The eyes, for their expressiveness and functional importance, are a frequent cause for consultation in Plastic Surgery. Thus, Blepharoplasty or eyelid surgery has become one of the most performed cosmetic procedures today. The heavy and tired look brings some patients to a pre-judgment on the cause of this appearance, linking it to habits like alcoholism and insomnia. The most visible signs of aging in the orbital-eyelid region include vertical eyelid stretching, appearance of malar bags, herniation of fat bags (fat pockets) and accentuation of infrapalpebral depression, known as the nasojugal groove (tear trough).
Eyelid surgery corrects these changes by removing excess skin and reducing fat pockets, thus reestablishing a facial look that is more cheerful and in a rested state. The incisions are always hidden in the natural creases of the upper eyelids and the fat pockets (eye bags) of the inferior eyelids are removed by the transconjuctival blepharoplasty (through the conjunctiva) in which the incision is hidden inside the eyelid.
Eyelid surgery generally does not correct distortions caused by dynamic wrinkles around the eye (crow’s feet); the choice of botulinum toxin is now a widely used option. Various surgical techniques and the use of fillers such as hyaluronic acid have been used increasingly providing improved dark circles and appearance of sunken eyes.
Anesthesia can be local, local + sedation or rarely general.
Length of stay:
Two hours, when used local anesthetic. It can be extended to 24 hours in the case of general anesthesia or as directed by the doctor EL Hachem.
There is always formation of edema (swelling) and ecchymosis (bruising), which may vary in intensity. Usually this disappears in the first week or possibly up to 10 days. These conditions are minimized by using cold saline compresses in the first two postoperative days. Another important precaution is to avoid heat (very hot baths, cooking, etc.), which favor the formation of edema and ecchymosis.
Dr. El Hachem assures you that complications are quite rare. But as every surgery has its risks, the following can be mentioned: hematoma, infection, dehiscence (opening of the suture), ectropion (inversion of the lower eyelid) and anesthetic problems.
However, complications rarely occur when surgical indication is accurate and the surgical technique is well-performed.
The results generally are rewarding and predictable. All excess skin cannot be removed from the eyelids. Their function is to protect the cornea which is the main part of the optical eye; the eyelids also serve to protect the eyeball.
Soon after the 8th day, approximately 50% of the desired result will be achieved, and in two to three weeks following, this percentage tends to improve markedly.
Frequently asked questions To Dr. Charbel EL Hachem
2) Are the blepharoplasty scars visible? Where are they?
Since the skin is very thin at the level of the eyelids, scars tend to be almost concealed in the skin furrows. The scar maturation period is believed to be approximately three months. By their location, they can be disguised with light makeup, in the early days.
3) What type of anesthesia is used in blepharoplasty?
Most cases are operated under local anesthesia. Some cases may require prior sedation. This procedure is rarely performed under general anesthesia.
4) Is there pain in the postoperative period?
Generally, not. Even if higher sensitivity or small outbreaks of pain occur, they may be completely eliminated with the use of common analgesics.
5) Will the eyelids be very swollen? And for how long?
Edema (swelling) of the eyelids varies from patient to patient. Some patients already in the 4th or 5th day present a very natural look. Others achieve this result after the 8th day or more. The first three days after surgery are those in which there is greater “swelling” of the eyelids. The use of sunglasses may be useful at this stage, as well as the use of cold packs which reduce the intensity of edema. Only after the third month will the residual edema be discreet and will not compromise the final result.
6) How long is the hospital stay?
Local anesthesia: 2 hours.
General anesthesia: up to 24 hours.
7) How long does the eyelid surgery last?
Typically, about 45 minutes. Depending on the case, there are details which may prolong this time. It is rare for the operation to exceed 50% of predicted time.
8) What are the “purple spots” observed in certain cases?
Nothing else than the blood leakage in the underlying skin, and even the conjunctiva; they are due to the surgical trauma itself. Dr. El Hachem assures all patients that this does not constitute any future problem and is not considered as a complication but rather a transient and reversible complication. Generally, these spots disappear 10 days after surgery.
9) Will the eye be sealed after eyelid surgery?
Not necessarily. The only recommendation is to place cold compresses for 15 minutes, several times a day; this prevents the formation of severe edema.
1) Arrive to the site of surgery (hospital, clinic) as scheduled.
2) Do not wear any makeup on the day of admission.
3) Bring sunglasses.
4) Fast for 8 hours before the scheduled appointment before being admitted to hospital the same day of operation.
5) Avoid any medication with an acetylsalicylic acid base (AAS, Aspirin etc.…) or any medication with an anticoagulant effect at least seven (7) days prior to surgery.
Postoperative recommendations by Dr. El Hachem:
1) Apply compresses of cold saline for 15 minutes every 1 hour the first two days.
2) Wear sunglasses when in natural light.
3) Avoid sun, wind and cold for 45 days post-surgery.
4) Carefully follow the prescription.
5) Avoid any medication with an acetylsalicylic acid base (Aspirin, etc..) or any medication with an anticoagulant effect for at least fifteen (15) days after the surgery.
6) Return to the clinic for dressing.
7) Do not traumatize or ” scratch ” the eyes.
8) You can return to all normal activities three days post-op.