WHAT IS BLEPHAROPLASTY?

We are proud to offer blepharoplasty services in Minneapolis! Blepharoplasty is plastic surgery of the eyelids. It usually involves the removal of extra skin, fat, and muscle from around the eyes. It is performed on the upper eyelids when the normal aging process or genetics cause the eyelids to droop excessively. Blepharoplasty can also be used under the eyes to remove the sagging skin responsible for under-eye bags.

The skin of the eyelids is of the thinnest skin in the body. Therefore, it can be affected first by the loss of collagen with aging. Blepharoplasty is often a patient's first experience with cosmetic surgery.

PROCEDURE OVERVIEW

During the eyelid lift surgery, we will make a careful incision within the creases of the eyelid. The extra or sagging tissue will then be removed and the wound carefully stitched. Scarring is usually minimal and hidden by the normal creases in the eyelid. 

When the lower eyelids are involved, the surgeon will use natural smile creases and the lash line to hide the incision. If under-eye puffiness is caused mostly by excess fat, the whole procedure can be performed through a small incision made on the inside of the lower lid. In these cases, dissolving sutures will be used and no scars will be visible.

The procedure can be performed alone or as part of a more comprehensive cosmetic treatment which may include a facelift, brow lift or other skin treatments.

Surgery can be intimidating, especially in the setting of an operating room. The surgeons at the Hilger Face Center offer blepharoplasty in the office, so that you can avoid the hassles of a pre-operative physical and the angst of a surgery center. Under local anesthetic this procedure can be done comfortably. 

Eyelid lift before and after blepharoplasty before and after, Hilger Face Center Minneapolis and Edina

GOOD CANDIDATES FOR EYELID SURGERY

As with any surgery, only a qualified physician can tell a patient if he or she is healthy enough for this procedure. A patient’s past medical history and overall health should be reviewed to determine if the benefits of the eyelid lift surgery outweigh its risks. Special attention should be paid to underlying medical conditions that affect circulation, the eyes themselves or the ability of a patient to heal properly.

Age, weight, skin type and ethnic background can also affect the outcome of this type of surgery and should be discussed with a physician.

Eyelid lift before and after blepharoplasty before and after, Hilger Face Center Minneapolis and Edina

BENEFITS OF EYELID SURGERY

Blepharoplasty can be performed for cosmetic reasons, to improve vision or for a combination of these reasons. For some people, particularly those with a genetic predisposition to droopy eyelids, the extra upper eyelid tissue can sag into and block the field of vision. When this is the case, the procedure is deemed medically necessary and can substantially improve a patient’s quality of life.

Sagging eyelids and under-eye bags can also be unattractive. Some patients chose to have them removed to achieve a more rested or youthful appearance.

Almost everyone has had the experience of getting up for work or school in the morning and seeing dark circles or bags under the eyes from time to time. It’s never an attractive look and, unfortunately, many people suffer from bags and dark circles constantly.

WHAT CAUSES BAGS UNDER EYES?

TEMPORARY UNDER EYE BAGS

These are usually caused by water retention under the eyes and can be influenced by many different factors, such as:

  • Sleep deprivation
  • Colds, sinus infections, or allergies,
  • Alcohol
  • Excessive salt intake
  • Smoking
  • Menstruation
  • Lack of exercise
  • Crying

PERMANENT UNDER EYE BAGS

These are usually a result of hereditary disposition or aging. Aging causes the muscles and skin around the eyes to weaken, allowing fat to bulge below the eye. Though this process is normal, it is upsetting to most people. Bags like these can make a person look chronically exhausted and unhappy–decidedly not a youthful and fresh appearance.

PREVENTING EYE BAGS

A healthy lifestyle with sun protection will help will help prevent water buildup and keep your muscles and skin strong and supple. You can also try sleeping with your head slightly elevated to further prevent water buildup.

HOME REMEDIES FOR EYE BAGS

Spas use cucumbers over the eyes for a reason! The cooling effect can help reduce puffiness. Some people find that over-the-counter creams are effective as well. Eating foods high in antioxidants and avoiding salty, greasy, and processed foods can also help.

BLEPHAROPLASTY AS A SOLUTION FOR EYE BAGS

If your under-eye bags are the result of sagging fat and skin, a blepharoplasty (eyelid lift) might be your best option. The surgery is performed by removing excess skin and fat through tiny external incisions or invisible incisions inside the lower lid. The procedure typically produces excellent results, with patients looking more awake, alert, and youthful. Some patients also develop depressions or crescent shaped indentations beneath the fat bulges that accentuate the bags. This combination of a bulge immediately above an indentation is not uncommon and is best treated with a technique we have used for the past decade that in essence allows us to reposition the protruding fat into the adjacent depression thus correcting both problems. This newer procedure is performed by a limited number of surgeons and produces a more youthful look. Fine wrinkles can be treated simultaneously with resurfacing techniques that can also correct dark circles that are due to excess skin pigment.

Swelling and bruising caused by the blepharoplasty lift surgery itself usually subsides within one to two weeks. The final outcome will be apparent within several months.

Like any soft tissue surgery, the results of eyelid surgery change gradually over time. The skin will continue to lose elasticity and some laxity will develop and the pace which this happens is unpredictable from one patient to the next. If the upper eyelid skin seems to become redundant over time, one of the important considerations is to review the position of the brow because the heavier brows may begin to sag later then the eyelids skin may need to be addressed. Elevating the brow back to a normal attractive posture often reduces the amount of redundant upper eyelid skin. In the past years, we’ve also seriously considered the volume of the lid as a sign of youth. Thus, for the majority of lower lid blepharoplasties that we perform, volume is added or repositioned and stays stable over a long period of time and thus reduces the appearance of saggy eyelid skin again. If the revision procedure is required particularly for the upper eyelid, this is often a very limited procedure and can be performed often even in the office under local anesthesia for a subtle but gratifying correction.

No. Other than removing skin that is blocking vision, eyelid lift surgery does not affect eyesight.

An upper lid blepharoplasty can be performed at the same time as the laser resurfacing or a chemical peel.  The upper lid blepharoplasty addresses redundant skin and resurfacing addresses the finer wrinkles in the lid.  Generally, the excess skin is trimmed from the upper lid and there’s very little work done under the skin adjacent to the incision line, thus this area can be resurfaced at the same time providing one recovery with improvement in both laxity and fine wrinkles.

Blepharoplasty is considered safe and minor. As with all surgical treatments, there is a small risk of postoperative bleeding and infection. Any concerns should be discussed with a trusted physician before having eyelid lift surgery.

As we age, find that our moisturizing glands in the eye work less effectively and there’s a tendency to have dry eye. For some patients, this problem can be severe and this usually requires that a more conservative operation be carried out but nonetheless gratifying changes can be made. If you’ve had LASIK or other refractive eye surgery, we recommend that you not have a blepharoplasty for at least six months, as the LASIK surgery is affiliated with some dryness of the eye and we would not want the eyelid surgery to compound this problem. But once a period of time has passed, these patients can certainly proceed with a blepharoplasty. So, dry eye and recent ophthalmologic surgery are the two major conditions that would influence the decision regarding blepharoplasty.

In the lower eyelid, when there are fat bulges or bags, we’re often able to tweak these with incisions inside the eyelid that are not visible and this can also be associated with less risk of downward displacement of the eyelid. When there’s a significant degree of skin redundancy, particularly seen in the upper lid, an incision is made in a crease line so the access can be re-draped, but if they’re just bags or bulges on the lower lid, these can be corrected with incisions hidden inside the lid.

Your physician should be board-certified in Facial Plastic Surgery and have years of experience in various types of eyelid rejuvenation. There are many factors to consider when choosing the best Blepharoplasty surgeon for an upcoming procedure. An eyelid lift is a very delicate surgery, requiring an extremely skilled and experienced cosmetic or plastic surgeon.
The best surgeon for your upcoming eyelid lift surgery should have an unparalleled reputation as a provider of naturally looking surgical results, an assurance to you that he will be able to achieve your desired aesthetic goals.

Call our office promptly if:

  • You have a temperature over 100°
  • There is unusual bleeding or discharge from the incision
  • You have any change in vision
  • You have increase in pain which is progressive and not easily relieved with medication.

WHAT CAN I EXPECT ?

  • Some bruising, swelling and discomfort will be expected, which is often worse the second day after surgery.
  • Tearing and light sensitivity is expected, but only for a short duration.
  • Some oozing of blood from the wound is typical for the first day after surgery.

HOW DO I CARE FOR MYSELF ?

  • A non-aspirin, mild pain medication may be needed after surgery, since severe discomfort or pan is rare. / Apply cold compresses or ice several times in the first 24 hours to reduce swelling and bruising (ten minutes on, ten minutes off).
  • Eye drops or an eye ointment may be prescribed.
  • Do not get stitches wet for two (2) days. Simply clean with alcohol or hydrogen peroxide and apply antibiotic ointment (Polysporin or Bacitracin) with Q-tips twice a day for seven (7) days.
  • Sutures are usually removed within one (1) week of surgery. The incision line should be cleaned 2 to 3 times a day with saline or hydrogen peroxide, and then a thin layer of antibiotic ointment should be applied. A thin layer of Aquaphor (or Vaseline) may be applied.
  • Sunglasses may be worn to reduce light sensitivity
  • Apply warm compresses to reduce crusting of eyes, which may appear in the first two (2) days after surgery.

DO NOT:

  • Wear contact lenses for the first five (5) days after surgery.
  • Exercise, lift or strain during the first two (2) weeks after surgery.
  • Use non-prescription medication for the first two (2) weeks – especially mediations containing aspirin.
  • Swim — until approved by your physician
  • Remove the dressing(s).
  • Scrub, wash or massage your eyes. Do not wear make-up until approved by your physician.

IF YOU HAD A CHEMICAL PEEL OR LASER SURGERY:

  • Keep the area moist with A&D ointment or Aquaphor at all times during the first 5 to 7 days following surgery or until seen at the office.
  • After 24 hours, the area can be cleansed with full or half-strength hydrogen peroxide. Be sure to re­apply the A&D ointment or Aquaphor. Repeat this process three (3) times a day.
  • Do NOT apply cover make-up until approved by your physician.