For a Rejuvenated, Youthful Appearance

Eyelid Surgery Scottsdale, Arizona

Sagging eyelid skin and fatty tissue fullness can create a look of fatigue that often leads to others saying, “You look tired.” This is especially bothersome when you’ve had a good night’s sleep and don’t feel fatigued. Although most often associated with aging, fatty tissue fullness of the lower lids can even present as early as your twenties due to hereditary factors. Eyelid surgery, known clinically as blepharoplasty, is designed to remove the excess skin and puffiness for a rejuvenated, youthful appearance. To learn more about eyelid surgery, contact Dr. Pamela Henderson in Scottsdale, Arizona, today.

The Eyelid Surgery Consultation

During the consultation, the brows are examined to determine the extent to which they contribute to the appearance of hooding of the upper lids. If necessary, the brow is then gently manually lifted to the desired level, and the extent of residual skin laxity of the upper lids is assessed. If present, fatty tissue puffiness may be noted near the inner corner of the upper lid. The lower lid is examined for skin laxity and puffiness as well as hollowness along the rim of the orbital bone corresponding to the border of the eye socket located at the top of the cheek. The lid is also examined for tone by gently pulling the lower lid away from the eye and assessing the distance of distraction away from the lid as well as the speed that it snaps back into place once released. In patients with poor lower lid tone, the lid may not snap back into place without blinking. This is important to identify since it may dictate the surgical approach.

Because eyelid surgery does not address superficial wrinkles, additional treatment with either laser or chemical peels may be desired. In addition, assessment of the position of the brows is important since drooping of the brows often accompanies the aging changes of the eyelids, and a brow lift may be necessary to achieve the desired result.

Preparing for Surgery

Once the decision is made to proceed with eyelid surgery, patients are scheduled for a preoperative appointment approximately two weeks prior to the surgical date. During that appointment, patients are given preoperative instructions and consent forms are reviewed. These instructions generally include avoiding medications that increase the risk of bleeding including herbs, vitamin E, aspirin, and NSAIDS such as ibuprofen, as well as taking supplements to reduce swelling and bruising.

Anesthesia

In most cases, eyelid surgery is performed using IV sedation often referred to as “twilight anesthesia.” In cases where only the upper lid surgery is performed, local anesthesia alone or combined with an oral or intramuscular medication for relaxation can be utilized. For either local or IV sedation procedures, the surgery is performed in our accredited in-office surgical suite as an outpatient procedure.

The Eyelid Surgery Procedure

Prior to entering the operating room, the patient’s upper lids are marked indicting the amount of skin that can be safely removed while maintaining complete eye closure. For upper eyelid surgery, the incision is made in the natural upper lid crease with extension slightly beyond the corner of the eye but not beyond the tail of the brow in a natural wrinkle. The excess skin and a strip of underlying muscle are removed. If prominent fat is noted in the inner corner of the lid, this is gently exposed and removed to improve the contour of the lid. The incision is then closed with fine sutures, some of which are dissolvable.

For the lower lids, the most common technique is an external pinch procedure to remove the excess skin using an incision just below the lash line combined with an inner lid incision known as the transconjuctival approach for addressing the fatty tissue fullness and hollowing. This combination avoids transecting the muscle in the lower lid which is important for structural support of the lid and as a result decreases the potential risk of pulling down of the lower lid and changing the shape of the eye. In the past, the standard eyelid surgery technique involved removing the fat, and while this reduced the puffiness, it did not create a more youthful appearance but instead resulted in more hollowing. Instead, the goal through the internal lid incision is to expose the fatty tissue fullness which allows for release of the fat to be repositioned into the pre-existing hollowing along the bony rim. By repositioning the fat rather than removing it, the risk of creating more hollowing is avoided. Generally, the fat in the mid and central lower lid may be repositioned whereas that in the outer portion is often removed due to difficulty in using it for re-contouring. In eyelid surgery patients with poor lid tone, a lid tightening procedure may be necessary and in those cases, an external approach alone using a skin muscle flap is chosen.

After Surgery

Following eyelid surgery, it is recommended that cool compresses be applied to the eyelids for 24 hours to reduce swelling. An ophthalmic antibiotic ointment is prescribed to reduce crusting and help dissolve the sutures. Strenuous activities should be avoided for approximately two to three weeks. Swelling and bruising gradually resolve over one to two weeks and final results are seen at approximately six to eight weeks.

Risks

Although uncommon in association with eyelid surgery, complications can occur with any surgery. These include but are not limited to bleeding, hematoma, infection, asymmetry, numbness, lower lid retraction, ectropion (pulling of the lower lid away from the eye), abnormal scarring, and inability to close the eye with possible complications related to exposure of the cornea.

Learn More about Eyelid Surgery

Blepharoplasty creates a well-rested, youthful, and rejuvenated facial appearance. If you are considering eyelid surgery, contact Dr. Henderson in Scottsdale, Arizona to arrange a personal consultation.