- Jean-Paul Abboud, M.D., Ph.D.
10 things you need to know before considering cosmetic upper eyelid blepharoplasty
Updated: Dec 7, 2019
1. What is cosmetic upper eyelid blepharoplasty and what do you mean by "customized" blepharoplasty? Blepharoplasty is one of the most commonly performed facial procedure worldwide and the most common procedure Dr. Abboud performs. Cosmetic upper eyelid blepharoplasty involves the surgical removal of redundant eyelid skin and, if necessary, the removal and/or contouring of the fat around the eyes. It aims to rejuvenate the area surrounding the eyes and to render an overall more youthful and rested appearance to the face.
Since no two sets of eyes are the same, no two blepharoplasty surgeries should be the same either. A customized blepharoplasty tailored to each patient's aesthetic desires and unique features is necessary to achieve the best cosmetic results. It requires that the surgeon have a keen artistic understanding of what a beautiful eye looks like, a consideration for ethnic and gender differences, expert knowledge of eyelid architecture and function, and the advanced surgical skills to remove, reposition, and/or tighten the eyelid fat, skin, and musculature. An expert eyelid surgeon (i.e., one with extensive training in oculoplastic surgery), must additionally have the foresight to recognize when to preserve and/or reposition fat, when and where to refashion an eyelid crease, and when to combine a blepharoplasty with other procedures, such as a brow lift, lower eyelid blepharoplasty, canthoplasty (tightening of the outer corner of the eyelids), and eyelid ptosis repair (eyelid lift) to achieve the desired post-operative result.
2. What results should I expect and when will I see them? While results do vary, you should expect to see brighter, tighter, and more open eyes after cosmetic upper eyelid blepharoplasty. The results can be subtle but impactful. You should look natural, yet more alert and rested, more youthful, and more vibrant.
You should notice a difference in your eyelids immediately following your surgery. However, post-surgical swelling and discoloration may initially obscure your final outcome. While many patients return to work 1 to 2 weeks after blepharoplasty, it may take several weeks for your swelling to subside completely. You should be able to see your final results from cosmetic eyelid surgery in about 4 to 6 weeks following your surgery.
3. What does cosmetic upper eyelid surgery entail and what type of anesthesia is used? Upper eyelid blepharoplasty, depending on its complexity, can be performed in the operating room or in the office. Surgery is typically performed with minimal sedation or with local injections of anesthetics.
Before the procedure, Dr. Abboud will mark the eyelid crease and carefully measure and outline the amount of skin to be removed. After injecting local anesthetics, he will then use a fine scalpel and electrocautery to precisely remove the redundant skin. He will remove just enough skin to give you the natural-appearing and youthful look you desire but not too much to an extent that eyelid closure (and thus the eye) is compromised. Based on your pre-operative consultation, he will then proceed with any other necessary steps to customize the procedure. After ensuring symmetry between both eyes, he will then close the skin with sutures.
4. Will I get different results if surgery is performed with a laser instead of a scalpel? Results of your blepharoplasty will not depend on what cutting instrument is used, but rather on how skilled your surgeon is using it. Assuming the skill level of the surgeon is the same, your results will be the same. Which instrument is used typically depends on the surgeon's preference. Dr. Abboud prefers to use a fine scalpel and electrocautery to achieve the intended results.
5. Are there any risks to cosmetic eyelid surgery? Cosmetic eyelid surgery, like any surgery, has risks. Minor side effects associated with blepharoplasty include temporary blurry or double vision, temporary swelling or bruising, and tiny bumps along the incision. These, however, are part of the normal healing process after surgery and are often temporary as they typically resolve on their own. More serious risks include asymmetry, dry eyes, or difficulty closing the eyes. However, the more qualified and experienced your doctor is in eyelid surgery, the lower that risk. Permanent blindness and double vision are exceedingly uncommon and rarely do they happen in experienced hands. During your consultation, Dr. Abboud will thoroughly go over the risks of the surgery, particularly those pertaining to your procedure.
6. Will I be able to see after surgery? Following your blepharoplasty, your vision may be temporarily blurry due to minor corneal swelling and the use of eye lubricants that we provide. However, your vision will recover fully in a few days. There will be no patches that will completely cover your eyes following surgery.
7. What is the recovery like for cosmetic eyelid surgery? The recovery process is usually not extensive. There may be some swelling and bruising, but most people do not experience much pain. Application of ice packs and elevating your head can help reduce swelling and speed up recovery. While light activity and refraining from heavy lifting are recommended for 2 weeks following surgery, most patients may be able to return to work only a few days after surgery.
8. Will there be noticeable scars on my eyelids? As with any surgical procedure, some scarring is to be expected. However, since upper eyelid blepharoplasty only requires small incisions placed within the natural crease of the eyelids, the resultant scars should be barely noticeable after healing. Patients may see some redness around the incisions immediately following surgery, but this typically fades quickly in the weeks and months following surgery. 9. Are results of cosmetic blepharoplasty permanent? The results of cosmetic blepharoplasty are designed to be long-lasting. Nevertheless, over time, the elasticity of your skin and the quality of your underlying facial muscles will continue to change in response to aging and other environmental factors. Dr. Abboud recommends that patients protect the skin surrounding their eyes with routine moisturizing and sun protection in order to maintain the results of their eyelid surgery as long as possible.
10. Am I a candidate for upper eyelid blepharoplasty and at what age can it be performed? The most common candidates for upper eyelid blepharoplasty are men or women who notice signs of aging in their face that cause their upper eyelids to droop. Some candidates for blepharoplasty are genetically prone to have naturally drooping eyelids that can cause them to look permanently tired or aged. As such, there really is no set age when eyelid surgery is performed. Ideal candidates for cosmetic upper eyelid blepharoplasty are non-smokers who are in good physical and mental health and who have realistic expectations about their results.
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