The eyes are the first thing you see when you meet someone. If your eyes look tired, puffy, or droopy, this gives people the wrong impression. You may look tired, even though you feel great. Dr. Hunts is an oculofacial plastic surgeon, specializing in plastic and cosmetic surgery of the eyelids and face. By using his advanced surgical skills and artistic talent, Dr. Hunts can restore your eyelids to their more youthful and natural appearance.
Before/after gallery: Upper/lower eyelids
At the beginning of the procedure, the upper eyelids are marked in the natural crease. Local anesthetic is then used in a gentle manner (minimal discomfort), leading to a pain free experience. The upper eyelids are then sculpted by removing/shaping the skin, muscle, and fat. This helps to create a more youthful, open, and symmetric appearance. The procedure lasts less than one hour and can be performed with local anesthetic only, or in combination with IV sedation. People can typically return to normal activity within a few days to a week. Sutures are easily removed at the one week follow-up visit.
Cosmetic surgery of the lower eyelids can easily be done at the same time as surgery of the upper eyelids. After having upper eyelid surgery, consider combining your surgery with a BOTOX® or Dysport™ treatment to help maintain the youthful eyelid appearance (see Injectables).
When the upper eyelid skin has significant redundancy, this can negatively impact vision, creating a medical condition often covered by insurance.
Before/after gallery: Upper eyelids
Prior to your surgery, Dr. Hunts determines the best surgical approach to rejuvenating your lower eyelids. This may be a transconjunctival approach (no skin incision) or a subciliary incision, just beneath the eyelashes. The specific approach taken is based on the shape of your eyelids. A customized plan is developed by you and Dr. Hunts at your consultation. The lower eyelids are then injected with local anesthetic, either with or without IV sedation. The procedure last less than one hour, with the ability to return to normal activity within one to two weeks.
Before/after gallery: Lower eyelids
Recovery from eyelid surgery
There are no bandages or patches following surgery, and discomfort is minimal. Icing the eye area is important for the first 24-36 hours after surgery to keep bruising and swelling to a minimum. Frozen peas layered over a cool wet washcloth or gauze is effective and recommended as much as possible the first two days.
Maximum bruising and swelling will occur during the first three days. In most cases bruising will last one week, with some individuals, residual bruising may last up to 3 weeks. Keeping the head elevated at night will help with swelling. It is also common to heal differently on each side.
The incisions may ooze slightly for the first few hours following surgery. A drop of blood from the incision site every now and then is common.
As eyelids swell, it may appear as if the incision is pulling apart. This small separation of skin is not unusual, and you do not need to be alarmed. Your eyes may feel "tight" and burn slightly, this is normal. Some blurring of vision and/or dryness of your eyes is not uncommon the first few days following surgery.
Dry eyes may be treated with artificial tears during the day and a lubricating ointment at night for one to three weeks. When the sutures are removed, patients may wear makeup and resume near normal physical activity. Incisions are slightly pink and the eyelids may feel numb for weeks to months.
Surgery of the upper and lower eyelids is commonly performed at the same time with only one recovery period. This leads to a more youthful appearance of both upper and lower eyelids together. This can easily be performed under local anesthetic, with or without IV sedation.
Before/after gallery: Upper/lower eyelids
The Asian eyelid has subtle differences in its shape and anatomical structure. Understanding these differences is critical to achieve successful results. With Dr. Hunts' advanced training in eyelid surgery, he is able to give a natural and more youthful appearance to the Asian eyelid, both upper and lower.
Before/after gallery: Asian eyelids
Hyaluronic acid (HA) fillers can be used to give a nonsurgical in-office alternative to surgical blepharoplasty. By using the smooth quality of HA fillers along with Dr. Hunts' significant experience and artistic skills, a natural and youthful appearing eyelid can be achieved. This HA blepharoplasty procedure is performed in the office with topical anesthetic and little to no discomfort. The results last for several years! See RESTYLANE® and Juvéderm™ for more information.
Before/after gallery: Fillers/HA blepharoplasty
An acquired or congenital condition, causing drooping of the eyelid margin (the part of the eyelid touching the eye). Ptosis is often associated with a reduction of the visual field and is therefore considered a functional or medical condition. The surgical correction of ptosis usually takes less than 30 minutes using local anesthetic, with or without IV sedation. Recovery is usually quick with minimal postoperative discomfort.
Before/after gallery: Ptosis
Retraction, or widening of the upper and/or lower eyelids, is most often associated with thyroid eye disease or previous eyelid surgery. Eyelid retraction often leads to eye irritation, tearing, and discomfort. This is considered a medical condition. Surgical repair of eyelid retraction is usually performed with local anesthetic and IV sedation. The goal of this surgery is to restore the widened eyelid to normal, and in turn, lead to more normal function and comfort for the eye. For complex cases, skin grafts or internal spacers maybe required.
Ectropion is the medical condition associated with a rolling out of the lower eyelid (occasional upper), causing irritation and tearing. This condition is most often due to laxity of the lower eyelid support structure and tendon. Ectropion is repaired in less than 30 minutes with local anesthetic and IV sedation, using sutures that dissolve. Recovery is usually just a few days, with minimal discomfort after the surgery.
Entropion is the medical condition associated with a rolling in of the lower eyelid (occasional upper), causing irritation and tearing. This condition is most often due to laxity of the lower eyelid support structure and tendon. Entropion is repaired in less than 30 minutes with local anesthetic and IV sedation, using sutures that dissolve. Recovery is usually just a few days with minimal discomfort after the surgery.
Skin cancer does occur on the eyelids, requiring the precise excision and reconstruction of the affected eyelid. Dr. Hunts, uses the method of "frozen section control", to clear the cancer. This is done with the assistance of a pathology consultant, and has a success rate similar to Mohs surgery. Once the skin cancer is cleared, the eyelid is reconstructed. This procedure is usually performed under local anesthetic with IV sedation.
Will I be black and blue?
Though the extent to which people show bruising varies, everyone shows discoloration to some degree. Bruising and swelling will reach a peak approximately 12 to 24 hours after surgery. The discoloration generally lasts about 3 to 12 days. Cold packs should be used on and off for 48 hours after surgery to control swelling and bruising. Expect to sleep with your head elevated on several pillows to minimize the swelling.
What can I do after surgery? When?
We would like you to have bed rest for the first 24 hours after surgery. Then you must continue to take it easy at home for the next few days. It is a good idea to slow down for a week after surgery as excessive activity will cause swelling. Stitches will be removed 5 to 7 days following surgery and a little concealer may carefully be used 48 hours after stitches are removed.
How long do the results last?
Eyelid surgery is quite long lasting. You never lose the improvement you have gained, but the process of aging continues. Some individuals may require additional tightening of their eyelids in the years to come.
What about cosmetics and eyelid surgery?
Many women decide to have blepharoplasty when they realize that their eyelids have drooped so much that it is difficult to apply make-up to the upper eyelids. The make-up tends to get lost in folds of skin. The blepharoplasty will redefine and improve the natural folds of your upper eyelids. You may resume wearing make-up once sutures have been removed.
I wear contact lenses. Can I have a blepharoplasty?
For a few days after surgery, it is a good idea to wear glasses instead of your contact lenses. Afterwards, you can resume their normal daily use. Some types of contact lenses may require a slightly longer time to resume normal wear.
Will my health insurance pay for eyelid surgery?
If the droop of your upper eyelids reduces your vision, generally, insurance companies will pay for the upper eyelid surgery. An examination by an ophthalmologist is required to document visual field impairment caused by upper eyelid laxness. Your health insurance does not pay for the lower eyelid surgery.
Are there any risks to blepharoplasty?
As with any surgical procedure, there are risks. Bleeding, infection and scarring may occur. It is important that your caregiver stay with you the first 24 hours after surgery. It is not uncommon to have a sense of irritation for a few weeks after the surgery. Loss of vision, though extremely rare, has been known to occur. This information is given not to frighten you but to help you make an informed decision. Though eyelid surgery is generally a very safe procedure, it should not be taken lightly.
Is blepharoplasty right for me?
This is a question only you can answer. At your personal consultation, speak frankly, ask questions and explain your expectations. We will work together to help you make the decision that is right for you.
Learn More About Eyelid Lift:
- See before & after photos of Eyelid Surgery.
- Contact our office for more Eyelid surgery information or a consultation.