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Additional
Blepharoplasty Information
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Frequently Asked Questions About
Blepharoplasty (Eyelid Tuck) FAQ
1. What is
Blepharoplasty?
Blepharoplasty or eyelidtuck surgery is designed to remove or re-suspend the
herniated fat and atrophied muscle, as well as lax, excess skin from the upper and lower eyelids. It is a very popular
procedure as hooded eyes seem to lack luster and seem old or tired by many
patients. Many individuals who choose this procedure are very aware that their
upper eyelids have seemed to disappear within the fat of the upper eye
area. Fat herniation is quite normal and will happen to everyone once we
age.
Sometimes a blepharoplasty can improve an
individual's vision. This is achieved by removing the excess fat and skin that
may block an individual's peripheral field of vision. If this is the
case, your health insurance may cover the cost of the procedure. Whatever the case, the
purpose of a blepharoplasty is for the aesthetic appeal that wider, youthful
eyes possess.
Blepharoplasty is usually performed using
a combination of local anesthesia and light sleep sedation or General. The incisions are made
within the natural creases of the eyelids. Your surgeon removes or
re-suspends the herniated
fat and excess skin and sutures the incision with very fine hair-like sutures.
It should be mentioned that aggressive removal of the fat pads underneath the eye
should be discouraged. Aggressive removal of this fat has proven to be quite
disastrous in most patients, even further down the line in their lives.
Aggressive fat removal often results in hollowness or a dark, sunken
appearance. Minimal removal (or re-suspension) has proven quite
beneficial in those who may need it. In those who do not need fat
resuspension or removal, only the
excess skin should be removed.
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As with any surgical procedure some
scarring should be expected. Although the scarring associated with
blepharoplasty is quite minimal and practically non-existent after several
months. The scars are placed within the normal creases and folds of the upper
and lower eyelids so that when the eyes are open the scars are invisible. With
lower blepharoplasty, where the fat is to be removed only with no skin excision,
the incision can be made either on the inside of the eyelid or right under the
lash line. Many surgeons prefer the transconjuctival incision with fat
removal-only cases. However, not all surgeons will offer this or agree with its
efficacy.
Although there is no set age when
blepharoplasty is performed, the usual ages that patients start making
consultation appointments for blepharoplasty is from 35 years of age and up.
However, this is highly individual and excess skin and fat around the eye area
may be desired to be removed younger than 35 years of age.
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A blepharoplasty is not designed to remove
the wrinkles (Crow's feet) from the eye area, nor lift the brows. It is
designed to remove the excess skin and/or re-suspend herniated fat from the lid areas only.
There are other procedures available that are area-specific to these
complaints. Chemical Peels
and Laser Treatments
can help soften peri-ocular (around the eye) wrinkles significantly. For a
non-surgical solution, Botox is very
effective of ridding you of Crow's feet or lifting the brows. I regularly
partake in this little indulgence!
Please
consult with a qualified surgeon to determine your exact needs. It is also best
to seek at least three opinions.
Swelling will be apparent at first and
there may be some bruising. Although, this factor should be considered
individual. Some are prone to bruising more than others. Some
patients suggest
Arnica montana sublingual capsules and a topical ointment as
well. Some patients also suggest
Bromelain.
Your eyelids may feel tight and sore as
the anesthesia wears off, but your pain medication should be able to control any
discomfort. Your vision may be a little blurry for the first few days due to
the swelling and your eyes may be watery or they may be dry. You should not be
in any extensive pain. Patients have described post-operative pain as
associated with blepharoplasty as mild discomfort, as if the skin was sunburned,
wind burned or the eyeballs having been irritated or scratched.
Your stitches are normally removed within
3 to 5 days of the operation. The removal process may sting a little bit as the
tight, fine sutures are very small and require very fine tweezers and scissors
for removal. The surgeon might accidentally snip a piece of superficial skin
and there may be a stinging sensation form tugging on the sutures while removing
them.
After the swelling goes down you will be
able to see a definite difference with the amount of over hang in the upper eye
area if you had an upper blepharoplasty. You must realize that when you wake up
no matter what time of day there will be increased swelling. This is due to
fluids pooling, lack of movement, not having urinated in many hours, (this
actually can contribute to swelling of the tissues even without having surgery).
Also swelling will be more apparent if you are not elevated properly. If you sleep with your head well elevated (with
at least three pillows) during the interim of your recovery, this will be
less apparent.
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The minor complications that
are associated with blepharoplasty include:
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double or blurry vision for a few
days
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temporary swelling at the corners of the eyelids
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milia (or tiny
whiteheads) that can be removed by your surgeon by pricking them with a
sterile micro-needle
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asymmetry during
healing or excessive scarring if you are prone to such a thing
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difficulty in closing your eyes when
sleeping. In rare instances this condition may be permanent.
Moderate to severe complications may include:
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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.
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If you have thyroid problems (hypothyroidism or Graves' disease) dry eyes or
insufficient tearing, circulatory disorders or high blood pressure, having
blepharoplasty 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 blepharoplasty. Edema will not be corrected
by surgery.
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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.
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Sometimes the eye area will not heal correctly and you just may have to have an
additional surgery to correct it. The surgeon normally does not charge any
additional fees if another surgery is necessary. I think the doctor shouldn't
charge you but you may not be that lucky.
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There is also the risk of a
doctor cutting and removing too large of an oval of skin for your eye size
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There is also the risk that your doctor
may remove too much of your fat pads (sub orbicularis oculi fat pad, SOOF) under
your eyes. More and more, doctors are discontinuing this as they are finding an
increasing amount of patients suffering eye abnormalities with this practice.
Patients are complaining of sunken eyes, eye hollowness and a tired, aged look.
*myxedematous: severe hypothyroidism
characterized by firm inelastic edema, dry skin and hair, and loss of mental and
physical vigor. (Merriam-Webster dictionary)
also known as:
Mountain Tobacco, Mountain
Arnica, Common Arnica, Leopard's Bane and Sneezewort
plant family: Asteraceae
type: Herbaceous perennial
parts used: Roots and flowers
description: Arnica montana or Leopard's Bane is a perennial herb,
growing close to the ground. The leaves form a flat rosette, from the center of
which rises a flower stalk, 1 to 2 feet high, bearing orange-yellow flowers.
The rhizome is dark brown, cylindrical, usually curved, and bears brittle wiry
rootlets on the under surface.
habitat: Indigenous to Central Europe, in woods and mountain pastures,
although it has been found in England and Southern Scotland.
warning: This herb should NEVER be taken in raw form. This plant, like
many medicinal plants if ingested, can cause intestinal bleeding, abdominal
cramping and sickness. Homeopathy is the medicinal use of tinctures and
suspensions using herbs and other plants and should never be consumed without
proper preparation. Only respectable homeopathic remedies and tinctures should
be consumed.
Read
more on Arnica Montana?
11. What
about Bromelain? Does this help with swelling and bruising as well?
from the plant of the:
Pineapple
also known as: Ananas, Nanas, Pina
plant family: Bromeliaceae
type: herbaceous perennial
parts used: mostly in the stems of
pineapples, but some fruit is used as well.
description: 2 1/2 to 5 ft. high
with a spread of 3 to 4 ft. The plant is like a thick stem with a rosette of
wide, waxy leaves. These pointed green, red, and white/off white striped leaves
are approximately 18 to 70 inches long and graced with a spiny needle-like
tip. The plant produces a sweet to tangy and sometimes sour fruit that is yellow
to white in color. The unpeeled fruit is brownish with a hard, spiky covering
and a large green sprout from it crown. The fruit is shaped like a coffee can
with rounded ends and is about 10 to 12 inches long usually when considered
prime and may even weigh up to 10 lbs.
habitat:
Indigenous to southern Brazil and Paraguay,
The fruit is now grown all over in green houses and in the fields of Spain,
Guatemala, Hawaii and more. The pineapple is a tropical plant and thrives in
hot, humid places. Although it can survive cold snaps, it is not recommended for
the more northern areas if intended to be grown outdoors.
Read more on Bromelain?
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