Eyelid Surgery Washington DC/McLean/Tyson’s Corner

After surgery, the upper eyelids no longer droop and the skin under the eyes is smooth and firm.

Introduction

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As people age, the eyelid skin stretches, muscles weaken, and fat accumulates around the eyes, causing “bags” above and below.

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The surgeon closes the incisions with fine sutures, which will leave nearly invisible scars.

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Before surgery, the surgeon marks the incision sites, following the natural lines and creases of the upper and lower eyelids.

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Underlying fat, along with excess skin and muscle, can be removed during the operation.

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In a transconjunctival blepharoplasty, a tiny incision is made inside the lower eyelid and fat is removed with fine forceps. No skin is removed, and the incision is closed with dissolving sutures.

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Eyelid surgery (blepharoplasty) is a procedure to remove fat and/or excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes – features that make you look older and more tired than you feel, and may even interfere with your vision. However, blepharoplasty will not remove crow’s feet, eliminate dark circles under your eyes, or lift sagging eyebrows (browlift). Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or brow lift.

If you are considering getting a blepharoplasty in Washington, D.C., Dr. Baker’s web page will give you a basic understanding of the procedure-when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask Dr. Baker about anything you don’t understand.

Dr. Baker’s Credentials for Eyelift

  • Professor of Plastic Surgery, Medstar Georgetown Department of Plastic Surgery
  • Director Medstar Georgetown Center for Facial Restoration
  • Authored multiple peer-reviewed manuscripts on facial rejuvenation
  • Face Q pioneer and expert on outcomes studies in patient satisfaction in facial aesthetic surgery including eyelift (one of several practices in the United States selected to participate in this study funded by the Plastic Surgery Foundation).
  • Training in plastic surgery, maxillofacial surgery, and craniofacial surgery provide him the tools to perform a complete assessment of each patient’s facial structure. He is trained in all modalities of addressing your problems, so he is not limited in the solutions he can provide to address your concerns.

The Best Candidates for Eyelid Surgery

Blepharoplasty can enhance your appearance and your self-confidence, but it will not necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Baker.

The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.

A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery. Also, it is recommended that you wait at least six months after a LASIK procedure before having a blepharoplasty.

All Surgery Carries Some Uncertainty and Risk

When eyelid surgery is performed by a board-certified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following Dr. Baker’s instructions both before and after surgery.

The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring.

Planning Your Surgery

The initial consultation with Dr. Baker is very important. He will need your complete medical history, so check your own records ahead of time and be ready to provide this information. Be sure to inform Dr. Baker if you have any allergies; if you are taking any vitamins, medications (prescription or over-the-counter), or other drugs; and if you smoke.

You should also provide any relevant information from your ophthalmologist or the record of your most recent eye exam. If you wear glasses or contact lenses, be sure to bring them along.

You and Dr. Baker will carefully discuss your goals and expectations for this surgery. You will need to discuss whether to do all four eyelids or just the upper or lower ones, whether skin as well as fat will be removed, and whether any additional procedures are appropriate.

Dr. Baker will explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved. Dr. Baker encourages any questions you may have, especially those regarding your expectations and concerns about the results.

Preparing For Your Surgery

Before your blepharoplasty, Dr. Baker will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

While you’re making preparations, be sure to arrange for someone to drive you home after your surgery, and to help you out for a few days if needed.

Where Your Surgery Will Be Performed

Eyelid surgery may be performed in a surgeon’s office-based facility, an outpatient surgery center, or a hospital. It’s usually done on an outpatient basis; rarely does it require an inpatient stay. Dr. Baker can perform your blepharoplasty in his Washington, D.C. office.

Types of Anesthesia

Eyelid surgery is usually performed under local anesthesia–which numbs the area around your eyes–along with oral or intravenous sedatives. You will be awake during the surgery, but relaxed and insensitive to pain. (However, you may feel some tugging or occasional discomfort.) Some patients prefer to have general anesthesia; in that case, you will sleep through the operation.

The Surgery

Blepharoplasty usually takes one to three hours, depending on the extent of the surgery.

In a typical procedure, Dr. Baker makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes.

Working through these incisions, Dr. Baker separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.

If you have a pocket of fat beneath your lower eyelids but do not need to have any skin removed, Dr. Baker may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.

After Your Surgery

After surgery, Dr. Baker will lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication. If you feel any severe pain, call Dr. Baker immediately.

Dr. Baker will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising (bruising varies from person to person: it reaches its peak during the first week, and generally fades by the end of the second week). You will be shown how to clean your eyes. Eye drops may be recommended, since your eyelids may feel dry at first. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.

Dr. Baker will follow your progress very closely for the first two weeks. The stitches will be removed a week after surgery. Once they are out, the swelling and discoloration around your eyes will gradually subside, and you’ll start to look and feel much better.

Getting Back to Normal

You should be able to read or watch television after two or three days. However, you will not be able to wear contact lenses for about two weeks, and even then, they may feel uncomfortable for a while.

Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor’s instructions, you’ll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.

Dr. Baker recommends that you keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. It is especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol, since it causes fluid retention.

Your New Look

Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they will fade to a thin, nearly invisible white line.

On the other hand, the positive results of your eyelid surgery-the more alert and youthful look-will last for years. For many people, these results are permanent.

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