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EYELID LIFT – BLEPHAROPLASTY

1WHAT IS EYELID LIFT?
Eyelid lift is also known as ‘Eyelid surgery’ or ‘Blepharoplasty’. It is a surgical procedure to improve the appearance of the eyelids. Surgery can be performed to improve the appearance and solve functional problems by firming saggy skin, tightening loose muscles and removing fat. Upper lids or lower lids, or both can be treated at the same time resulting in the area surrounding the eyes rejuvenated.
2WHAT ARE THE LIKELY CAUSES OF EYELID PROBLEMS?
Eyes are probably the first place where you may realize signs of aging. The following are the main factors that accelerating the aging process:

⦁ Genetics: Genetic background affect the aging process and considered to be the main reason for drooping or sagging eyelids.

⦁ Time: Loss of elasticity of the skin is a natural cycle of aging and causing eyelid problems.

⦁ Sun exposure: Getting excessive amount of sun cause to look older than the actual by developing lines and wrinkles in the face.

Although some of the non-surgical procedures including Botox and fillers can be a temporary solution to improve aging, eyelid lift procedure remains to be the only permanent solution for sagging tissues and excess skin.
3WHAT CAN BE IMPROVED BY AN EYELID LIFT?
Eyelid lift is usually performed when the skin loses its elasticity and lower eyelids start to sag. The surgery can potentially improve the appearance of eyelids that have the following conditions:

⦁ Loose or excess skin around the lower or upper eyelids that sometimes hinder vision

⦁ Sagging or drooping lower or upper eyelids

⦁ Fatty bulges and bags around the eyes

⦁ Drooping lower eyelids that disclose the white below the iris

4WHO ARE THE IDEAL CANDIADATES FOR EYELID LIFT?
Ideal candidates for an eyelid lift surgery are as follows:

⦁ Are in good overall health

⦁ Not have serious eye conditions

⦁ Have realistic expectations about the procedure

⦁ Non-smokers

⦁ Are looking to restore a more youthful appearance

5WHAT DO I NEED TO CONSULT WITH THE SURGEON BEFORE THE SURGERY?
MediExpert surgeon will discuss the following issues during your eyelid surgery consultation:

⦁ Your surgical goals to be achieved

⦁ Your general health status will be evaluated, allergies, previous medical treatments particularly related with the eyes will be checked

⦁ Current prescribed medications and the usage of supplements and vitamins will be checked

⦁ Smoking, alcohol and drug usage will be asked

⦁ Previous surgery history if any

⦁ Eyelid surgery options will be discussed

⦁ Course of treatment will be recommended

⦁ The type of anesthesia that will be used will be discussed

⦁ Photos of the eyes will be taken

⦁ Potential complications and the risks of eyelid surgery will be discussed

6WHAT DO I NEED TO DO PRIOR TO THE SURGERY?
Following should be done in terms of preparation prior to the eyelid surgery.

⦁ Blood testing will be required to evaluate general health status prior to the surgery and EKG may also be requested from your surgeon

⦁ Avoid all sorts of blood thinners and certain anti-inflammatory drugs at least 10 days prior to the surgery as they might increase bleeding and bruising

⦁ Stop smoking at least two months prior to the surgery as it can delay the healing process. If you are a heavy smoker, we will try to encourage you to avoid smoking as much as possible prior to the surgery

⦁ Avoid alcohol 1 week prior to the surgery

⦁ Avoid vitamin E supplements, ginseng, gingko biloba weeks before the surgery as these may prolong the bleeding

⦁ Your eye and the vision health will be checked along with the confirmation of the use of medication related to an eye

⦁ You will have prescribed medication of antibiotics, pain relievers and eye drops. Ensure that the medication is ready prior to the surgery

⦁ Ensure to have cold compresses ready to use after the surgery

⦁ Whether using contact lenses, ensure to have glasses ready to use after the surgery as contact lenses will not be allowed

⦁ Have dark glasses with you to use it after the surgery to reduce discomfort

⦁ Wear comfortable and loose clothes and not wear jewelry and necklaces at the day of the surgery

⦁ Do not eat or drink anything 8 hours prior to the surgery except any prescribed medication

⦁ Ensure that the bed in pre-arranged with plenty of pillows as elevation of the head will reduce swelling after the surgery

⦁ Ensure that a family member or a friend is arranged to take care is available to stay with you for assistance the night after the surgery

⦁ Do not wear any lotion, perfume, makeup and sort cosmetic products at the day of the surgery

7WHAT TYPES OF EYELID SURGERY ARE AVAILABLE?

⦁ Upper Eyelid Surgery

Upper eyelid surgery typically involves the removal of excess, sagging skin and in some cases excess fat in order to correct the droopy appearance of the upper eyelid. You are most likely to experience the following improvements after the surgery:

⦁ Definition to the upper eyelid crease refined

⦁ A more open and alert appearance to the eyes restored

⦁ Hooded look to the upper eye lids corrected

⦁ Vision is improved if sagging skin obstructs the sight

⦁ Lower Eyelid Surgery

Lower eyelid surgery typically involves the removal of sagging tissues underneath the eyes and above the orbital bone. The procedure may also involve removal of fat or skin, or tightening and repositioning tissues in order to smooth the area. You are most likely to experience the following improvements after the surgery:

⦁ Wrinkles underneath the eyes are smoothened

⦁ Eye bags are eliminated or reduced

⦁ Tired and depressed appearance is improved

8WHAT ARE THE STEPS TAKEN IN AN EYELID SURGERY?
The following steps are taken in a common eyelid surgery.

⦁ ADMINISTRATION OF ANESTHESIA

A typical eyelid surgery is performed under a local anesthesia and intravenous sedation. General anesthesia is performed whether facelift or/and brow lift is performed at the same time.

⦁ OPENNING INCISIONS

The incision lines made during eyelid surgery are performed with the intention to conceal scars within the natural structures of the eyelid region. To correct the droopy appearance of the eyelid; incisions are made within the natural eyelid crease to correct the upper eyelid which allows for the repositioning or removal of fat deposits, tightening of the muscles and removal of excess skin. On the other hand, lower eyelid may be corrected with an incision under the eyelash lines (Transcutaneous incision), whether only excess skin removal is required. Moreover, incision may also be created inside the lower eyelid which is an alternative technique called ‘transconjunctival incision’ to remove or redistribute excess fat when there is no need to remove the excess skin. Eyelid surgeries can be performed using scalpel ,laser or radio frequency depending on how the procedure is performed. laser, radio frequency (RF), or scalpel.

⦁ CLOSING THE INCISIONS

At the end, incisions are then precisely closed with extremely fine sutures to minimize scarring.
9WHAT ARE THE BENEFITS OF EYELID SURGERY?
Some of the potential benefits you may be experiencing from an eyelid surgery include:

⦁ Signs of aging in the face will be corrected which enables a more youthful appearance

⦁ Tired and sad look in the face will be converted to a more sharp look

⦁ More open and alerted appearance of the eyes

⦁ Reduction in excess skin and fat of the eyelids

⦁ Vision can be improved if you are suffering from a severe drooping of the lids that is obscuring your eyesight

⦁ Self-confidence may be increased

⦁ High patient satisfaction

⦁ Long-lasting results

10WHAT IS EXPECTED IMMEDIATELY AFTER THE SURGERY?
Post operative period is extremely important for a quicker healing and recovery period. Following are most likely to be expected within the first few days after the surgery:

⦁ you will be kept under observation for few hours following the surgery

⦁ you will have cold compress gauze dressing over your eyes

⦁ you may experience minimal discomfort, some bruising and swelling for a week

⦁ your vision may be a little blurry, double vision and more sensitive to light for a day or two due to medication

⦁ you may feel dryness and itchiness in the eyes

11HOW LONG IS THE EYELID SURGERY?
The length of the surgery is typically around an hour whether lower or upper eyelid surgery is performed alone, whereas it may take between one and a half hour to two hours whether both performed together.
12HOW OLD DO I HAVE TO BE TO UNDERGO THE SURGERY?
There is no certain age limitation to undergo the procedure, however most of our patients tend to be in their late 30’s and over. This is usually when the eyelid begins to develop signs of sagging.
13WHAT KIND OF PAIN SHALL I EXPECT AFTER AN EYE LIFT?
Although pain tolerance may vary from patient to patient, most of the patients are surprised to experience how mild the discomfort is. Pain medication is prescribed to reduce any possible discomfort and often used between 2-5 days. It is very uncommon for the patients to report extreme pain following the surgery.
14WILL THERE BE ANY SCARS LEFT?
Good News: The scars will be virtually invisible! Thanks to the modern techniques used in today’s eyelid surgeries, there will not be virtually visible scarring once the recovery period is over. Incisions are placed in the natural creases of the upper and lower eyelids and along the lash line or inside the lower eyelid allow the surgical scars to remain well hidden. This way, incisions will be virtually unnoticeable once healed.
15HOW LONG IS THE RECOVERY TIME?
After the surgery, you may experience minimal discomfort and some degree of bruising and swelling. The vision may be blurry or double vision due to applied medication. Don’t panic if one eye gets well earlier than the other, this is because one eye might have been treated more extensively than other. You may experience increased sensitivity to the light, therefore it is advised to wear dark sun glasses to avoid sun irritation. It is also recommended to avoid contact lenses and keep the sun glasses instead for two weeks to protect the eyes from the elements when you go out. Cold compresses or ice packs can be used to reduce swelling as well as keeping the head elevated for the first few days will also help. Smoking and drinking should be avoided for few weeks to fasten the healing period. You should be able to watch TV or read straight after the surgery. Regular activities can be resumed after 10 days, however anything to increase the blood pressure including energetic exercises should be avoided for 6 weeks.
16CAN BRUSUING BE PREVENTED?
Most patients of the patients will have a bruising in to a certain extent. Bruising can be minimized by using Arnica 2 days before and after surgery and following the complete instructions of your surgeon.
17SHOULD I NEED TO STAY IN THE HOSPITAL AFTER EYELID SURGERY?
It is typically an outpatient procedure meaning that it is not required to stay at the hospital overnight.
18WHEN WILL THE STITCHES REMOVED?
The stitches will be typically removed within 3-5 days after surgery.
19WHEN CAN I GO BACK TO WORK?
It is typically to return for a desk job within 7-10 days. You may need to take few more weeks for a physically demanding job. Your surgeon will advise you the recommended date back at work following the surgery based on your specific type of strenuous job.
20CAN I DRIVE AFTER THE SURGERY?
It is typically 4 days required to start driving after the surgery.
21WHEN CAN I START EXERCISING?
Light exercises can be resumed within 10 days after the surgery, whereas strenuous exercises should be avoided for 4-5 weeks.
22IS THERE A NON-SURGICAL OPTION TO EYELID SURGERY?
Injectable fillers and Botox may be a temporary solution to improve the appearance of drooping eyelids. However, eyelid surgery remain to be the only permanent solution.
23CAN EYELID SURGERY COMBINED WITH OTHER PROCEDURES?
There are number of different cosmetic surgical procedures that can be safely performed in combination with an eyelid surgery. It is in fact very common to address other parts of the face in order to achieve a comprehensive facial rejuvenation. Some of them include brow lift (forehead lift), neck lift, facelift, lip augmentation, eyebrow lift, rhinoplasty (nasal surgery), chin implant as well as non-invasive procedures such as laser resurfacing and Botox. There are benefits of having these surgeries at once as initially it avoids the risks of two surgeries, anesthesia applied one at a time and advantageous in terms of minimizing recovery process, saving time and money accordingly.
24CAN EYELID SURGERY CORRECT "CROW’S FEET"?
Eyelid Surgery will not improve the ‘crow’s feet’ that is also known as ‘laugh lines’ . These wrinkles are caused by excessive activity of the muscle surrounding the eye and can be best treated by Botox, laser resurfacing and dermal fillers.
25CAN EYELID SURGERY CORRECT "FROWN LINES"?
Frown Lines are wrinkles in the forehead that are caused by persistent tightening of the forehead muscles. This condition can be treated by a Botox injection on temporary basis, whereas upper eyelid surgery can permanently overcome this problem.
26WHEN CAN I HAVE A PERMANENT EYELINER AFTER THE SURGERY?
It is recommended to wait around 6-8 weeks in general before having a permanent eyeliner until swelling fully subsides.
27WHEN CAN I SEE FINAL THE RESULTS?
Immediate improvements can be seen after the surgery, however these changes will not be the final results. It may take 6-8 weeks for the swelling to fully resolve and the final results are more likely to be achieved within 12 weeks following the surgery, while final outcome would be long-lasting as long as maintaining a healthy lifestyle.
28WHAT ARE THE POTENTIAL COMPLICATIONS AND RISKS OF BREAST AUGMENTATION?
Although eyelid surgery is generally a very safe procedure, all the surgeries carry uncertainty and risk in to some extent. Some of the complications and risks include:

⦁ Anesthesia risks

⦁ Swelling and bruising

⦁ Bleeding

⦁ Dry eyes

⦁ Increased sensitivity to light can be permanent

⦁ Difficulty closing the eyes

⦁ Ectropion

⦁ Infection

⦁ Seroma

⦁ Hematoma

⦁ Lid lag

⦁ Temporary or even rare permanent change in vision, and very rare chance of blindness

⦁ Changes in skin sensation or numbness of the eyelashes

⦁ Possible need for revision surgery

⦁ Unfavorable scarring

29HOW LONG WILL THE RESULTS LAST?
The improved results will be long-lasting, for many it is a life-long permanent results. However, a touch-up procedure may be required after some years depending on aging or external factors including massive weight loss, smoking and sun damage.
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