Upper Eyelids
Drooping or sagging skin of the upper eyelids is corrected by removing the excess skin from the upper eyelid. For some individuals, the fat tissue deeper to the eyelid skin is also removed to reduce the heaviness or bulging of the upper eyelid skin.
The procedure is done with a local anesthetic. Excess eyelid skin is removed and the skin is sutured closed. These stitches are mostly hidden in the crease of the upper eyelids.
Lower Eyelids (loose skin and bags under the eyes)
Lower eyelid bags and loose skin can be treated by one of two methods:
1) External Approach - Transcutaneous
The first approach involves removing excess skin and underlying bulging fat by placing a small incision just beneath the lash line of the lower lid and out into the crow’s feet area. If any fat needs to be removed, it is removed at this time, and a small amount of skin is also removed to take some of the excess skin out of the baggy or loose wrinkly areas from under the eyes. In some cases the lower eyelid margin may need to be tightened a little at this time to ensure the lower lid remains in the proper position. This is sutured closed and heals extremely well.
2) Internal Approach - Transconjunctival Bleparoplasty
When the lower lid has minimal, loose, or wrinkled skin, the fat bulges, creating bags that can be removed from a small incision placed inside the lower eye lid. No sutures are required, but there will still be some swelling and bruising even though there is no external incision that needs to be sutured closed to heal. The skin under the lower eyelid may be treated with a resurfacing laser to tighten and rejuvenate the lower lid skin. Patients with fair skin, minimal wrinkles, and age spots are good candidates for this approach.
Aftercare
Patients are accompanied home with a custom icepack that fits comfortably over the bridge of the nose and the eyes, and is held in place by a Velcro strap. They are encouraged to use this as often as they can in the first 2-3 days. Many use it over the first week because the coolness provides a very soothing sensation. Patients are asked to remain at complete rest for the first 48 hours with no straining or lifting. Minimal activity is important to minimize the risk of bleeding, which could lead to more swelling or bruising. Generally, most people take a week or so off of work. The eyes may still be bruised or swollen in the second week, but make up or cover-ups can be used and full activities may be resumed.
Patient Preparation
When considering cosmetic eyelid surgery, it is important to inform Dr. Cole of any abnormalities of your eyes, vision, or general eye health.
Eyelid surgery is very safe but complications can occur when patients over exert themselves. When having eyelid surgery, patients often feel great shortly after surgery and can have a tendency to overdo activities such as sports, home projects, gardening, exercise, etc. In order to avoid complications, it is very important to refrain from strenuous activities that require bending or lifting for a week after surgery. In addition, drugs that increase bleeding such as aspirin, anti-inflammatories, some vitamins and herbs, and some over the counter medications need to be discontinued 2 weeks before surgery.
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