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DESCRIPTION
As we age some of the most visible
signs of aging first appear in the face. These changes
occur gradually. As tissues begin to lose their support
and skin continues to lose its elasticity, noticeable
signs of sagging begin to be noticed by patients. A
blepharoplasty or cosmetic surgery of the eyelids is
designed to rejuvenate and re-fresh the upper facial
and eye regions. By refreshing the area of the region
around the eyes, eliminating the lower lid bags and
removing the excess upper lid skin, we are able to essentially
rejuvenate the area. This procedure is not meant to
stop Father Time and the continued process of aging.
It can however recuperate a more youthful appearance.
Because it has limitations you must be cognizant that
we cannot state that it will take 5, 10 or 15 years
off your looks. Suffice it to say that the end point
should be a more refreshed and youthful look. Blepharoplasties
are most commonly performed on individuals between the
ages of 35 to 70. Men and women undergo this procedure
and it is commonly combined with other ancillary procedures
such as a facelift or rhinoplasty (nasal surgery). Most
women will first notice a desire to rejuvenate this
area around 35 years of age while men may present in
their 50s.
PROCEDURE
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A blepharoplasty can be performed
under local anesthesia with intravenous sedation or
general anesthesia. The procedure is performed as an
outpatient allowing you to go home afterwards. Various
techniques exist for performing a blepharoplasty. However,
in most cases an upper lid incision will be made in
the normal fold that is created when you have your lids
open. It is strategically placed in an area where it
will be camouflaged. The upper lid contains two fat
pockets whereas the lower lid contains three fat pockets.
This incision allows the excess amount of skin and fat
to be removed from the upper lid. Next an incision is
made in the lower lid just below the eyelash line. Again,
this allows for the removal of excess skin and fat.
In some special cases (usually a young patient with
no redundant skin) the incision is made in the inner
part of the lower eyelid. Any additional procedures
will then be performed. Ice compresses are then applied
and you are taken to the recovery room.
POST-OP RECOVERY
You will be allowed to go home after your surgery. You
will need to apply ice compresses for the first 24-48
hours.
You will experience a feeling of
tightness and discomfort in the first 24-48 hours. This
is normal. Pain is infrequent following a blepharoplasty.
It is normal to experience some blurred vision, dry
or teary eyes following your surgery. Pain medication
will be provided for you and we suggest that all your
post-operative medications be purchased prior to surgery.
You should not be the person controlling the meds to
avoid self-medication. At home, it is suggested that
you rest. You will be asked to come to the office the
next day for a routine follow up visit. It is normal
and expected for you to have a swollen and bruised eye
area. Don't fret, this will resolve.
We will need to see you within the week for suture removal.
Following your suture removal you may apply cover-up
make -up. Most patients require 7 days recovery before
returning to work and/or driving their car unless your
work requires strenuous activity in which case you may
need 2 weeks. Exercise may be continued after 6 weeks.
Always check with us. Household chores may be started
within the second post-operative week. Every patient
is unique and will recuperate differently. If you feel
great, don't over do it.
COMPLICATIONS OF BLEPHAROPLASTY
Although complications are not frequent and percentages
will vary, you need to be aware that the following complications
may occur:
DRY EYES, HEMATOMA, TEARING, ECTROPION/ENTROPION (Eversion/inversion
of lower lid), CONTOUR IRREGULARITIES, PROMINENT SCARS,
EXTREMELY REMOTE POSSIBILITY OF BLINDNESS
Some of these complications if severe enough, may delay
recovery time, require further surgery for correction
at additional costs and may involve other specialists
within the medical field. Please be aware that smokers,
diabetics and overweight individuals have a higher incidence
of complications when compared to those who don’t
smoke, have diabetes and/or are overweight. You should
also note that patients undergoing combined procedures
(i.e. rhytidectomy and blepharoplasty) would also have
a higher complication rate than those undergoing a single
procedure.
WHAT & WHAT NOT TO EXPECT
These procedures are considered
refreshing, rejuvenating and enhancing in nature. They
are not meant as a retardant to the natural process
of aging. Nor are they meant to totally change someone's
looks. We have found that one of the key factors in
achieving patient satisfaction is patient expectation.
No guarantee implied or in writing is given regarding
how young you will look. The end point of this surgical
procedure is to make you look more rested, refreshed
and rejuvenated. A suggestion is made by Dr. Perez-Gurri
based on his professional experience as to the procedure(s)
best suited to achieve your aesthetic goals. Remember
that many things are taken into consideration but the
one limiting factor is the skin elasticity and availability
of good tissue.
There seems to be an inverse relationship with expectation
and satisfaction. That is, the higher the expectation,
the lower the satisfaction. Body image is unique and
what the patient frequently sees may not be what is
seen by the surgeon. Therefore, it is important that
you become keenly aware of your expectations for the
procedure, know its limitations and fully discuss any
concerns that you may have regarding the procedure with
Dr. Perez-Gurri. We encourage questions and have allowed
ample time to answer them personally or with our literature
and videotapes. Please realize that the results obtained
through a blepharoplasty are not permanent. Gravity
continues to have an effect on the tissues and the aging
process and laxity of tissues continue at the same rate
as before. Every patient is different and will have
a unique experience.
OTHER QUESTIONS
Does smoking affect my results?
Yes. Multiple studies have been done that show that
smoking has an adverse effect on tissues and often times
will delay healing. We ask that you stop smoking for
2-3 weeks prior to your surgery. Although this will
not prevent all complications of healing, it will more
probably than not improve pulmonary function.
How long does the procedure take to perform?
It will vary depending on how many procedures are performed
in conjunction with the blepharoplasty. On average if
a bilateral upper and lower lid Blepharoplasty is performed
it will take approximately 2 hours.
Are my results permanent?
No. The normal processes of aging & gravity that
cause continued laxity of the tissues eventually lead
the tissues to sag again. There is no sure way of predicting
how long this process takes in any particular individual.
On average, upper lid results may last 7-10 years. While
lower lid results may last 15-20 years.
Will I be very swollen and bruised?
Probably. Every patient will be different. However,
most patients will experience significant swelling and
moderate bruising following their surgery. Do not be
frightened. Swelling usually reaches its peak during
the first 48 hours.
What about my droopy eyes on the side (or laterally)?
This appearance is frequently influenced by the degree
of brow ptosis (pronounced TOSIS) that the patient may
have. In other words, if the patient has a saggy forehead
this condition will influence the appearance. A forehead
lift or brow lift may be suggested. Although it can
be done in conjunction with an upper lid blepharoplasty.
Our recommendation is to do it as a staged procedure.
The above information has been compiled as a benefit
to you. We hope that this document has served to better
inform you on the proposed procedure. We encourage dialogue.
Dr. Perez-Gurri and his staff at Imagos Institute of
Plastic Surgery, Inc welcome your questions.
It is our sincerest wish that your surgical experience
at IMAGOS INSTITUTE OF PLASTIC SURGERY, INC. be a pleasant
and informative one. We recognize that all patients
will experience pre-operative anxiety and fear of elective
surgical procedures is normal. Our trained professional
staff and doctors are here to serve your needs and answer
your questions.
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