Dr. Andrade performs an upper eyelid lift procedure that involves removal of excess skin, so it is no longer draped along the eyelashes. It can typically be done under local anesthetic (“freezing”) and takes about 60-75 minutes. However, it is important to have a proper in-person assessment to determine if removal of skin alone will provide the best outcome. Some patients have concurrent problems, such as excess fat deep to the eyelid muscles, or weak eyelid muscles that cause the entire lid to sit to low on the eye (ptosis), which obstruct vision. In this case, correcting the problem is not entirely cosmetic and would better be managed by an oculoplastic-specialized surgeon who manages these other conditions. Also, some patients require more extensive facial cosmetic surgery around the eye to improve a drooping brow position or to correct bulging lower eyelids. When a client reaches out to the clinic and provides information about their goals, we will advise if we are best able to meet their needs. We focus on patients who require a relatively straightforward procedure with minimal downtime. This nicely complements our mainly nonsurgical approach to facial aging, with facial injectables.
The consultation involves taking a medical history and doing a physical examination to ensure upper blepharoplasty surgery is appropriate. Those patients with significant medical problems (for example if they are taking anticoagulants or blood thinners), or with major eye problems (Grave’s disease, glaucoma, severe dry eyes, etc.) may not be ideal candidates for this procedure. The exam includes but is not limited to checking the degree of skin laxity, assessing for ptosis (abnormal lid position) and lid closure, eye movements and pupillary responses, eye position (enopthalmos or exophthalmos), and the degree of overall facial aging.
The vast majority of Dr. Andrade’s patients have eyelid lift surgery as a relatively brief, awake operation done under local anesthetic, but it can be done under sedation or general anesthetic if desired. Patients having the procedure under local anaesthesia are discharged home about 30 minutes after the procedure, after we ensure that vision and eyelid closure are normal. We do not recommend driving on the day of the procedure in case there is temporary eye irritation or swelling, so patients are advised to arrange for a responsible adult to take them home. However, most patients are driving and doing their typical activities of daily living within a few days.
The recovery process for blepharoplasty surgery is straightforward. Showering is permitted the following day. Care must be taken to avoid irritating the area, for example during sports or activities that might cause excessive sweating or rubbing the lids. Makeup should not be applied around the incision until sutures are removed and the incision is very well-healed (usually within 7-10 days). Dr. Andrade finds that using non-dissolving sutures provide a superior cosmetic outcome to dissolving sutures, so these stitches are removed 5-7 days postoperatively. The sutures are finer than a human hair and typically do not leave any marks after they are removed. Eyelid scars usually fade very well and become difficult to see after several months.
Complications are very uncommon after this procedure (less than 1%). Risks include but are not limited to excessive bleeding or swelling, delayed wound healing, infection, unsightly or asymmetrical scars, allergic reactions, eyelid closure problems, eye injury, or rarely blindness. The last complication is extremely unlikely to happen with the type of eyelid lift performed by Dr. Andrade, since only skin is being removed and there is no deep dissection that might increase the risk of complications. Disclaimer: this overview is intended to complement the advice of Dr. Andrade obtained during a proper consultation, so it is neither exhaustive nor complete.
Patients often ask if all the loose skin on the upper eyelid will be gone. During the aging process, skin loses some of its tone and elasticity, so even if a large amount of eyelid skin is removed, the remaining skin will still not be as tight as in youth. Dr. Andrade always gives patients a realistic idea of the amount of skin that can be safely removed while not intBlerfering with normal eyelid closure.
