Type of Surgery
Information
Last updated: 11/24/2009
Perhaps the most important thing to determine prior to eyelid surgery is whether your ptosis (drooping eyelid) is a sign of some other disease. Problems with the eyelid could be caused from a problem with the thyroid gland and may be the only visible manifestation of the disease. Even if you have had a drooping eyelid for a long time, this does not necessarily rule out a hormonal problem. Ptosis can occur as a consequence of neurological illnesses such as Bell’s palsy and myasthenia gravis; however, these are usually easily distinguished from other causes of a drooping eyelid. Generally speaking, when only one eyelid begins to droop in an adult patient it is more worrisome than if both droop. If one or both of your eyelids begin to droop, you should consult your primary care physician.
It is important to determine whether drooping eyelids are causing medical problems because their surgical correction could be covered by health insurance. Blepharoplasty is a technically challenging procedure for surgeons and can be quite expensive. If the procedure is intended to correct a problem with vision, it is more likely to be paid for by the insurance company. Preoperative testing may involve a simple test of vision to a full eye exam. You may need to be tested using a slit lamp to see if the eye has sustained any damage from debris. Your ability to make tears may also be examined. If the upper of lower eyelids are interfering with normal production and draining of tears it could be an indication for medically necessary surgical treatment.
Again, eyelid surgery is technically challenging and not all plastic surgeons choose to perform it. Choosing the right surgeon for blepharoplasty is critically important. You should do some searching in order to find a surgeon that has experience performing the procedure. Also, you should clearly describe what you hope to get from eyelid surgery and ask your surgeon if your goals are realistic. Be sure to ask the surgeon how many procedures of this type he or she has performed, what is the complication rate, and what to expect during and after the procedure.
The procedure is done as an outpatient so you will be able to go home the same day as the surgery. You will need to arrange transportation after the procedure because most surgeons will caution against driving immediately afterwards.
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A graphic animation of what causes fat and sagging eyelids. The video describes what takes place during eyelid surgery (blepharoplasty).
Other Information
Blepharoplasty can be both a functional and cosmetic surgical procedure intended to reshape the upper eyelid or lower eyelid by the removal or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons. When an advanced amount of upper eyelid skin is present, the skin may hang over the eyelashes and cause a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision. Patients with a less severe amount of excess skin may have a similar procedure performed for cosmetic reasons. Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid "bags" and reduce the wrinkling of skin.
Blepharoplasty is performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid. Initial swelling and bruising take one to two weeks to resolve but at least several months are needed until the final result becomes stable. Depending upon the scope of the procedure, the operation takes one to three hours to complete.
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