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Eyelid Plastic Surgery (Blepharoplasty)

The blepharoplasty (eyelid plastic surgery) operation is performed to rejuvenate the appearance of the eyelids. Blepharoplasty is one of the most common operations performed by plastic surgeons today. The vast majority of blepharoplasties are performed on an outpatient basis, usually in a freestanding ambulatory surgery facility.

There are several options of the procedure that are available. The choice depends on the age of the patient, the amount of fat in the upper and lower eyelids, and the general elasticity and tone of the lower eyelid.

Age of the Patient: The eyelid procedure is routinely performed on patients from their late adolescence through patients in their seventies. Obviously, the nature of each procedure varies widely depending on the age and needs of the individual patient.

Anesthesia: Blepharoplasty is almost always performed under intravenous sedation anesthesia supplemented with local anesthesia. Of course, as in all of our surgeries, the patient is continuously monitored by a board certified anesthesiologist. The patient is drowsy, pain-free, and unaware of the procedure that is being performed.

Convalescence: This procedure is usually characterized by patients having minimal discomfort in the postoperative period. However, the patient will look worse than he or she feels due to the bruising that usually accompanies blepharoplasty. Bruising (eccymosis) is mostly gone after 7 to 10 days. Sutures, if present, are removed by the fourth or fifth day. Patients can go out and do normal activities on the first day, but usually wear sunglasses to disguise their bruising.

Swelling usually lasts up to three weeks, and the final result is obtained by two months. Scars are placed in inconspicuous areas that are most difficult to see on the upper lid. On the lower eyelid, if a transconjunctival blepharoplasty is not performed, the scar is placed right below the eyelashes which is most difficult to see.

Complications: Dr. Sherman will discuss all potential complications, and the relative frequency (or infrequency) of their occurrences. This may include bleeding, dry eye, and swelling.

Variations of the Operation:

• Laser or Transconjunctival Blepharoplasty: Dr. Sherman has performed hundreds of these operations over the past 30 years, and was featured in an article describing this procedure in Elle magazine. This procedure is ideal for the younger patients, in their early adolescence through their early forties who have inherited a family tendency for puffy upper and lower eyelids. It is this fat that causes the puffiness, and is unrelated to dietary fat, and is unresponsive to dieting. A very thin patient may have this as well as one who is heavier.
  
  In the younger patient, the beauty of this operation is that the incision is made inside the eyelid, avoiding any type of scar, and teasing the fat out of the lower eyelid. Because of the elasticity in the younger patient, the skin drapes nicely, avoiding the need for skin adjustment. If a small amount of skin must be tightened, a laser or peel may be performed simultaneously.
  
  In laser blepharoplasty, the laser is used to make an incision in the conjunctiva of the lower eyelid (the pink area inside the eyelid). The fat is then removed. Skin may be tightened with the use of the laser, and bruising is minimal.
  
  This procedure is performed in the office, and takes less than one hour if all four eyelids are corrected. In the lower eyelid, if this is performed alone, it often takes less than 30 minutes. Most of our patients are back to work within a week, without the use and need for any suturing.
  
• Laser Resurfacing of the Eyelids: This procedure has the advantage of resurfacing the eyelids to provide a younger fresher look, and to minimize the finer wrinkling that is often present with aging and/or sun damage. This procedure is also performed as an outpatient.
  
  
• Lower Eyelid Resuspension or Canthopexy: Occasionally the lower eyelid may need to be repositioned. This is due to aging and poor tone. The patient often notices that too much sclera (white of the eye) shows below the iris (the colored part of the eye). This procedure restores the natural shape and the tension of the lower eyelid; it is usually performed in conjunction with the lower eyelid blepharoplasty on older patients if needed.

To set up a private consultation with Dr. Sherman, contact us today. Call us at (212) 535-2300 or e-mail us.