Eyelid Surgery (Blepharoplasty)

Conveniently located to serve Waldorf, St. Charles, and White Plains If you are unhappy about the appearance of your eyes due to sagging eyelids and undereye bags, you may benefit from eyelid surgery in Maryland. Also known as blepharoplasty or an eye lift, this popular cosmetic procedure gives the eyes a more youthful appearance.

Ideal Candidates for Eyelid Surgery

Patients who look constantly tired and older than they actually are due to aesthetic eyelid issues are excellent candidates for this procedure. Good candidates have realistic expectations for the outcome of the surgery and are in overall good health. Patients who do not smoke are ideal candidates for blepharoplasty surgery. If you are a smoker, you must quit smoking at least two weeks before the date of surgery. In addition, you must avoid smoking for the entirety of the healing process. Smokers experience a prolonged recovery period and increased risk of complications.

The Procedure

At the start of the surgery, anesthesia is administered to ensure that the patient is comfortable and free of any pain. Once it has taken effect, very small incisions are created. For the upper eyelids, the incision is made in the natural crease of the upper lid. For the lower eyelids, the incision is made inside the lid or right below the lash line. Muscle, skin, and fat are then adjusted as needed to achieve the patient’s aesthetic goals. Finally, the incisions are closed using dissolvable sutures.

Blepharoplasty – Surgical Goals

The upper eyelid should exhibit a visible crease (supratarsal fold) that compliments the eye without being too deep. The crease should extend the length of the upper eyelid. Fat pockets surround the eyeball, and frequently the fat bulges excessively. Only a small amount of fat should be removed. If too much is removed the eyes may develop a “sunken” eye appearance. Patients most commonly complain of the “bags” and excess wrinkling of the lower eyelid skin. The usual and incorrect approach is to remove too much fat from the lower eyelid area resulting in a hollow appearance. In addition, the inexperienced surgeon may excise too much lower eyelid skin resulting in a lower eyelid that is positioned too low on the eyeball. These patients will have problems of dry eyes and incomplete closure especially when they are fatigued. The cosmetic appearance is always poor since the outer half of the lower eyelid sags below its proper anatomic position.

Steps to achieve the best cosmetic result when considering eyelid surgery:

1. Determine if the eyebrow is at the correct height. If yes——-→ consider upper lid Blepharoplasty If no——-→ perform brow lift first, then —————→ +/- upper lid Blepharoplasty
2. Perform lower lid Blepharoplasty with fat conservation with +/- Lower eyelid support

The systematic approach to aesthetic surgery of the area around the eyes is to first assure that the eyebrows are situated at the appropriate height. The characteristics of attractive eyes are associated with proper brow height and shape, the presence of a well defined fold in the upper eyelid and the absence of any form of swelling or puffiness about the eye. In the stock photos below, you will see that the maximum height of the eyebrow is just above the outer border of the iris. It arches gently without too much of a curve. If the brow is elevated too high, the patient will have a surprised or startled look. As the distance between the eyebrow and upper eyelid lashes narrows, the patient will invariably look tired. This is demonstrated in the previous section regarding brow lifts. In many patients, the brow position is satisfactory, yet the patient’s eyes appear swollen, “puffy” upper and lower eyelids. This condition is called blepharochalasis and is the result of thin stretched out upper and lower eyelid skin combined with prominent fat pads which surround the eyeball.

Upper Eyelid

An upper eyelid Blepharoplasty involves removing the excess skin in the upper eyelid, recreating a crease and removing excess peri-orbital fat thereby giving the patient a more youthful appearing eyelid. Some surgeons remove too much periorbital fat and the patient will develop a sunken eye appearance which is very unsightly and difficult to correct. If too much skin is removed, the patient can not close their eyes which is a very serious problem. Conservative eyelid surgery is preferable.

Lower Eyelid

Lower eyelid blepharochalasis is also a frequent cosmetic problem. Swollen “baggy ” lower eyelids are very distracting and give the patient a very tired appearance. Again, a conservative approach to improvement is advised. Removing and repositioning selected areas of periorbital lower eyelid fat is very important. Excessive removal of lower eyelid skin results in the lower eyelid being pulled below the iris, a condition called lagophthalmus.

Blepharoplasty Recovery

After eyelid surgery, the patient must be driven home by a friend or a family member, since they will not be able to drive immediately following surgery. Once the patient returns home, the healing and recovery process begins. During healing, it is vital that the patient closely follow Dr. Fontana’s post-surgical care instructions. This ensures quality results and minimizes the risk of any complications. It also makes for as short and comfortable a healing process as possible. The eyes will be drier than normal for a time; eye drops may be prescribed to help moisturize the eyes. It will be important to keep the eyelids protected during recovery, since they will be temporarily weakened. Wearing sunglasses helps to protect against wind and pollutants, and wearing proper sunscreen helps avoid sun damage.

How Much Does Eyelid Surgery Cost?

The price of an eye lift depends on the exact details of the procedure. The length of the procedure, the techniques utilized, and the anesthesia used all affect eyelid surgery cost.

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