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SOOF Lift (Sub-orbicularis Occuli Fat Pad)
As we age,
the Orbicularis oculi, the muscles around the eyes, and
its surrounding fat and fascia start sagging and can make us
look, tired, haggard and sometimes even angry. The orbit
becomes hollow-looking and your tear troughs become
apparent, resulting in a worn look. The SOOF lift may be able to
help you cosmetically but is a great procedure to help correct
functional disorders, as well. Fat repositioning sure has its
benefits and advantages, as for rejuvenation purposes it can
sometimes be safer to resuspend fatty tissue to rejuvenate the
midface and undereye area.
What Is
a SOOF Lift?
This surgery is
meant to reposition the fat pad rather than remove it such as is
practiced with a standard lower blepharoplasty including fat
removal. However, it is common to have lower blepharoplasty
which may require only skin excision. Just remember that the
SOOF lift is a newer procedure and may not be offered in all
surgeon's offices. Please discuss this procedure fully and
determine your surgeon's expertise before committing to a
surgery as there are inherent risks which go along with this
procedure.
This
procedure can also be performed for the below reasons as well
for cosmetic. The definitions for some terms may not be
familiar so they have
been provided in
blue
for your convenience.
-
after
involutional ectropion: [: an
abnormal turning out of a part (as an eyelid) due to bodily
changes after menopause]
-
ciatricial ectropion
-
7th
nerve palsy (aka Facial Nerve palsy or Bell's palsy):
a disorder where the
eye muscle can not blink or close the eyelid. Usually persons
with these disorders cannot produce enough tears to lubricate
the eye properly due to the inability to blink or close the
lids. So, artificial lubricant drops are used during the day
and a thicker, ointment used at night.
-
traumatic lid retraction:
retraction of the eyelid
due to blunt force or sharp, physical trauma.
-
Congenital lid retraction:
Can be caused from several
acquired factors...
-
thyroid
eye disease
-
secondary
to contra-lateral [: occurring on
or acting in conjunction with a part on the opposite side of
the body] ptosis
(due to increased neuromuscular stimulation to the ptotic
[sagging] eye.
-
iatrogenic [: induced
inadvertently by a physician or surgeon or by medical
treatment or diagnostic procedures]
from overzealous ptosis [sag]
operation.
-
neurogenic (from lesions in the upper dorsal midbrain,
Collier's signs and can occurs with Parinaud's syndrome
[: paralysis of the upward
movements of the two eyes that is associated esp. with a
lesion or compression of the superior colliculi of
the midbrain])
-
myogenic
[1 : originating in muscle]
dysfunction
-
other
(where lid retraction occurs in other direction of gaze but
not in primary position)
-
post
blepharoplasty:
see the
Blepharoplasty Page for more info.
[: plastic surgery on an eyelid esp. to
remove fatty or excess tissue ]
-
reconstruction after lower lid excision
cosmetic
uses:
-
malar
festoons: excess
skin and Orbicularis resting on the upper malar region
-
tear
trough deformity:
the palpability and
appearance of the prominent inner-under eye area due to lack
of fat or ptotic (sagging) fat.
-
infraorbital dark circles:
dark circles
[: situated beneath the orbit]
due to fat loss or sag.
-
prominent nasolabial folds:
The folds or deep grooves
[: of, relating to, located between,
or occurring between the nose and the lips]
cosmetic
uses:
-
malar
festoons: excess
skin and Orbicularis resting on the upper malar region
-
tear
trough deformity:
the palpability and
appearance of the prominent inner-under eye area due to lack
of fat or ptotic [:sagging]
fat.
-
infraorbital dark circles:
dark circles
[: situated beneath the orbit] due to
fat loss or sag.
-
prominent nasolabial folds:
The folds or deep grooves
[: of, relating to, located between, or occurring
between the nose and the lips]
It is worth
mentioning that some surgeons consider a SOOF lift a cheek pad
lift, or midface lift. Teh SOOF is the fatty area right under
the eye.
Understanding the
Structure of the Eye
In standard
Blepharoplasty procedures, the fat pads and atrophied muscle are
removed. With SOOF lift it is repositioned instead. An
aggressive approach can cause complications such as ectropion,
entropion, unusual eye roundness, hollowness and more, in some
patients.
The many
reasons for an improper functioning eye post-op Standard
Blepharoplasty -- or even cosmetic deficiencies -- result from
too much tissue (be it fat, muscle, skin) being removed.
"The
orbital septum, which lies deep to the Orbicularis, is a key
structure and landmark in blepharoplasty. The septum is a thin
sheet of fibrous tissue that originates along the superior
orbital rim and hangs like a curtain across the lid. It joins
the levator aponeurosis by interdigitating fibers at the upper
edge of the tarsal plate. The septum keeps the orbital fat in
its posterior position. Weakening of the septum with aging,
hereditary predisposition, or trauma may cause protrusion of
the orbital fat." 8
Are You a Candidate for
SOOF Lift?
First and
foremost, an individual must be in good health, not have any
active diseases or pre-existing medical conditions and must have
realistic expectations of the outcome of their surgery.
Communication is crucial in reaching one's goals. You must be
able to voice your desires to your surgeon if he/she is to
understand what your desired results are. Discuss you goals
with your surgeon so that you may reach an understanding with
what can realistically be achieved.
You must be
mentally and emotionally stable to undergo an cosmetic
procedure. This is an operation which requires patience and
stability in dealing with the healing period. There is
sometimes a lull or
depression after surgery and if there is already a
pre-existing emotional problem, this low period can develop into
a more serious issue. Please consider this before committing to
a procedure.
Most
individuals seek out Blepharoplasty in their mid thirties.
However, if saggy or fatty under eye bags are hereditary you may
wish to go undergo a SOOF Lift or
blepharoplasty procedure at an earlier age.
Also, if you
have Hyperthyroidism, or myxedema -- THINK THIS OVER. No
amount of surgery will ever reduce your edema (swelling from
fluid retention) of your eye - ever. If you would like to hear
more on this as well as from patients who have had negative
outcomes regarding misdiagnosed situations go to our Cosmetic
Surgery Message Board and ask outloud. It could be a matter of
your eyes never looking "normal" again. This is important.
Please
read the risks, complications and contraindications of a SOOF
Lift.
"Blepharochalasis
is a commonly misused term that should be reserved for a rare
familial condition characterized by chronic, recurrent edema
of the eyelids with subsequent breakdown of the tissues within
the eyelids, including the orbital septum. This causes
prolapse of the orbital fat, resulting in drooping of the lid.
Blepharochalasis is a functional indication for a
blepharoplasty. Dermatochalasis means relaxation of skin. It
is associated with the aging process and variable amounts of
fat herniation and prolapse. This is part of the normal aging
process and is not a functional indication unless there is
dermatochalasis causing "pseudoptosis" with superior visual
field defect. Blepharoptosis, or the drooping eyelid is caused
by a malfunction of the levator muscles. Levator function is
measured by blocking the action of the frontalis muscle and
measuring the excursion of the eyelid from downgaze to upgaze.
Levator excursion from 15-18 mm is considered normal and 10-14
mm is good function." 8
What to Expect at Your
Consultation
After checking a
few surgeons' backgrounds and credentials, you will make an
appointment for a consultation. You will meet with these
surgeons and discuss your goals and you will disclose all
information regarding your health. These surgeons should ask
for your complete medical history. It is advisable to go over
any medical records to refresh your memory prior to your meeting
with the surgeon. The surgeon should ask but if he does not, be
sure to disclose any allergies that you may have, disorders,
past illnesses and if you are a smoker. Be sure to advise him
of the medications, if any, you are taking. T his includes
vitamins, herbal supplements, over the counter medications, etc.
You should not take any aspirin containing products at least 2
weeks prior to any surgery.
See
Medication & Supplement List for an extensive, but partial,
list of medications to avoid before surgery. If you are taking
any of the listed medications advise your surgeon and
anesthesiologist so that they can take note of it or have you
cease consuming them.
You will then
discuss your complaints and concerns. Your surgeon will explain
the technique and incision placements or methods that may be
most appropriate for you and should discuss the risks
associated with SOOF lift with you, as well.
You will also
discuss the available anesthesia that will be used for your
procedure. Most SOOF lift procedures are performed under Light
Sleep Sedation or General Sedation. Either way, discuss this
beforehand as many people are not aware of the risks of
Anesthesia. If you do go under Deep General, ascertain that the
anesthesiologist is certified.
Please read
the All About Anesthesia Page -- the risks regarding
anesthesia should be considered for a fully informed choice.
You will
discuss where the surgery will be performed as well as after
care and post-operative visits. Discuss with your surgeon your
vision problems, if any and tell him if you wear contacts or
glasses. He will discuss with you all of the aspects of surgery
and if you will have blepharoplasty as well, if you should need
all 4 or just the upper or lower eyelids only operated on with
your SOOF Lift. *You will also be taught how to clean your eyes
post-operatively at your pre-operative visit.
He should
advise if he feels as if you have excess fat, skin or even
atrophied muscle that needs to be removed (blepharoplasty). You
will discuss the incision placement, the realistic expectations
you should have and what other options you may have instead of
surgery.
You will also
discuss fees, medication costs and any hidden costs that may
arise. If your eyelids interfere with your vision, you may be
able to get your insurance to cover the blepharoplasty portion
of the operation.
If you would
like more information on Consultations or a list of questions to
ask your surgeon please visit the
Consultation Help Page. If you should choose to book or
reserve a surgery date you will usually give a deposit to hold
your surgery date. Most times if you cancel a few days
beforehand, this amount is non-refundable. After paying your
deposit and scheduling a surgery date, you will also schedule a
pre-operative appointment...
Your Preoperative
Appointment
This appointment
addresses more questions you may not have thought to ask at the
initial consultation, such as more surgical details, concerns
and even ascertaining that your surgeon is aware of what you
desire from your procedure. Just as your surgeon will make
certain that you know what it realistically possible from this
procedure.
You will also
discuss your pre-operative instructions and speak about the
recovery period instructions and what to expect in the months
ahead. You will be given prescriptions for antibiotics, pain
relievers, perhaps blood pressure medicines, prescription
anti-inflammatory drugs and perhaps a box or directions for
gaining a box of Arnica montana. Would like to know more
on the benefits of
Arnica
montana? Perhaps you will be instructed to obtain
Bromelain
or other types of remedies, although many surgeons would rather
have you not take ANYTHING other than your prescription
medications, please do not go against your surgeon's wishes.
Remember, always ask your doctor before taking any of these
products.
Please do not
hesitate to address any concerns that you may have during this
time and even after your pre-operative appointment. If you
remember something when you get home or the next day or even the
day of surgery -- don't be afraid to ask.
Preparing for Your Surgery
You should be
given a pre-operative information packet that explains
everything you should do and know before your surgery date. The
packet should include a list of all the medications you should
not take starting usually at 2 weeks before your
surgery. These medications will include, but are not limited
to, aspirin containing products, stimulants, seratonin
supplements, etc. Would you like to view a typical
Medication & Supplements List? We have a
printer-friendly version as well. Also, if your surgeon
advised that you may take Arnica montana,
Bromelain,
etc. for swelling and bruising you should either have this in
your packet or begin shopping for your necessities.
It is quite
possible that you will have preliminary blood work performed.
This is normally an extra out-of-pocket expense that the patient
must participate in to check your white and red blood cell count
(complete blood count or CBC) to alert your surgeon to disease
or disorders beforehand. If you are a female they may take an
extra vial for a pregnancy test. Some surgeons ask that you
have physical. This can be yet another out of pocket expense so
ask at your consultation what will be needed when you are quoted
a price.
So many
things to do... so little time. Surgery will be here before you
know it so visit the
Preparing For Surgery page and relax. This section
contains, printer-friendly pre-op lists, tips and advice as well
as things you must do to prepare for your big day.
How This Procedure Is
Performed
A SOOF Lift
normally takes from 1 to 3 hours to perform. If you are having
upper blepharoplasty as well the surgery will last closer to 3
hours. If this is the case, the upper Blepharoplasty will more
than likely be performed first. Larger amounts of skin are
excised for upper Blepharoplasty and the swelling is more
intense than with the lower lids. The exception is when
unusually large bags are present.
First, you will have
monitoring pads attached to you so that the surgical team can
properly monitor your vital statistics before, during and after
your operation. When you are brought to the operating room,
electrodes will be plugged into these pads which are connected
to the monitoring equipment.
Once you are on the operating
room table, you will then be given your choice or your surgeon's
preference in anesthesia as discussed prior to your surgery
date. If you had been given an oral sedative or valium prior
you will have less anxiety. They will more than likely insert
an IV for a saline drip to keep you hydrated and have a vascular
doorway for anesthesia, antibiotics, and other medications. If
you haven't been given a sedative, it is more stressful for some
patients. If you feel that you may experience anxiety inquire
beforehand regarding an oral sedative. Having an IV inserted
feels sort of like blood being drawn, but for a shorter period
of time. It's the initial placement of the IV that may sting a
bit. Some people get heir IV placed in the crook of the elbow,
some the hand, it all depends upon your veins though. So
if your veins are not very prominent this can be a problem.
You are then brought to the
O.R. if you aren't on the table yet. After the needle is
injected into the vein it is pulled out and a little plastic
tube is left in your vein. This is called a catheter. The
catheter is taped to your skin so it is not accidentally knocked
or pulled out and is ready to be used as a sort of entryway for
anything the surgical team deems necessary for your body. This
is usually done before you get into the actual O.R. -- by a
nurse -- and you have a saline bag hooked up to you. The
medications will usually be given with a drip system with this
saline. As said before, the saline will keep you hydrated both
during and post-operatively.
If you have
chosen an IV Liquid Sedative, they will insert a hypodermic into
your tube that you are attached to or they attach the bag of it
with a drip system to add a few drops every few seconds and when
they spring open the stopper and it starts heading towards your
body. The the effects of the anesthesia are felt soon after
injection or opening the stopper - a few seconds in fact. It
may feel similar to a sensation of heat entering your arm or
hand at the catheter site. It then feels as though it is
creeping up your arm -- then it jumps from your shoulder to a
metallic-like taste under your tongue and then you are
blissfully anesthetized. The anesthesiologist or surgeon will
then determine if you are sedated properly, your stats are
stable and if you are ready for the surgery to begin.
You will then
be marked with a magic marker type pen for the placement areas.
You will then be scrubbed with Betadine although the surgical
marker markings will remain -- although not as dark. However,
some surgeons scrub beforehand and then mark the skin. You will
be injected with a solution of Lidocaine, epinephrine and
saline. The epinephrine is a vasoconstrictor. This will impede
your skin's ability to bleed excessively.
The incisions will follow
along the natural lines and creases of the upper and lower
eyelids. All efforts possible should be made in order to achieve
inconspicuous scars. Although, the incisions may extend into the
crow's feet area (aka smile lines) at the outer corners of your
eyes.
There are two
SOOF lift techniques that are usually performed. The definitions
for some terms may not be familiar so they have been providedfor
your convenience.
The External Approach with a visible scar:
1. A lateral
canthal incision of 1-2 cm is made. Which means an incision at
the outer corners of the eye where the two lids meet.
2. Lateral Canthotomy and Inferior Cantholysis
3. Lateral Canthopexy
4. create pocket superiorly [: in or
to a more superior position or direction]
to expose deep temporal fascia and periosteum [:
the membrane of connective tissue that closely invests all bones
except at the articular surfaces] over the
lateral orbital rim.
5. The skin is
then dissected [separated from the underlying structure]
at a lateral aspect incision, extended 2-3 cm inferiorly to
create a flap [: a piece of tissue partly severed from
its place of origin for use in surgical grafting]
of malar [cheek or
zygomatic] fat, SMAS [Superficial (or Sub-) muscular Aponeurotic
System], Orbicularis oculi
[muscle around he eye] and SOOF [the sub-Orbicularis
oculi fat pad]
6. With forceps
the SOOF is grasped and two braided permanent sutures are
threaded through the flap and anchored to the deep fascia
[the thick white muscle covering]
of the temporal area
[: of or relating to the temples or the sides of the skull
behind the orbits] and
periosteum.
7. The excess skin is then excised [removed]
8. The suture lines are then closed
The Transconjunctival, or through the conjunctiva
[: the mucous membrane that lines the inner surface of the
eyelids and is continued over the forepart of the eyeball]
approach:
1. the
incision/permanent suture is made subperiosteal
[: situated or occurring beneath the
periosteum, or : the membrane of connective tissue that closely
invests all bones except at the articular surfaces]
and the above techniques are applied, the only difference is the
incision placement. The Transconjunctival technique leaves no
visible scar.
After the
surgery is completed, the surgeon will lubricate your eyes with
an ointment and perhaps apply a pressure dressing. Your eyelids
will feel tight and quite tender as the anesthesia wears off.
Your prescribed medication should alleviate this pain and
discomfort. However, if you believe your pain to be out of the
ordinary, call your surgeon or the staff on call immediately.
You will be driven home by your spouse, significant other or
friend as you will not be able to see, much less drive yourself
home.
The Road to Recovery
You may be groggy
from the anesthetic and/or oral medications and probably won't
remember much of the first day or two. You will have to take it
easy and sleep on two pillows to keep your head elevated for
7-14 days - or however long your surgeon suggests. When you wake
up you will notice that your eyes will look even more swollen in
the first 3 days. But, as the days go on the swelling will
dissipate. There may be bruising, but this will go away, as
well. So make a mental note of this or you may be shocked into a
depression. Bruising and swelling are a normal occurrence in
most surgeries.
Your will be
instructed to keep your head elevated for several days. Two to
three medium-filled pillows should do the trick. Take your
temperature regularly. An elevated Temperature could mean an
infection. Take those antibiotics ON TIME. And don't forget if
you are taking birth control that some antibiotics can interfere
so in the event that you do have relations, use another form of
protection as well. You should also use cold compresses to keep
swelling and bruising to a minimum. Some surgeons may recommend
the Swedish Therapy Gel Eye Mask or the BioDermis HydroGOLD™ eye
mask because it is incredibly comfortable and stays cool,
without being "wet", for long periods of time.
The amount of
bruising varies with the individual. It will be at its worst
during the first week. You may not swell and bruise too much
directly after the surgery, but the next day and especially the
third, you may feel as if the swelling and bruising is rather
extreme. You will begin cleaning your eye area as shown at the
pre-operative visit. Your surgeon may recommend using eye drops
or oculo-wetting solution to help with lubricating your eyes. It
is quite possible that your tear glands will not be able to
produce enough tears to lubricate your eyes properly for the
first few days or even weeks. Although quite the opposite is
possible as in excessive tearing. You may also experience light
sensitivity and blurred or double vision. You may be instructed
to wear a special hard mask over your eyes while sleeping. This
type of mask is also utilized for post-operative care of LASER
vision correction (LASIK) patients. This mask prohibits the
patient from accidentally applying pressure or rubbing the eyes
while at rest.
Your sutures will be removed after 2 - 5 days, more than likely
3 days. You swelling will begin to subside at the end of the
week although it is known to remain for 3 weeks. You will
instructed to not wear contacts (if your vision requires it).
And even after the allotted time your contacts may give you
discomfort while wearing them. You may still experience hyper-lacrimation
(excessive tearing) or hypo-lacrimation (excessive dryness from
lack of tears) of the eyes. This should return to normal within
a few weeks and may be more of n aggravation than anything.
Most patients return to work in a 7 to 10 days. You should limit
your sun exposure as your eyes will be sensitive to it as well
as your incision sites; sun block should be used on the eye
area. Make sure that the sun block is safe for eyes and will not
irritate them.
Avoid too
much movement for the first few days (about 5). And even if you
are feeling better, you should take it easy while you are
recovering. Do not participate is strenuous activates for at
least 3 weeks. And definitely NO CONTACT SPORTS. Your bruising
will subside within a few weeks and after your surgeon gives you
the "go ahead" you may begin wearing cosmetics to hide residual
bruising.
Risks & Complications of SOOF
Lift
The minor
complications that are associated with SOOF Lift include double
or blurry vision for a few days, temporary swelling at the
corners of the eyelids, and milia (or tiny whiteheads)
that can be removed by your surgeon by pricking them with
a micro-needle. It is possible to develop asymmetry during
healing or excessive scarring if you are prone to such a thing.
It is possible that you may experience difficulty in closing
your eyes when sleeping. In rare instances this condition may be
permanent. Also there is the rare possibility of ectropion.
Ectropion is a condition where your lower lids are pull down or
gape. If you should develop ectropion, further surgery will
more than likely be needed to correct it. Which could lead to
more risks and more cost to you, the patient. Ascertain whether
or not, if you should develop ectropion, your surgeon's fees
will be waved.
If you have thyroid problems (hypothyroidism or Graves' disease)
dry eyes or insufficient tearing, circulatory disorders or high
blood pressure, having a SOOF lift may be more risky for you
than an otherwise "healthy" individual who does not have such
disorders. Grave’s disease is frequently associated with severe
swelling of the periorbital tissues. This swelling may be
misdiagnosed as excess under-eye fat pads. If you are
myxedematous* (in a severe state of hypothyroidism) you may
have severe edema, or fluid retention, especially in the
eye area; is a common symptom of hypothyroidism. The fluid
filled tissue areas are often misdiagnosed as excessive fat in
the eye area and when removed can lead to disastrous results. As
your edema subsides and your fluid levels level out, after
removal the eye area will look very sunken in. Ascertain that
your surgeon establishes whether or not your eye "bags" are
caused by fat or chronic edema prior to
your SOOF lift. Edema will not be corrected by surgery - ever.
"A review
of the past medical history is also important to reveal any
contraindications or underlying illnesses that may affect the
surgery. The surgeon should always be aware of the possibility
of thyroid disease manifesting as orbital disease. Graves'
ophthalmopathy can cause globe protrusion, eyelid retraction
and symptoms of dry eyes, while hypothyroidism may produce
myxedema, which the patient and surgeon may misdiagnose as
protruding orbital fat. Previous facial palsy may result in
persistent weakness of the periorbital musculature, which may
lead to inadequate corneal lubrication and corneal desiccation
or ulceration. Allergy may cause intermittent swelling and
dermatitis of the eyelid skin and recurrent periorbital edema.
Chronic renal disease and diabetes may affect wound healing
and increase the risk of infection." 8
Other
disorders that may increase your risks are myasthenia gravis,
cardiovascular disease, diabetes, a detached retina or glaucoma
(and other high pressures of the eye), poor circulation and poor
elasticity. Please disclose all disorders or concerns with your
plastic surgeon - you're health and well-being might depend on
it.
Sometimes the eye area will not heal correctly and you just may
have to have an additional surgery to correct it. The surgeon
may or may not charge any additional fees if another surgery is
necessary.
Even though
the SOOF lift may be sought to re-suspend or re-position the fat
pads instead of removing them partially, or entirely. Some
patients do need fat removal.
*myxedematous:
severe hypothyroidism characterized by firm inelastic edema, dry
skin and hair, and loss of mental and physical vigor.
(Merriam-Webster dictionary)
The Average Prices of SOOF
Lift
Although costs may vary from
region to region and depending upon the physician, the average
prices: $2,000. - $5,000. US. These prices may not include
medications, post-operative supplies or O.R. and anesthesia
fees.
The Least You Need To Know
-
What:
The SOOF lift is
a procedure to lift the Sub-orbicularis oculi Fat and/or cheek
fat pad
-
Why:
This surgery is
meant to reposition the SOOF and cheek pad. Some surgeons may
consider this lift to involve lifting only the SOOF, others
both the SOOF and cheek fat pad. Be sure you find out ahead a
time.
-
When: from late 20's to 70's,
usually.
-
Who: Research your doctor
very well! He should help you decide which technique would be
best for you and discuss this openly.
-
Where: Accredited Surgical
suite or hospital
-
Risks:
READ THEM!
-
incisions/scars: in
the outer area where the lids meet or inside the lower
lid.
-
Anesthesia: IV Sedation
(Light Sleep) or General.
Read All
About Anesthesia
-
Duration:
1-3 hours
-
Pain Factor: mild, pain meds
should alleviate any discomfort. If not, call your surgeon
immediately!
-
Swelling: Moderate -- Medium;
depending upon individual; I suggest arnica montana and
bromelain.
-
Bruising: Moderate -- Medium;
depending upon individual; I suggest arnica montana and
bromelain.
-
Post-operative instructions:
Have someone there to help
care for you during your recovery, keep elevated -- even when
sleeping. A recliner works best. Cold compresses for first 48
hours are suggested. As well as cleansing of the eyes after
your pre-operative visit. You shouldn't try to read or watch
television -- at least for long periods of time -- for up to
three days post-operatively. And do NOT wear your contacts,
if you wear them, for at least 2 weeks post-operatively. Try
not to rub your eyes in the weeks following your surgery.
This action could further irritate your eyes. Some surgeons
offer a metal or hard plastic face mask (coated with a soft
material) to keep wandering hands and fingers away during
healing times. Patients having undergone Lasik are familiar
with these face masks.
-
1st
Post-op visit:
day 2 to 5 (more than likely day 3) for suture removal
-
Return to work: 7 to 10 days
-
Activity: No exercise until
at least 3 weeks post-operative. Be careful not to raise your
blood pressure for several weeks, you don't want to inhibit
proper healing or get an infection. You should remain inactive
for 3 to 5 days. Check with your surgeon!
-
Sun exposure: UV light may
cause hyperpigmentation in some patients around the incision
lines.
-
End result: The swelling and
proper positioning of the eyelids post-op may take several
months.
-
Loss of Sensitivity: It is
possible to lose sensation along the incision lines. Long
term or permanent loss of sensitivity is possible.
-
Anything else? Possible
eyebrow and eyelash loss from medications. Possible asymmetry
as well. Possibility of hypertrophic scarring that some
patients get Erbium laser treatments to abate.
-
Longevity:
the skin is
still subject to aging, especially with photo-aging. You may
wish to seek
Erbium or CO2 laser for wrinkles, or even
NLite.
-
But Wait! There's More!
Research as much as you can on the subject. Disclose all your
medical background. If you are a smoker, if you are taking
medications, or if you have any other medical concerns. Have
realistic expectations about your results. If you are 50
years of age and you choose to undergo Blepharoplasty, the
procedure will not give you the eyes of 20 year old. Besides
this look would not suit your face and appear done. NO
plastic surgeon can perform miracles, he can only try and
improve upon what you have beforehand.
-
The
average prices for a SOOF Lift
both lower lids, $2,000. -
$5,000.;
Related Links
EyeRepairs.com - Plastic Surgery and Reconstructive Surgery for
the Eye and Orbit.
Emedicine - Eyelid Surgery
Meronk - Eyelid and Facial Anatomy in Photos
Oculoplastic Photo Gallery
References
Hamara ST. The
Role of Orbital Fat Preservation in Aesthetic Surgery.
Clinics of Plastic Surgery; 23(1) 17-28. 1996
Hamara ST. The Aging face: Analysis Surgical Approach and Result
Assessment: Aesthetic Surgery Quarterly 16(1), 65-74
Hoenig JA, Shorr N, Shorr J, The Sub-orbicularis Oculi Fat In
Aesthetic and Reconstructive Surgery; International
Ophthalmology Clinics; 37(3): 179-191. 1997
McCord, CD et al. Re-draping the Inferior Orbicularis Arc.
Plastics and Reconstructive Surgery; 102(7): 247 1-9. 1998
M. Sean Freeman, MD, Trans-conjunctival Sub-Orbicularis Oculi
Fat (SOOF) Pad Lift Blepharoplasty: A New Technique for the
Effacement of Naso-jugal Deformity
Goldberg, Robert Alan; MD, FACS "SOOF Lift Helps Rehab Eyelid
Complex Fat Relocation Rather Than Removal Is The Name Of The
Game In Today’s Lower Lid Blepharoplasty" *R. Goldberg can
be reached at the Jules Stein Eye Institute, 100 Stein Plaza,
Los Angeles, CA 90095-7006; (310) 206-8250; fax: (310) 825-9263.
Ophthalmics Direct, Differential Diagnosis of Common
Physical Signs in the Eyelids
8 Greenberg, Jayson, M.D.; Baylor College of
Medicine. The Bobby R. Alford Department of Otorhinolaryngology
and Communicative Sciences. Blepharoplasty February 4, 1999
Merriam-Webster Medical Dictionary
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