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Lid Lift
Aesthetic eyelid surgery is performed on adults of all ages. Some people have eyelid surgery to correct problems that are a result of aging, while others have inherited traits that cause them to seek treatment as early as their 20s or 30s.
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Am I a good candidate for a eyelid surgery?
Any one or combination of the following conditions may indicate that you are a good candidate for eyelid surgery:
- Excess skin obscuring the natural fold of the upper eyelids
- Loose skin hanging down from the upper eyelids, perhaps impairing vision
- A puffy appearance to the upper eyelids, making the eyes look tired
- Excess skin and fine, crepey wrinkles of the lower eyelids
- Bags and dark circles under the eyes, often with a depression along the bony border of lower eyelids
- Droopiness of the lower eyelids, showing white below the iris (colored portion of the eye)
Aesthetic eyelid surgery can usually correct these problems, though other treatments may also need to be considered. For example, if the upper eyelid condition is accompanied by sagging of the eyebrows, then a brow lift may be recommended. Smoothing of crow's feet may require medical skincare products, chemical peeling or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with a bleaching solution or chemical peel. Your plastic surgeon can provide further information if you have an interest in any of these additional procedures.
Your Personal Consultation
During the initial consultation, you will be asked to look in a mirror and point out exactly what you would like to see improved. This will help us to understand your expectations and determine whether they can be achieved realistically.
How will Dr. Robinson evaluate me for aesthetic eyelid surgery?
You should come to the consultation prepared to discuss your medial history, including previous surgeries, past and present medical conditions, current medications, including diet pills, vitamin E and dietary supplements, especially ginseng, ginkgo, garlic. These all can affect your surgery, even to point of stopping your heart. Also important is smoking history, drug abuse, and heart and lung disease. It is important you provide complete information. High blood pressure, thyroid problems or diabetes are among the medical conditions that may increase the risks. Family histories of blood clots, trouble with anesthesia, and heart disease should also be revealed.
We will want to know if you have allergies, especially if they affect your eyes and whether you have ever tried and were unable to wear contact lenses. It will be necessary for him to know if you were ever told by an ophthalmologist that you have a condition called "dry eye" or if you have any other problems with your eyes.
One of several surgical techniques may be suggested to improve the appearance of your eyelids. The particular technique that Dr. Chili recommends will depend on many factors such as the amount of excess fat and skin in the eyelid areas, the position of your eyebrows, and the condition of muscles around your eyelids.
How Aesthetic Eyelid Surgery is Performed
Because of individual factors, not everyone will achieve the same results from eyelid surgery. We will select the surgical technique that we feel will obtain the best outcome for you. How is Dr. Robinson able to improve the appearance of my upper eyelids?
For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, excess skin and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it will be well camouflaged when healed.
What is done to improve the appearance of my lower eyelids?
For lower eyelid surgery, often an incision is hidden just below the lower lashes. Through this incision, excess skin, muscle and fat are removed, or fat may be redistributed to eliminate puffiness or bulges. Other adjustments to correct special problems such as muscle laxity may be performed. As in upper eyelid surgery, the incision is well camouflaged by natural creases.
In some cases, you and Dr. Chili may decide that the best approach for removing excess fat is through an incision placed inside the lower eyelid. This technique requires no external incision, but it cannot be used to remove excess skin. A laser may sometimes be used in conjunction with this method to tighten the lower eyelid skin.
Your Surgical Experience
The goal of Dr. Robinson and the entire staff is to make your surgical experience as easy and comfortable for you as possible.
How should I prepare for surgery?
If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Diet pills can stop your heart during surgery. Dr. Chili will provide you with additional preoperative instructions.
Aesthetic eyelid surgery is performed on an outpatient basis. You must arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
What will the day of surgery be like?
The night before surgery you can take your medications (except those cancelled as above) and eat until midnight. This will ensure an empty stomach in the morning. An hour before surgery you will take your pre-operative medications with a sip of water, but NO FOOD. Wear something warm, like jogging pants and a shirt or jacket that can be buttoned or zipped, so your arms do not have to be raised after surgery.
Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and IV sedation are used for patients undergoing eyelid surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your eyes will be in cold compresses to reduce swelling. Staying in the sitting position with the eyes higher than the heart will also help reduce swelling. Your vision will be blurry as a result of ointment used to soothe and protect the eye during surgery as well as from the swelling that is a normal aftermath of eyelid procedures. There is surprisingly little discomfort, however, from the surgery.
You will go home after a few hours; you will be drunk but able to walk. That is why you need a friend to take care of you for at least the first night.
Initially, you may feel a "tight" sensation around the eyes and some mild discomfort that can be controlled with oral medication. During the first 48 hours following surgery, patients experience varying degrees of swelling and bruising. Some patients find that mild swelling persists for several weeks, while others may see swelling resolve in as little as one week. Bruising typically disappears within seven to 10 days. Within the first week you will be permitted to use makeup, if desired, to conceal any discoloration. Stitches are removed within a week of surgery.
Your vision may continue to be somewhat blurry for a few days or longer. Your eyes may be temporarily sensitive to light, and you may experience excess tearing or dryness. Sometimes Dr. Robinson recommends eye drops to help relieve any burning or itching. You may want to wear dark sunglasses for a couple of weeks to protect your eyes from wind and sun irritation.
When can I resume my normal activities?
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within five days or less. Although you might feel like going back to work just a few days after surgery, your vision may still be slightly blurry, which could make reading or other paperwork more difficult. You should not wear contact lenses for a week or two.
Results of Your Eyelid Surgery
Aesthetic eyelid surgery has the effect of making you look more rested, refreshed and alert. Since the healing process is gradual, you should expect to wait at least several weeks to get an accurate picture of the results of your eyelid surgery. Incisions will fade over a number of months until they become barely visible.
How can I learn more so that I can make an informed decision?
Fortunately, significant complications from aesthetic eyelid surgery are infrequent. Every year, many thousands of people undergo successful eyelid surgery, experience no major problems, and are pleased with the results.
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and Dr. Chili, or with a staff member in his office.
Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia. Following the surgery, there can be a feeling of dryness or irritation in the eye that requires treatment. There is a possibility of a temporary decrease in sensation of the eyelid skin or impaired eyelid function that sometimes may need to be corrected by additional surgery. A rare (Dr. Robinson has never seen it 25 years) but potentially disastrous complication is bleeding behind the eye; if left unattended it could cause blindness in that eye. That is why no aspirin or blood thinners is so important. You can help minimize certain risks by following the advice and instructions of Dr. Chili both before and after your eyelid surgery.
How long will the results last?
The results of aesthetic eyelid surgery are long-lasting, but they may be affected by your heredity and lifestyle factors.
Removal of fat (which is usually the cause of puffiness and bags) from your eyelids is permanent. The skin continues to age, however, and skin laxity along the fine wrinkling of the eyelid area may, at some point, return. Sometimes loss of tone in the forehead causes additional sagging of the eyebrows that mimics a recurrence of drooping upper eyelids. If this happens, correction may require a brow lift or a secondary eyelid procedure.
Even though the aging process continues, patients are usually happy with their appearance for many years following eyelid surgery. Some patients find that they want to make additional improvements at a later time.
Maintaining a Relationship with Your Plastic Surgeon
Please remember that your relationship with us does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact us.
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