The first signs of facial aging often show up around the eyes. This is due to the combination of very thin eyelid skin and very strong eyelid closing muscles underneath the skin that cause wrinkling. Genetics, smoking, and being outdoors in sun and wind can accelerate this aging process. Blepharoplasty is eyelid surgery that removes, reshapes, and / or repositions excess skin, muscle, and fat around the eyes. It is the most commonly performed aesthetic surgery around the world because the eyes are so expressive and immediately noticeable as the focal point for those who are looking at us. Our eyes make a first impression because we are wired to socially engage others with eye contact and they convey our emotional states.
Dr. Vivian Schiedler trained as an eye microsurgeon doing cataract surgeries with the tiniest of instruments and sutures. This prepared her well for cosmetic eye surgery, which is one of the most detailed and critical of facial plastic surgeries. Her 2 year competitive fellowship and decade of experience has given her a finesse and appreciation for subtleties that have a huge impact on vision and eye comfort.
Upper Eyelid Surgery – Blepharoplasty
Upper eyelid blepharoplasty can have a dramatic impact on rejuvenating a person’s entire face. When done in a way that preserves a youthful fullness, rather than excessive removal of tissues that can lead to a gaunt and aged look, this procedure can make one look many years younger. Makeup can be applied much more easily. The natural beauty and expressiveness of the human eye is enhanced.
Excess loose upper eyelid skin is excised through a hidden incision in the natural upper eyelid crease line. Care is taken to preserve existing fat in this region as fullness to the upper eyelids is more youthful. In fact, this procedure is sometimes combined with fat transfer or filler into the upper eyelid / brow area for those with hollow areas. If the eyelid is droopy (ptosis), the muscle that raises the lid can also be tightened (ptosis surgery).
Am I a good candidate for upper eyelid surgery?
You might be a great candidate for an Upper Blepharoplasty in our Ashland, OR office if you have any of the following:
- Wrinkled, saggy, loose upper eyelid skin.
- A lost (hidden) natural eyelid crease/fold.
- Puffy pouches of fat in the eyelids that create a tired, aged appearance.
- Excess eyelid skin that interferes with peripheral vision.
Brow position may also need to be addressed in order to obtain optimal eyelid rejuvenation results. Combined eyelid and eyebrow surgery is very common. Eyebrows naturally tend to drop over the eyes as we age. In some cases, if both the lid and brow are not repositioned, it is possible to end up with a suboptimal result by only doing one or the other. Dr. Schiedler will address this prior to your surgery.
How is the procedure performed?
Incisions are placed in the natural creases of the upper eyelid, and just below the lashes in the lower eyelid. Exact placement and gentle handling of the tissues are crucial for minimizing scars and avoiding eyelash problems. Dr. Vivian Schiedler, as an oculoplastic specialist, has had to revise procedures done by non-eyelid specialists whereby overly aggressive surgery was done, leading to watery eye problems, severe corneal problems, exposure problems due to inability to close the eyes, asymmetry, and distressing eye pain. It is critical to assess the quality of the skin and underlying tissues including the bony support that the midface gives the lower lids, in order to predict how any given patient might heal in the near and distant future as their face continues to age.
What to expect after upper or lower eyelid blepharoplasty?
Because the eyelid skin is so thin, the incision typically heals as a very fine line. It is placed in the natural crease hidden by the eyelid fold. In some people, the outer part of the incision may be visible, but typically blends well into smile lines or crow’s-feet.
Blepharoplasty can be performed with local and oral anesthesia in the office, or under deeper sedation in a surgery center. To keep bruising and swelling at a minimum, patients should stay home for 2-3 days after the procedure in order to frequently apply soft, lightweight, cold compresses to the eyelids. Sleeping with the head elevated in a recliner chair also helps prevent additional swelling.
It usually takes 1 to 2 weeks for the bruising to disappear completely, although for some patients who regularly take blood thinners, it may take longer. It is important to stop blood thinners before and after surgery in order to reduce the risk of bleeding and potential for vision complications. Physical activity should be limited for the first week after surgery in order to prevent bleeding. Sutures are removed at one week.
Dr. Schiedler prefers using non-dissolvable sutures in order to minimize redness and bumps that occur with dissolving sutures.
Final results can be seen as early as 3-4 weeks, but in some patients may take 3-4 months, when the swelling fully resolves and the incision softens completely. If all four lids are done, it may cause some swelling on the surface of the eye, which typically resolves within a few weeks.
Healing progress depends a lot upon adherence to postoperative instructions as well as individual health status. Dr. Vivian Schiedler strives to create a smooth experience before, during, and after surgery by making sure her patients are well educated throughout the entire process.
If you have noticed that you tend to look tired or have had people tell you look tired when you’re not, we recommend you contact Dr. Vivian Schiedler at Oasis Eye to schedule a personalized consultation to determine if you are a good candidate for upper or lower eyelid surgery. Call 541-708-6393 or contact us online today.