Blepharoplasty (Eyelid) Surgery
Blepharoplasty is performed to correct sagging eyelids, bags beneath the eyes, and redundant skin folds. This procedure involves the removal of excess skin and fat of the upper and/or lower eyelids and is often performed in conjunction with other cosmetic procedures including facelifts, brow/forehead lifts and even dental implants. Blepharoplasty is performed in our office surgical suite, normally with intravenous (IV) sedation. Pre-medication is utilized prior to surgery in order to decrease swelling and bruising after the operation.
Dr. Spanganberg will trace the natural lines and creases of your eyelid and make very fine incisions from the inner to the outer edge of the eyelid. Surgery of the upper eyelid is performed with the incision hidden in the fold of the lid. The incision is made below the eyelashes of the lower eyelid and excess fat and skin are removed in both. The amount of fat removed is determined by the degree of protrusion of fat prior to surgery. Small sutures are used to close the incision and special ointments and dressings are applied. The surgery can take up to 2 hours. In certain cases, lower eyelid incisions are made inside the lid. In this case, a laser may be used at the same time to reduce wrinkles. The decision of where to place the lower eyelid incision is made based on patient age, amount of excess skin and fat and elasticity of the skin.
Before Blepharoplasty (Eyelid) Surgery
Preoperative Instructions for Patients Undergoing Intravenous (IV) Anesthesia
- The patient may not have anything to eat or drink (including water) for six (6) hours prior to the appointment except to take your normal medication or medication prescribed by our office.
- A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home after the procedure.
- The patient should not drive a vehicle for 24 hours following anesthesia or for 4 hours after taking narcotic pain medication.
Wear loose fitting clothing with short-sleeved shirts or sleeves that can be rolled up past the elbow. Contact lenses, jewelry and dentures should be removed before the time of surgery.
After Blepharoplasty (Eyelid) Surgery
Initially, dry eyes can occur after blepharoplasty as the lids may not close completely because of swelling during the initial post-operative period. You will be instructed to place lubricating eye-drops after surgery until the swelling subsides. In addition, you may be sensitive to bright light and wind for a period of time. Numbness and itching may also occur during the healing process. Final healing takes up to 6 months.
- Positioning: For the first week it is best to keep your head elevated. This minimizes swelling and bruising. When you return home from surgery, sit in a recliner with your head elevated, with ice packs on your eyes (20 minutes on, and 20 minutes off). Crushed ice in a “baggie” or frozen peas work well. Ice is helpful up to 36 hours after surgery. It is not necessary to stay up all night changing packs. When sleeping, keep your head elevated above the level of your heart. You do not need to sleep upright. Extra pillows under you head, or a blanket or two under the mattress work well.
- Cleaning: Beginning the night of surgery, clean the eyelid incisions 2 to 3 times per day. Dab the incision and stitches gently with a Q-tip soaked in 3% Hydrogen Peroxide if dried blood is present. Then clean incision and stitches with a dry Q-tip and liquid soap. Next, gently wipe the incision and stitches with water, and place a light coat of antibiotic or A&D ointment. (If there is no dried blood, use only soap and water to cleanse. Peroxide used repeatedly, dries the skin, and if used regularly, may slow healing).
- Swelling/Bruising: Swelling and bruising are normal body responses to surgery. Swelling usually peaks the second or third day after surgery, and then decreases. Most of the swelling is gone in 2 weeks, but the remainder takes months to completely resolve. Bruising can last from 7-14 days. Taking the prescribed medications and following these instructions, will help minimize swelling and bruising.
- Nutrition: Good nutrition is very important in optimizing healing after surgery. Make sure you eat a balance diet.
- Exercise: Light exercise, such as evening walks, can begin the day following surgery. Do not lift heavy objects, bend over, or return to strenuous activity until instructed by Dr. Spanganberg or staff. On average, moderated exercise begins in 7-10 days, and vigorous exercise 3-4 weeks after surgery.
- Medication: If you are able to take Ibuprofen, take over-the counter Ibuprofen (Advil, Motrin) 200mg tablets, 3 tablets (600mg), 4 times per day, for 3 days after surgery. Do not drive for 4 hours after taking narcotic pain medication.
Your insurance company may pay for part of the cost of surgery if the procedure is performed as a result of visual impairment. Because every insurance carrier is different, it is recommended that you check with your own insurance company to determine the level of coverage.