Cosmetic Surgery of the Eyes - Blepharoplasty:

The eyes and surrounding structures account for a large part of the expression of the human face; they project an array of emotions including happiness, sorrow and fear. Yet the eyes themselves are virtually expressionless structures. It is the contour of the skin - the tissue, muscle, fat, hair and lashes around the eyes - that conveys expression. Wrinkles and deep lines as well as puffiness of the lids begin to develop with the passage of time. As we age, two things happen in the eyelid area. One, the skin looses it's ability to "snap back." There is stretching because of loss of elasticity and two, there is a loss of skin thickness with thinning out of the skin. Exposure to the sun and genetic predisposition can also be contributing factors. The result can be marked changes in expression causing a tired and/or older appearance. These physical changes can produce anxiety and actual visual impairment. Today, several remarkable surgical techniques, involving blepharoplasty, have been developed to eliminate many of these problems.

Blepharoplasty can correct aging eyelid skin, pouches beneath the eyes and excess folds around the eyes. This surgical procedure involves the removal or repositioning of excess skin and fat on upper and lower eyelids and is often done in conjunction with other surgical procedures including fat grafts, dermal fillers, facelift, eyebrow and forehead lift.

BEFORE SURGERY
Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient. A thorough examination of the eyes and face is made to determine the most effective surgical approach. The amount, distribution and type of excess skin to be treated is carefully noted. Dr. Gordon will discuss the anesthesia to be used, the procedure, what results might realistically be expected, and possible risks and complications. An examination by an ophthalmologist may be recommended. Preoperative directions may include the elimination of certain drugs containing aspirin in order to minimize the possibility of increased bleeding. Antibiotics may be prescribed for a few days prior to surgery to prevent infection. The areas to be excised are marked and photographs are taken before surgery.

THE PROCEDURE
Blepharoplasty is usually performed in the accredited Complete Cosmetic Surgery Center, or at Spring Valley Hospital, depending upon the patient and Dr. Gordon’s preference. It is done under general anesthesia with the patient asleep. Prior to surgery, medication to relax the patient can be administered.

Dr. Gordon, following natural lines and creases, makes very fine incisions from the inner to the outer edge of the eyelid. The upper eyelid is worked on first with the incision made in the fold of the lid. On the lower eyelid, the incision is made inside the eyelid or directly below the eyelash. Excess fat and skin are then removed from the underlying compartments. The amount of fat excised is determined by the degree of protrusion of fat when pressure is gently applied to the area. Small sutures are used to close the incision and special ointments and dressings will be applied. The procedure can take from one to two hours.

FOLLOWING EYELID SURGERY
Antibiotics will be continued for several days following these surgeries. Sutures are removed within two weeks. Some swelling and bruising will occur but subsides in a few days. Dr. Gordon will prescribe ice compresses and medications to reduce swelling and regain mobility. Women may be allowed to use eye makeup ten days to two weeks after surgery but are cautioned to cleanse the area thoroughly after each use. Dr. Gordon determines when normal activities can be resumed; however, strenuous exercise must be avoided for at least two weeks following surgery.

After blepharoplasty, excessive drying of the eyes can occur, but this condition can be alleviated with medication. There may be sensitivity to bright light and wind in which case the use of dark glasses is indicated. Sensory changes such as numbness and itching may occur during the healing process. Final evaluation may not be possible for several months following surgery. There are certain inherent risks connected with every surgical procedure which will be thoroughly discussed by Dr. Gordon. Patients can minimize complications by carefully following directions given by Dr. Gordon.