What happens during Eyelid Surgery?
In upper blepharoplasty, an incision is made in the crease of the eyelid so that the tiny scar will be camouflaged. Excess skin and fat (if indicated) are removed, and the new skin edges are sutured together for a tighter but natural-looking result.
In lower blepharoplasty, the incision is variable. If excess skin needs to be removed, the incision is made in the first wrinkle line under the lower eyelashes. Placement of the incision here not only camouflages the scar but also preserves the integrity of the muscle surrounding the eye near the lid margin to help prevent downward pulling of the eyelid (ectropion) that may sometimes result when the incision is placed too close to the eyelashes.
If no excess skin is present in the lower lid, the incision can be made inside the eyelid in what is called a transconjunctival blepharoplasty. This results in no visible scar.
In both techniques, the protruding fat in the under-eye bags is either removed or repositioned to create a more youthful midface. Following fat removal or repositioning, excess skin is removed if the external approach has been chosen. Both techniques can be combined with skin resurfacing procedures (e.g. laser or peel) and/ or Botox to address the wrinkles that may be present around the eyes.
Depending on your particular case, your eyelid surgery for both eyes can be completed in approximately 30-45 minutes.
Blepharoplasty is an outpatient procedure that is usually performed under a local anesthetic with intravenous or oral sedation so that you are not fully asleep but completely relaxed with the eyelids numbed. In some cases, however, the surgery is performed under general anesthesia. Either way, you will be drowsy after your procedure and will need someone to take you home.
Asian Eyelid Surgery
Asian eyelid surgery is a surgery performed to transform eyelids with classic Asian features into more Caucasian-appearing eyelids. The surgery centers around creating a natural-looking crease in the upper eyelid, which Asians classically lack because of their anatomy. Other maneuvers involve removing the excess fat found in the upper lids of Asians.
The incision required for this surgery and the setting in which surgery is performed is the same as standard blepharoplasty, as described above. If desired, Dr. Velargo can also address the epicanthal fold found in most Asians, which is a web of skin that connects the medial portion of the upper lid to the side of the nose. Correcting this fold of tissue allows the medial corner of the eyelid to become more visible. It is accomplished by a small “z” pattern incision, and the scar usually heals in an inconspicuous way.