What are the limits of blepharoplasty?

Blepharoplasty will not correct changes in the skin quality including pigmentation, discoloration or wrinkles. The procedure may be coupled with skin resurfacing techniques including peels or laser that will improve the skin quality. The dynamic lines that are seen at the corner of the eyes often termed “crow’s feet”, are a consequence of the orbicularis oculi muscle that underlines the skin. These wrinkles are not affected by blepharoplasty and are best treated with Botox® treatments

How long does the procedure take?

Depending upon the scope of the procedure, the operation takes approximately 1 to 3 hours to complete. The procedure may be completed only on the upper eyelids, the lower eyelids or both concurrently.

What type of anesthesia is used?

Blepharoplasty is routinely performed under local anesthesia and may include the use of sedation (oral or intravenous) or “twilight anesthesia”. Compared to general anesthesia, local anesthesia with sedation is associated with less bleeding, increased safety and faster recovery.

I take aspirin do I need to stop before blepharoplasty? Are there any medications I should stop before blepharoplasty?

It is important to avoid any medications that thin the blood and encourage bleeding before surgery, these include: aspirin, ibuprofen, vitamin E, and any type of herbal supplements. Dr.Orloff will direct you with the proper supplementation prior to and post procedure.

Do I need anyone to care for me after blepharoplasty?

It is also important that the blepharoplasty patient arrange for a caretaker for the first 24 hours after their surgery. Patients need a responsible caretaker to be with them for the first night. Patients are not allowed to drive themselves or take public transportation alone to home because of the effects of the anesthesia. Dr. Orloff’s surgery staff will ask for the caretaker’s name and contact information as well as who will be taking the patient home from the recovery room.

What is the care after blepharoplasty?

After your surgical procedure, when you arrive home, we encourage you to relax keeping your head elevated on several pillows, at a 30-40 degree angle. For the next two weeks you should sleep on your back with your head elevated.

For the first 48-hours, you should use ice compresses over your eyes for approximately 15 minutes of every hour. This reduces swelling and aides in your comfort.

You may shower the day after your surgery and care should be taken to avoid the direct spray of water on your face. Baby shampoo is preferred because it is gentle on your eyes.

Avoid straining or any activity that causes a feeling of pressure in the face and eyes. Strenuous physical activity is dependent on the type of surgery and could be from 2-6 weeks. You should not be driving if you are still taking pain medicine or have any blurring of vision.

Eyeglasses can be worn after your surgery if you need them. Contact lenses can be used after a 2-week period. Sun exposure should be avoided as much as possible.

What is the down time and recovery period like?

There is initial swelling and bruising that occurs after the procedure and takes about 1 to 2 weeks to resolve. With the use of ice packs every hour while awake for the first three days, there is a reduction in the amount of postoperative swelling. Usually the patient may return to normal non-strenuous activities 1 week after the procedure and by 2 weeks the eyelids are on average 90% improved. The best result is usually seen several weeks to months later.

Is there much discomfort or pain after surgery?

The surgery generally causes mild ache or discomfort which settles over less than 48 hours, and the surgery is not regarded as painful. Usually over the counter analgesia is sufficient to reduce the discomfort

How long do the swelling and bruising last?

Most patients experience some bruising particularly of the lower eyelids. Postoperative swelling peaks the day after surgery and mostly resolves over the next two weeks to a month.

How long do I need to be off work?

Most people are advised to take a week off work, however in most cases, normal tasks can be resumed within two days. Exercise or any strenuous activity that may lead to an elevation in blood pressure are advised against for a minimum of 1 to 2 weeks as they will lead to an increase in swelling and delay in resolution. Many patients ask about using a computer and watching television. Eyelid surgery causes some blurring of the vision for several days as a consequence of eye drops, ointment and swelling. Watching television or using a computer will not affect the healing process and can usually be resumed after several days.

Are the scars noticeable after surgery?

In upper blepharoplasty, the incision is hidden in the crease of the eyelid and is often barely visible even 1 week after surgery. In lower blepharoplasty, the incision is placed either in the conjunctiva (termed transconjunctival) of the eyelid in which case it is completely hidden. Or the incision is just below the lower lid eyelashes (termed transcutaneous) within several weeks this incision is hidden by the eyelashes of the lower eyelid.

How long does the improvement last?

Blepharoplasty is a long lasting surgery and generally speaking has a lifelong result. All of us will have further ageing with time and if you have blepharoplasty in your 30s to 40s, you will have further ageing with time.

When can I use contact lenses after blepharoplasty?

After eyelid surgery there is a period of recovery with which it is best to leave the contact lenses out to enable healing of the eyelids and avoid unnecessary stretching of the eyelids when the tissues are healing. For upper eyelid surgery it is best to wait 1-week before using your contact lenses. For lower eyelid surgery it is best to wait 2-weeks before using your contact lenses. A further consideration is that with blepharoplasty the tear production may be effected and the eyes may feel more tired for a few weeks after surgery and it may be more comfortable to reduce contact lens wear to 6-8 hours for the first few weeks.

Can both Upper and Lower eyelid surgery be done at the same time?

Upper and Lower Blepharoplasty can be completed at the same time or separately.

There are some advantages to completing the surgery at the same time, the recovery is generally 1-2 weeks for both surgeries, and hence the recovery time is doubled if the procedures are completed separately. In addition there is saving in cost as returning to surgery for a second time does result in an increased use of resources.

Dr. Orloff finds that some of his patients prefer to have both surgeries completed at the same time and others prefer to have a shorter procedure first and having gained confidence in the results have the other eyelids as a second procedure. The decision to have the procedures at the same time or separately is a personal preference and will not affect the final result of the blepharoplasty.