LOWER EYELID
What is Eyelid Surgery?
Eyelid surgery, called blepharoplasty, is a surgical procedure to improve the appearance of the eyelids. Surgery can be performed on either the upper and lower lids, or both. Whether you want to improve the signs of aging or address concerns at a younger age, eyelid surgery can rejuvenate the area surrounding your eyes.
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Specifically, eyelid surgery can treat:
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Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid
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Excess fatty deposits that appear as puffiness in the eyelids
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Bags under the eyes
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Excess skin and fine wrinkles of the lower eyelid
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In general, good candidates for eyelid surgery include:
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Healthy individuals who do not have a life threatening illness or medical conditions that can impair healing
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Non-smokers
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Individuals with a positive outlook and specific goals in mind for eyelid surgery
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Individuals without serious eye conditions
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Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to relaxation of the forehead skin and eyebrow. Dr. Smith will evaluate your anatomy thoroughly to determine the causes of your eyelid appearance, and what procedures might best remedy them.
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Consultation and Preparing for Surgery
During your consultation be prepared to discuss:
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Your surgical goals
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Medical conditions, drug allergies, and previous medical treatments and specifically any problems you have had with your eyes
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Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
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Previous surgeries
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Dr. Smith will also:
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Evaluate your general health status and any pre-existing health conditions or risk factors
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Take photographs
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Discuss your eyelid surgery options
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Recommend a course of treatment
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Discuss likely outcomes of eyelid surgery and any potential risks
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Discuss the type of anesthesia that will be used
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Prior to surgery, you may be asked to:
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Get lab testing or a medical evaluation
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Take certain medications or adjust your current medications
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Stop smoking
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Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
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Eyelid surgery may be performed in an accredited office-based surgical facility, outpatient or licensed ambulatory surgical center, or in a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
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Be sure to ask questions. It's very important to ask Dr. Smith questions about your eyelid surgery. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with Dr. Smith.
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The Procedure
Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Dr. Smith will recommend the best choice for you.
Step 2 - The incision
The incision lines for eyelid surgery are designed so the resultant scars will be well concealed within the natural structures of the eyelid region.
Upper Eyelid
The upper eyelid can be corrected through an incision within the natural crease on the eyelid. This allows for removal or repositioning of fat deposits, tightening of muscles, and removal of excess skin.
Lower Eyelid
Conditions of the lower eyelid may be corrected with an incision just below the lower lash line. Through this incision, excess skin in the lower eyelid is removed.
A transconjunctival incision, created on the inside of the lower eyelid, is Dr. Smith’s preferred technique to correct lower eyelid conditions and redistribute or remove excess fat. With this technique, skin may or may not be removed.
Step 3 - Closing the incisions
Eyelid incisions typically are closed with:
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Removable or dissolving sutures
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Low profile surgical tape might be applied to the incision for the first few days after surgery
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Dr. Smith may also suggest use of a chemical peel to reduce discoloration of the lower eyelids.
Step 4 - See the results
The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and surrounding region, and an alert and rejuvenated appearance.
Risks and Safety
The decision to have eyelid surgery is personal, and you'll have to decide if this surgery will achieve your goals, and if the potential risks are acceptable. Be sure you understand the surgery and recuperation completely, and don't hesitate to ask Dr. Smith questions.
The risks include:
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Anesthesia risks
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Swelling and bruising
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Bleeding from the incision lines
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Dryness to the eyes
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Sensitivity to sun or other bright light
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Difficulty closing your eyes
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Ectropion, an outward rolling of the eyelid
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Infection
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Lid lag, a pulling down of the lower eyelid may occur and is often temporary
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Temporary or even permanent change in vision, and very rare chance of blindness
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Changes in skin sensation
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Pain, which may persist
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Poor wound healing
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Possible need for revision surgery
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Unfavorable scarring
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These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with Dr. Smith.
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Recovery After Surgery
After your procedure is completed, lubricating ointment and cold compresses may be applied, and in some cases your eyes may be loosely covered with gauze.
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You will be given specific instructions that may include how to care for your eyes, medications to apply or take orally, specific concerns to look for at the surgical site or in your overall health, and when to follow-up with Dr. Smith.
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Initial healing may include some swelling, bruising, irritation or dry eyes, and discomfort that can be controlled with medication, cold compresses, and ointment. Irritation at the incision sites is also possible.
Be sure to ask Dr. Smith specific questions about what you can expect during your individual recovery period.
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Where will I be taken after my surgery is complete?
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What medication will I be given or prescribed after surgery?
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Will I have dressings/bandages after surgery?
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When will they be removed?
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Are stitches removed? When?
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When can I resume normal activity and exercise?
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When do I return for follow-up care?
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You must practice diligent sun protection and use darkly tinted sunglasses until the healing process is fully complete.
Results
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The results of eyelid surgery will be long-lasting. Your final results will appear within several weeks, but it may take up to a year for incision lines to fully refine. While eyelid surgery can be expected to correct certain conditions permanently, you will continue to age naturally. Life-long sun protection will help to maintain your results. Satisfaction with your new image should continue to grow as you recover from surgery. As swelling and bruising subside, the results of eyelid surgery will reveal a smooth, better-defined eyelid and surrounding region and an alert and rejuvenated appearance.
Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Following Dr. Smith’s instructions is essential to the success of your surgery. It's important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Dr. Smith will give you specific instructions on how to care for yourself.
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Cost
Prices for eyelid procedures can vary. The cost will be based on the type of procedure required to address your specific needs. Dr. Smith does offer patient financing plans, so be sure to ask.
You will be charged only one fee. This fee will include:
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Anesthesia fees
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Hospital or surgical facility costs
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Medical tests (if required)
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Post-surgery garments (if required)
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Surgeon's fee
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Dr. Smith
Your satisfaction involves more than a fee. When choosing a plastic surgeon for eyelid surgery, remember that the surgeon's experience and your comfort with him or her is just as important as the final cost of the surgery.
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Plastic surgery involves many choices. The first and most important is selecting a Plastic Surgeon you can trust. Plastic Surgeons such as Dr. Smith, certified by the Royal College of Physicians and Surgeons of Canada meet rigorous standards:
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Board certification by Royal College of Physicians and Surgeons of Canada®
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Completed five years of surgical training following medical school
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Pass comprehensive oral and written exams
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Complete continuing medical education, including patient safety
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Perform surgery in a hospital or accredited surgical facility
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Following Dr. Smith’s Plastic Surgery residency, he completed an extra year of training, completing two additional clinical Fellowships to further his expertise in the field of Plastic Surgery. Please see his biography for more details.
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Do not be confused by other official sounding boards and certifications. Be sure to choose a highly trained plastic surgeon who is board-certified by The Royal College of Physicians and Surgeons of Canada.
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This procedural information is intended strictly for educational purposes. Only models are depicted in these procedural information pages. It is not intended to make any representations or warranties about the outcome of any procedure. It is not a substitute for a thorough, in-person consultation with Dr. Smith.