. Occasional eye irritation is controlled with the use of eye drops and gels. Initially, your eyes may fatigue more easily while reading or watching television.

Most of the stitches used will dissolve over the first 7 days. Remaining sutures are painlessly removed at this point. Average swelling and bruising may persist for up to 10 days. Most women wear makeup after 7 days to conceal any residual discoloration. Most patients resume their work and social activities within a week to ten days. Dr. Fechner recommends postponing strenuous exercise 14 days after the eyelid procedure.

Appearance after Blepharoplasty

The improvement achieved by cosmetic eyelid surgery is often significant and can be expected to last for many years. Most patients describe that observers are aware of the improved look but are unable to point out how this enhancement happened. Although the aging process will continue, there will be less likelihood of experiencing the same concerns of puffy fat pockets and excess skin. Although secondary procedures are possible in later years to maintain the benefits, this is a fairly uncommon request. By correcting the problem areas around the eyes, you will achieve a more youthful, alert, and rested appearance as a result of cosmetic eyelid lift.

Blepharoplasty is one of the most successful procedures for rejuvenating the area around the eyes and enhancing a youthful glow of one’s face. The recovery time for eyelid lift surgery is approximately one week and blepharoplasty is safely performed in an outpatient setting. The surgery is performed in Worcester and patients frequently come from the Boston area and throughout Massachusetts.

For more information about some of the most common facial cosmetic procedures please follow the links below:

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Facial Cosmetic Surgery

* Results may vary by individual.