Eyelid Surgery (Blepharoplasty)

Contents

Philosophy
Eyelid Anatomy
Good Candidates for Eyelid Surgery
Your Eyelid Rejuvenation Consultation
What to Expect from the Procedure
The Week After Eyelid Surgery
Eyelid Surgery Techniques
Complementary Cosmetic Procedures

Philosophy About Eyelid Surgery

Eyelid surgery can make you look years younger by reducing the appearance of wrinkles, skin laxity and puffiness around the eyes that can make you appear upset or tired. Dr. Bennett customizes procedures for each patient based on their individual needs to achieve a natural and long lasting result with techniques that allow patients to recover quickly. Dr. Bennett performs many different types of eyelid surgery to maintain the unique beauty of your eyes.

As we age, the skin and muscle of the eyelids starts to relax and drop. There is a tendency for the fat that cusions the eye to push out under the eye causing puffiness and dark circles. Dr. Bennett tightens the skin and muscle creating a more youthful contour. He works under the muscle to reposition or remove extra fat to make the eyes look more rested. This technique results in less bruising and swelling since he works beneath the muscle. Skin heals better because there is no tension on superficial layers. The eyes reclaims a very youthful and natural look. Scars are hidden in natural creases of the eyelids. Most patients resume their normal routines within seven to ten days of surgery. Dr. Bennett uses the combination of vitamin C, arnica montana, and probiotics to expedite healing and keep the body in balance during recovery.

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Eyelid Anatomy

Understanding the eyes can give insight into treatments that are effective. The key to a natural look is preserving normal anatomy. The major areas that are corrected by eyelid rejuvenation are addressed below.

Normal Eyelid Anatomy is seen below. The upper and lower eyelids are the main areas of concern for most patients. Eyebrow position is addressed by browlift techniques. The lateral hooding area is corrected by temporal lifting.

The Shape of the Eye should be maintained. Each corner of the eye is called a canthus. The canthus near the nose is lower than the lateral canthus. The area below the eye should be a smooth contour and not pulled down. Attention to these details in eyelid surgery will create a natural and rejuvenated appearance.

Hidden Incisions are are very important. Eyelid skin is the thinnest skin on the face and heals very well. Incisions are placed in the natural creases of the eyelids and below the lower eyelid lashline. Frequently, no external incisions are needed in the lower eyelid when the only concern is puffiness.

Upper eyelid folds (Dermatochalasis) are caused by laxity of skin and muscle and is more often noticed in the upper eyelid. Extra skin may obscure the natural folds of the upper eyelids. Conservative removal of the extra tissue makes the eyes feel and look less tired.

Extra eyelid fat (Steatoblepharon) is more often noticed in the lower eyelid although there may be a small area of puffiness near the nose on the upper eyelid. Removal or repositioning of this fat makes the eyes look younger and more rested. Fat can be removed without external incisions. No tension is placed on the skin resulting in a rested but not operated on appearance.

Lower Eyelid Rounding is caused by stretching over time of the lower eyelid ligament. Previous surgery with poor repositioning of the lateral tendon or removal of too much lower eyelid skin can also cause rounding. Reattachment with removal of extra ligament will bring a natural contour to the lower eyelid.

Crow’s Feet are the fine lines at the corners of the eyes caused by repetitive movement of the lateral eyelid muscles. Eyelid tightening may soften the lines a little but better results are obtained by Botox cosmetic to relax the muscles and prevent the lines from forming.

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Good Candidates for Eyelid Surgery

Eyelid puffiness and laxity can occur very rapidly in just a year or two. The youthful features we remember may be hidden by sagging eyebrows or temporal hooding. Realistic expectations are very important with respect to what eyelid rejuvenation can do for you. The best candidates for eyelid surgery:

– Have one or more of the aging features shown above
– Are generally healthy
– May be men or women
– Have realistic expectations
– Would like to look as good as they feel
– Desire eyelid surgery for themselves and not to please another person

Patients want facelifts for many different reasons. If you feel that the above describes you then you may be ready for cosmetic surgery.

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Your Eyelid Rejuvenation Consultation

Dr. Bennett individualizes every patient’s care. A minimum of an hour is needed to get a complete history and evaluation of your face and to fully understand your expectations. Knowing what to expect will make the entire experience more pleasant and increase your satisfaction with the surgical results. We will review your photos from different angles to  make sure we are on the same page. Dr. Bennett will discuss your questions in detail to make sure all of your questions are answered.

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What to Expect from the Eyelid Procedure

Knowing what to expect will make for a smoother and more enjoyable experience. The procedure is performed at Lenox Hill Hospital or at The Center for Specialty Care, an Upper East Side state of the art ambulatory surgical facility. You will arrive two hours before your case is scheduled and will speak to a nurse. Dr. Bennett will discuss your treatment and goals with you again before you receive any medications. You will then receive some medicine to relax you followed most times by a general anesthetic. You will leave the ambulatory center with your escort about an hour after surgery. Dr. Bennett’s techniques minimize the recovery period and allow most patients to return to a normal routine the week after surgery.

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The Week after Eyelid Surgery

The eyes will feel better using cold compresses for the first couple of days after surgery. You will be given some prescription pain medicine although most patients just have one dose and then switch to Tylenol. You will place drops in the eyes during the day and ointment in the eyes at night. You may have bruising and swelling of the eyelids and cheeks that will start to resolve within a few days. Most swelling resolves in a couple of weeks but subtle changes in the eyes can continue for a year or more. You will return to the office at one week and then as needed to have your healing followed. It is important to avoid strenuous exercise for 3 weeks for best results.

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Eyelid Surgery Techniques

Eyelid rejuvenation should be individualized for every patient. Patients have different cosmetic concerns and show aging in different ways. The blepharoplasty is customized and will contain the techniques needed to obtain the best results for you. Dr. Bennett employs many different surgical techniques to sculpt attractive and natural appearing eyes with a rapid recovery. These concepts are the basis for an excellent long-term outcome.

Eliptical Blepharoplasty

An ellipse is contoured to the upper eyelid to remove excess folds of skin. The incisions are placed in natural creases. Patients can go out and appear more rested in as little as a week.

Transconjunctival Fat Removal

No external incisions are used to remove the puffiness under the eye. Because the excision is completely hidden there is no external scarring and healing is even more rapid than normal.

Skin Pinch

Excess lower eyelid skin is tented to flatten and tighten the lower lid skin and then removed. Sutures are placed that are removed in five to seven days.

Skin-Muscle Flap

Conservative removal of a small strip of the bulging muscle underneath the lower eyelid will prevent a telltale bump from showing underneath the lower lid lash.

Eliptical Blepharoplasty

Upper eyelids will frequently have excess skin and muscle. A well placed incision will eliminate the crepe folds of skin of the upper eyelids. Dr. Bennett’s technique can have you more rested looking in just a few days.

Eyelid surgery combined with a Browlift or Temporal  Lift

Sometimes the eyes will look heavier from the eyebrows being too heavy or extra skin from the temples hooding over the sides of the eyes. In these situations, eyelid surgery can be combined with a Browlift to raise the heavy eyebrows over the eyes or a Temple lift to reduce the extra tissue that can block vision above and lateral to the eyes.

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Complementary Cosmetic Procedures

Adjunctive procedures may be performed at the same time as eyelid surgery. They will not be appropriate for all patients.

Rhinoplasty, especially with a nose that is drooping, can enhance a facelift. Facial features that are out of balance may seem more noticeable to patients after the rest of their face looks refreshed and rejuvenated.

Browlifts will open the eyes if the eyebrows are very heavy or blocking vision. This can be performed endoscopically with no visible scar or using incisions that allow extra forehead skin to be removed. There is a trend towards a fuller and heavier brow at this time and more conservative brow elevation if any is generally appropriate.

Temporal lifts raise the extra skin that hoods over the lateral side of each eye. The outside of the eyebrow becomes more elevated and the eyes appear healthier and more rested. The incisions are hidden behind the hairline.

Chin implants can give definition to the jaw line and will make the neck appear tighter. An additional benefit is that chin implants create the illusion that a nose is smaller.

Cheek implants can give definition to the upper face and elevate flattened cheekbones. They will also slightly tighten the skin lower and lateral to the eyes.

A facelift (Rhytidectomy) tightens the sagging facial tissue and remove the excess skin that make the face look aged.

Lasers will soften fine wrinkles around the mouth, eyes, or the entire face and can reverse sun damage. The fractionated CO2 laser gives great results and the skin looks refreshed in only a week.

Fillers like Restylane and Juvederm can plump the areas that have deeper folds. This can improve facelift results.

Botox Cosmetic will relax the superficial muscles and allow the skin to heal with less creasing. This can be performed at the time of surgery.

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