Eyelid surgery, known as blepharoplasty, is a corrective procedure that can reduce dark circles or “bags” under the eyes, remove excess wrinkles, and provide a more youthful appearance to the eyes.
One of the first things noticed about a person is their eyes. During the aging process, wrinkles, lines, and puffiness contribute to a tired or aged appearance. Dr. Gregory has performed thousands of blepharoplasties on numerous happy patients in Orlando and Celebration, FL.
Reasons for Considering Eyelid Surgery:
- Dark circles or bags under the eyes.
- Excessive skin or wrinkles surrounding the eyelids.
- A tired appearance or puffiness due to inherited factors.
How is Eyelid Surgery performed?
Blepharoplasty includes tiny incisions made in the natural contours around the eyes which should leave no visible scarring. Dr. Gregory will usually work on the upper eyelids first to remove any fatty tissue and tighten loose skin. Lower eyelids are completed next to eliminate puffiness and reduce dark circles. In some instances, Dr. Gregory will use laser technology to smooth lower eyelid areas. Additionally, Botox or Dysport may be used to firm fine lines and wrinkles.
Eyelid surgery generally takes about one to three hours and is performed in our accredited surgical facility within Celebration Health- a Florida Hospital. The blepharoplasty surgery is often performed in conjunction with other facial procedures such as a face lift or rhinoplasty (nose surgery). If additional cosmetic procedures are being performed, the eyelid surgery could last longer.
Normally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and reduce the recovery time. Patients sometimes report minor pain associated with surgery which can be treated with oral medication. While complications are rare, patients can minimize the risk for potential problems by carefully following the post-operative directions given after the surgery. The healing process for this procedure is slightly longer than most other forms of cosmetic surgery; however, the benefits are long-lasting. Our nurses provide each patient with detailed instruction on post-operative care to ensure a speedy recovery. Patients will have a more rested and youthful appearance.
Eyelids: Anatomy, Function, and Treatment by Richard O. Gregory, M.D.
Eyelids have a special role in the patient and our plastic surgery practice. While sagging cheeks and neck can have a distressing effect on the patient, drooping eyelids also create a functional as well as cosmetic problem. In addition to aging, inherited anatomy can significantly change the eyelids. We inherit the shape of our faces to a large extent. For instance, eyes can be shallow or deep, and have bony support that is sometimes insufficient. In addition, functional changes in anatomy can occur with aging.
A person who has inherited shallow eyes with minimal bony support in the brow or cheek area is more prone to develop functional problems. Aging causes drooping of the brow which should be considered separate but contributory towards fullness of the upper eyelid. Brow droop or ptosis may require a separate treatment. In addition, sagging of the lower eyelid can be problematic. The lower eyelid is like a hammock strung between two ropes. A small cartilage plate called the tarsal plate stiffens the upper and lower eyelid margin. Tendons at the nasal side and lateral side stiffen and support the eyelid. As we age, the tendons stretch and allow the eyelid to sag, e.g. the hammock sags as the ropes stretch. Other factors, including a lack of bony support, can add to the problem. Sagging eyelids then contribute to a functional lack of protection and dry eye. Decreasing tear production with age also contributes to this dry eye problem. Dry eye can be treated in some patients with drops but also may require more extensive treatment, even surgery.
As the brow sags it contributes to excess skin and bunching of the upper eyelids. Although not correcting the sagging brow, a simple skin excision of the upper eyelid sometimes is sufficient to help the fullness. In other circumstances Botox treatment of the brow or surgical treatment such as a brow lift can improve the upper eyelid. It has been said that while 75% of the cover for the eyeball is performed by the upper lid, the lower lid contributes 75% of the function in terms of protection, tear film, et cetera. As mentioned above, medical treatment may improve this but surgery may be necessary.
The eyelid anatomy is an important factor. As the lower eyelid sags with age the shape of the palpebral opening (exposed portion of the eyeball) will change. A lower eyelid which sags laterally fails to distribute the tear film and may even pull away from contact with the eyeball creating a situation known as ectropion, or scleral show. Patients may even complain of excessive tearing as well as dry eye, a conundrum created by dryness stimulating more tear production but poor drainage allows the tears to gather and drain laterally onto the cheek.
Appearance of the lower eyelid is frequently attributable to other nonfunctional factors. For instance, herniated fat or bags in the lower eyelids is due to a loss of support from the membrane holding the fat in the eye socket. In many instances this fat can be removed, perhaps without a scar showing. In addition, the tear trough or groove in the lower lid is created by attachment of the eyelid muscle to the bony ridge at the lower part of the orbit. It is possible to correct this with fillers or surgery.
Surgery is frequently needed to improve both the appearance as well as the function of the eyelids. This should be considered on an individual basis with a surgeon knowledgeable about eyelid function and anatomy. Temporary swelling causing exposure and dryness of the eye is common following surgery and usually corrects itself with time. Head elevation, ice packs and other means are used to reduce this. A risk of long-term exposure and perhaps need for additional surgery can be caused by excessive tissue removal. For this reason I am prone to use lasers to shrink the lower eyelid skin without skin removal.