Lower Eyelid Surgery
Taylor R. Pollei, MD
Fellowship Trained Facial Plastic Surgeon offers lower eyelid surgery in Beverly Hills and Mission Viejo CA
How do the eyes age?
What can a Lower Lid Surgery do for me?
Although each patient has individualized needs, blepharoplasty is an overall great procedure for most patients because it improves the following:
- Loose, sagging and/or folded lower eyelid skin
- Puffy fat deposits under the eyelids
- Under eye bags
- Sagging lower eyelids that may show the whites of the eyes below the irises
- Excess skin in the lower eyelids
- Fine wrinkles in the lower eyelids
Remember, a lower eyelid blepharoplasty does not affect the eyebrows, or treat dark circles under the eyes, or crow’s feet. The end goal of a lower blepharoplasty is to restore a youthful lid/cheek junction. And whether this involves removal of fat, removal of skin, or both just depends on what your individual needs are.
Who Is A Good Candidate For A Lower Eyelid Blepharoplasty?
Good candidates for a lower eyelid blepharoplasty are patients that are in good overall medical health and have demonstrated some of the previously mentioned signs of aging seen with the lower eyelid and cheek. Anyone with eye diseases or pre-existing history of severe eye dryness needs to be cautious. It is important for a patient to have realistic expectations before undergoing cosmetic blepharoplasty. Although the procedure can enhance appearance and improve self-confidence, it does not radically alter the face.
How Is A Lower Blepharoplasty performed & with what incisions?
There are two approaches to the lower eyelid blepharoplasty, either through the inside of the eyelid which is called a transconjunctival approach and leaves no scar, or an external approach with an incision just below the eyelashes called a subciliary incision. For fat removal, the transconjunctival incision is used and any fat is visualized directly and removed as needed. When patients have excess external skin, or the skin is very creepy or loose, then the transconjunctival incision can be coupled with the subciliary or external incision. Even when used together, these leave a very thin layer of eyelid tissue intact, thus decreasing eyelid trauma and the risk of postsurgical scarring.
After the procedure, if present external incisions are closed with incredibly thin sutures, and any internal incision heals without the need for sutures or suture removal.
What is the Preoperative & Day of Surgery Process?
Once you decide to pursue surgery, a lengthy and detailed pre-operative visit is scheduled. This gives an opportunity to review all concerns, answer your questions, review the day of surgery and postoperative instructions, and obtain prescriptions and supplies that will be needed to avoid as much “day of surgery” stress as possible. Consent forms are completed, photographs are taken and reviewed, educational information discussed, and extreme care is taken to make sure both your expectations and mine are congruent.
The surgery itself is performed as an outpatient procedure in my office-based surgery center facility located at the Lasky Clinic (Beverly Hills) or the Crown Valley Surgery Center (Mission Viejo). Patients have a choice of IV sedation or general anesthesia, both have their benefits. The procedure takes less than hour, depending on the degree of correction needed, and can take longer if additional procedures are being performed. The procedure can take anywhere from 45 to 90 minutes, depending on whether or not both the upper and lower eyelids are treated, or if any other procedures are being performed.
As with all surgery, nothing is to be eaten from midnight the night before. Immediately preoperatively, the patients face is washed, clothes are changed and after meeting with the anesthesiologist and having an IV started, surgical markings are placed. This is a very important step. Typically the next thing you will remember is waking up in the recovery room following surgery with small chilled gauze pieces resting on your eyelids. Once you are awake and alert enough you are discharged home with a loved one or friend that will accompany you overnight and help you return the next day to the office for you initial postoperative visit.
What Is Recovery From a Lower Eyelid Blepharoplasty Like?
Following blepharoplasty, I suggest applying artificial tears or other lubricating drops/ointment and cold compresses to aid in healing and minimize side effects. Most patients return to work within a few days to a week, but should definitely avoid exercise and strenuous activities for at least 2 weeks. Sutures if present are removed 6 to 7 days after the procedure. Most of the swelling and other side effects typically subside within 2 weeks. Contact lenses and eye makeup may not be worn for 2 weeks after surgery. Wearing sunglasses a helpful way to camouflage the incisions or bruising, and postsurgical sunscreen on the incisions during the healing process is key to decrease scarring.
What are the Risks?
Although there will typically be some swelling and bruising around the surgical site, this will always subside on its own. Complete wound healing can take several months or even up to one year. Uncommon side effects include infection, reaction to anesthesia, and double or blurred vision. Eyes may be irritated and dry due to a temporary change in tear distribution. Side effects such as uneven healing and permanent scarring are rare but, if they occur, may require surgical correction.
Contact our practice to learn more about lower eyelid surgery where we serve the Beverly Hills, Mission Viejo, and South Orange County areas.