Upper & Lower Eyelids What do your eyes say about you? The top one-third of your face is one of the first things people notice and will remember about you. Furrowed brow lines or drooping lids can make you appear tired, grumpy or just plain mean. First impressions are important so don’t let your eyes make a bad one! What is Blepharoplasty? An Eye Lift or Blepharoplasty is a popular cosmetic procedure to remove the epicanthic fold (the skin fold and fat) from droopy upper and lower eyelids. Good Candidates An eye lift will correct defects, deformities and disfigurations of the eyelids and aesthetically modify the upper and lower eye region of the face, improving baggy skin under the eyes, sinking upper eyelids or drooping eyelashes that impair vision. Plastic surgery can also treat Ptosis or drooping eyelids which is caused by poor muscle tone or nerve damage. Ptosis causes the eyelids to hang very low and again block eye sight. Most patients present with a combination of aging eye problems ranging from drooping brows, under-eye bags, puffy upper and lower eyelids or excessive, sagging eyelid skin. For best results, your treatment plan should deal with all three issues at once. Based on your hairline and style preference, a number of incision options and treatment plans will be presented before any kind of surgery begins. With the right combination of procedures, you can turn back time and put that youthful twinkle back in your eyes. Brow Lift When to Consider a Brow Lift A brow lift can fix a lot of problems that years of thinking and frowning have created. You should consider a brow lift if you notice deep creases across your forehead, sagging brows that are hooding upper eyelids, or if you just notice that you have more days where you look tired and sad instead of alert and youthful. Many women choose brow lift surgery when it becomes difficult to apply eye makeup due to the excessive skin on their lids. No matter the reason, you have more options today than ever before to erase those tell-tale signs of aging. Dr. Shvidler will help you decide if Blepharoplasty is right for you. He will discuss what you can realistically expect. Understanding what’s involved in blepharoplasty and exploring the benefits and risks can help you decide if this procedure is a good option. Surgical Options Over the years, brow-lift procedures have evolved from open techniques to more complex, short incisions and now include the use of endoscopic tools. After your initial consultation, Dr. Shvidler will go over the best type of incisions to make based on your natural hairline, the way you prefer to style your hair and the overall structure of your face. An Endoscopic incision is sometimes used to correct a mild to moderate brow droop and slight horizontal lines that appear across the forehead. An endoscope, or thin tube with a camera on the end, is placed through small incisions made in the hairline to manipulate tissue and muscle just below the skin to correct the source of the wrinkles and frown lines. A Coronal incision can be used on advanced brow droop with deep forehead wrinkles. This incision is made across the top of the head, from ear to ear. Skin is then lifted and adjustments are made to the muscle and tissue where the surgeon has direct view. The scar from a coronal incision is concealed completely with the hair. Once the adjustments have been made to your forehead and brow, any incisions will be closed using special clips, skin adhesives or removable or absorbable sutures. What to expect after surgery While the healing will continue for several weeks, you should be ready to return to normal activities in 10-14 days. During recovery your head should stay elevated and you should not participate in any vigorous physical activity until Dr. Shvidler says you are ready. As with any surgery, your recovery will be successful if you listen to and follow the advice of Dr. Shvidler, eat well and get plenty of rest. Upper Eye Lid When to consider Upper Eyelid surgery Blepharoplasty, or eyelid surgery, is used to correct problems that a forehead or brow lift can’t, such as baggy eyelids or crows feet. Often done together with a brow lift, upper eyelid surgery can correct the sagging skin that may impair your vision, improve the surface of your eyelids (making it easier to apply make-up), or help repair paper-thin eyelid wrinkles. Surgical Options During your consultation, be ready to answer questions about the overall health of your eyes. In addition to the standard pre-surgery health questions, you will be asked about any issues with dry eyes, glaucoma or eye related allergies. Dr. Shvidler will take multiple photos of your eyes from different angles and discuss different techniques as they relate to your desired outcome. When operating on your upper eyelids, incisions will be placed in the natural folds of your lids, keeping them small and hidden. Excess fat and skin will be removed and muscular adjustments will be made. The incisions are closed with fine sutures to minimize scarring and visibility. What to expect after surgery This is also a day surgery but you will still need help getting home. In order to protect your eyes and prevent dryness a lubricating ointment will be applied to your eyelids which may cause blurred vision. You can also expect possible double vision, sensitivity to light and excessive watering of the eyes just after surgery. Ice packs or cold compresses will help to reduce swelling and you will be given a pain reliever for mild discomfort. After surgery, it is important to stay away from any type of pain reliever that may increase bleeding such as aspirin, naproxen (Aleve) or ibuprofen. If stitches were used, they should be removed after three or four days. Your incisions will be red at first and you will experience swelling and bruising that may last a few days. You may even experience “black eyes” which could last a week or longer. If the pain or swelling becomes extreme or long-lasting, consult with Dr. Shvidler right away to rule out any problems. It is imperative that you follow post-operative care instructions. For the first few days after surgery you will need to apply an ointment to the incisions to keep them lubricated. You may also use eye drops to keep your eyes from drying out as you heal. You should sleep with your head elevated as much as possibly following surgery, which will help to minimize the swelling and bruising. Avoid heavy lifting or straining, especially anything that involves moving your head abruptly or increases blood pressure to your head. Your eyes will tire easily for a few weeks so don’t be afraid to nap as necessary. Take care to avoid activities that normally dry out your eyes such as working at a computer, reading for long periods of time or watching television. It may also help to wear dark sunglasses to protect the eyes from sun and wind. Eye-lid surgery should not need to be performed more than once. If your brow begins to droop again after a few years, that can be corrected with another brow lift. With proper recovery and healing, your peepers will stay young looking for years. Before – After Lower Eye Lid When to consider Lower Eyelid surgery Lower eyelid surgery is mainly used to remove the bags and deep grooves under your eyes that make you look tired all the time. This procedure is also generally done at the same time as a brow lift or upper eyelid surgery. Surgical Options With lower eyelid procedures, an incision is made just below the lower lashes. This is a more traditional approach that can be used to remove excess skin and fat, as well as tighten lower lid muscles. By using a transconjunctival incision, the small cut is made inside the lower eyelid. This method is most effective at removing excess fat, but not skin. Sometimes fat within the lower lids can be redistributed to eliminate puffiness and bulges. With either of these methods, the scaring is virtually invisible. What to expect after surgery The recovery process for lower lid surgery is identical to upper lid surgery. Keep your eyes lubricated, protected and rested, head elevated, no make up, no alcohol, smoking, television, computers, and no contact lenses. Don’t engage in any strenuous activity such as strenuous exercise, bending, lifting and follow Dr. Shvidler’s instructions for post-operative care. Normal activities can resume after 7-10 days. Strenuous activities can resume after about 3 weeks.