Do your eyelids droop over your eyes? Do your eyelids sag and make you look older? You may be a good candidate for eyelid surgery (also known as blepharoplasty or eyelid lift) performed by top Denver cosmetic surgeon, Randolph C. Robinson, MD, DDS, FAACS.
The eyes give great expression to the face and are the windows to the soul. The eyes show signs of aging when excess skin and fat cause the eyelids to bulge and lose the normal contours that are characteristic of youthfulness.
When youthful eyes are open, there is a fold in the upper eyelid. The eyebrows are positioned over the bony ridge above the eye. The highest part of the eyebrow curvature is lateral (to the outside of) the colored iris. A youthful lower eyelid has a small fullness just under the lashes and possibly a horizontal crease just below the fullness. There should be no puffiness, discolored circles, or sagging excess skin.
Horizontal creases (‘smile lines’ or ‘crow’s feet’) at the sides of the eyes are caused by the aging of the skin and the actions of the underlying muscles. These lines are not changed much by eyelid surgery but are best treated by a resurfacing chemical peel or laser or Botox.
Additionally, drooping eyelids can obstruct vision. Surgery can be used to ‘lift’ the eyelids and restore full range of sight.
The technical term for eyelid surgery is blepharoplasty. The conditions treated by this procedure are blepharochalasis, or bulging fat around the eyes due to angioedema, and dermatochalasis, or excess skin and fat in the eyelids. These conditions may cause visual problems making the surgery more than cosmetic. Typically, a blepharoplasty is done on each eyelid, so there are four incisions. Depending on the needs, it may be necessary to operate only on the upper lids or only on the lower lids.
In some cases, eyelid surgery is covered by insurance. Contact your provider for coverage details. To determine if you’re a qualified candidate for eyelid surgery, request a consultation with Dr. Randy Robinson today:
Keep reading to learn more about our blepharoplasty procedure …
The Eyelid Surgery Procedure
What is an eyelid lift? What are the procedure details? How long does it last? Denver cosmetic surgeon, Randolph C. Robinson, MD, DDS, FAACS, answers these common questions people have about the eyelid lift (blepharoplasty) procedure:
Eyelid surgery is performed in one to two hours, under general anesthetic or under IV sedation with local anesthesia and may be combined with other procedures, such as a face lift or brow lift, to give the full effect.
The incisions in the upper lids are placed about six millimeters (mm) above the lash line. The lower lid incisions are made 3 mm below the lashes. Excess fat and skin are removed, and a careful closure of the incisions is performed using a fine suture.
You will be seen the day after surgery to make sure there are no problems, and your sutures will be removed one week after surgery. If a laser is used, less bruising will result, but that surgery takes a little longer to perform. If extra skin does not need to be removed in the lower eyelid, then the incision can be placed on the inside of the lower lid.
Swelling, the body’s normal response to injury, will peak on the third day after surgery. Steroids are occasionally given to help reduce the amount of post-surgical swelling. Ice packs and elevating the head will reduce the amount of swelling.
The normal bruising that is associated with the surgery is most apparent on the third day and then changes from a dark color, to a greenish color, then to a yellow color as it fades. The color change may extend to the cheeks due to gravity. After the sutures are removed at seven days, the discoloration may be covered with makeup. Most patients find sunglasses helpful to hide any discoloration when they are in public.
Blurred vision usually occurs for the first few hours following surgery, resulting from the anesthetic around the eyes, from the ointment that is placed in the eyes for protection, and from expected routine swelling. Vision will be limited by the iced gauze packs. They are placed immediately following surgery to decrease swelling. It may be difficult to read or watch television for the first day or two following the procedure. You may experience excessive tearing or even dryness for a short time following surgery. See an ophthalmologist for any pre-existing vision problems.
Nausea can occur after surgery, sometimes caused by the anesthetics and strong pain relief medicines. It may be reduced by preceding each pain pill with a small amount of food (e.g. soda crackers or foods that you can see through; initially avoid dairy products). On the first post-operative day, if you don’t feel like eating, don’t force yourself to eat. Take the pain pill with repeated sips of clear liquids that you can tolerate, e.g. “flat” 7-Up, ginger ale, water, apple juice, etc. Call our office if you do not feel better, or if repeated vomiting is a problem.
Most patients do not experience excessive pain following the procedure. Discomfort is primarily related to the swelling around the eyes. Pain relief medication is rarely needed beyond two days.
Antibiotics are prescribed for several days following surgery. Antibiotic ointment is applied to the incisions until the sutures are removed. Some patients find a mild sleeping pill helpful, and steroids may be given to help reduce the amount of swelling.
Activity & Diet
Do not engage in strenuous activity for the first four weeks after surgery, and do not lift anything heavier than 10 pounds. Since the pain relief medicine may cause constipation, a laxative may help to avoid straining. Light walking or similar activity is acceptable and will help you feel better.
Most patients may eat whatever they enjoy eating for a balanced diet. A daily multiple vitamin with iron (on a full stomach) is recommended. As well, 1,000 mg of vitamin C, taken in four 250 mg doses each day is recommended.
Before and After Photos
The photos below show the results of blepharoplasty for a couple patients of Dr. Robinson. Keep in mind, not all people are the same and results can vary.
Example 1: Eyelid Surgery/Lift to Improve Appearance
Example 2: Blepharoplasty to Improve Appearance and Function
The most serious possible complication is, of course, blindness. This incident is reported in the scientific literature and is very rare; nonetheless, it is possible. Changes in the lower lid position, called entropion, which may cause the lid to roll in toward the eye, or ectropion, away from the eye are possible complications. These conditions can cause irritation to the eye and may require corrective surgery. Permanent damage to the tear drainage system is also a rare risk. Bleeding and infection that require intervention are possible also.
The most common complications are small suture cysts, asymmetry (uneven eyelids), and slight inability to close the eyes completely. These conditions usually resolve by themselves without intervention.
- Arrange for someone to take you home and stay with your after the operation for the first 24 hours.
- Do not eat or drink anything after midnight the night before the operation (or as instructed by your anesthesiologist). Let Dr. Robinson know about any previous problems you’ve had with anti-nausea medications.
- Wash your face and shampoo your hair the morning of surgery, but do not apply makeup to your face.
- Wear comfortable clothes that are loose and easy to put on. Wear shirts buttoned on the front.
- Take medications with only a sip of water as directed by your surgeon.
- Do not take any aspirin, ibuprofen, blood-thinning medications, or vitamin E two weeks before surgery, unless otherwise directed by your surgeon.
- For better healing, a more youthful appearance, and general well-being permanently stop smoking.
- Keep head elevated on two pillows while sleeping for two weeks.
- Place iced cotton balls or gauze pads over eyes every 20 minutes for the first 36 hours.
- Do not engage in strenuous activity for four weeks.
- Avoid lifting anything heavier than 10 pounds for four weeks.
- Do not wear contacts for the first week after surgery.
- Eat a balanced diet as you desire, but you may want to eat only lightly the first day after surgery.
- Lubricate your eyes with non-medicated eye drops and eye lubricant ointment as needed.
- Take one multiple vitamin with iron and 1,000 mg of vitamin C, in four 250 mg doses, daily for six weeks following surgery.
- Keep incisions clean a Q-tip with hydrogen peroxide solution three times daily. (Use a 50:50 hydrogen peroxide and water solution.) Then apply a thin layer of an antibiotic ointment like Bacitracin to the incisions after each cleaning.
- You may wash your hair and face the day after surgery but do not allow the water to hit your face directly for one week.
- Wear at least a 20 SPF sunscreen and a sun hat when outside.
- Call if:
- medication does not relieve your pain
- bleeding continues to saturate the cotton or gauze pads — spotting is normal
- swelling is asymmetric (uneven) or sudden over one to two hours
- nausea and vomiting persist, despite taking anti-nausea medications
- temperature is greater than 101.0° F by mouth
- temporary vision blurring worsens or deep eye pain develops
- Take medications as directed.
Talk to a Denver Eyelid Lift Specialist
Dr. Robinson is one of the most practiced eyelid surgeons in Denver, Colorado. Contact Robinson Cosmetic Surgery today to schedule an appointment.